A year ago this month, my father died of lung cancer. He was a non-smoker, did not consume alcohol, and lived a healthy lifestyle. From the time he was diagnosed to the time of his passing, it was less than two and half months. Sadly, like my father, countless individuals are at an advanced stage of the disease at the time of diagnosis, ending up with little time.

Lung cancer is the leading cause of cancer-related death worldwide. Patients with lung cancer are often symptomless yet have poor prognosis. In contrast to advances in the screening of breast, prostate and colon cancer, progress with early detection of lung cancer is falling behind.

Update on lung cancer screening

Currently, there is no well-accepted routine for lung cancer screening. Lung cancer is diagnosed mainly by:
1. Chest X-ray: less effective at an early stage and less costly.
2. Computed Tomography (CT): significantly more sensitive than chest X-ray for identifying lung cancer when it’s small and asymptomatic; however, it’s expansive, and not feasible for large population screening. Due to its sensitivity, of course, abnormalities revealed by CT scan are not all cancerous.

Other tests and promising methods include (but are not limited to):
1. Sputum cytology: used to check mucus brought up from the lungs by coughing;
2. Biopsy for area(s) of abnormality: effective though risky;
3. Lung cancer biomarkers: Although numerous biomarkers for lung cancer have been studied, their specificity and sensitivity are disappointing clinically.
4. Auto-fluorescence bronchoscopy: used to help detect mucosal changes of early lesions that may appear subtle on normal bronchoscopy;
5. Molecular screening for transformation of bronchial epithelial cells.

Advances in lung cancer screening are still underway. Despite the problems with various tests, screening for early detection can be a life-saving decision, particularly for people at higher risks.

Lung cancer risk factors include:

-  Cigarette/tobacco smoking (a major risk factor)
-  passive smoking
-  family or personal history of lung cancer
-  lung diseases (e.g. pulmonary tuberculosis, chronic obstructive pulmonary disease, pulmonary fibrosis)
-  radon exposure
-  asbestos exposure
-  environmental pollution
-  certain occupational exposures (e.g. arsenic, chromium, nickel, soot, and tar)
-  age over 65 years old

Who’s at the highest risk?

Although not everybody who has ever smoked should be over concerned with early detection, individuals with combined risk factors should certainly be encouraged to be proactive. These could include: former or current smokers who actually have incurred damage from their smoking, individuals who have prior history of cancer (even cured), patients who have any lung disease or have been exposed to asbestos or have family history of cancer. These folks are at increased risk for the development of lung cancer. The risk from air pollution is higher for all smokers. Furthermore, given an equal amount of tobacco exposure, women are at higher risk for developing lung cancer than men.

A dose of wisdom

Early detection of cancer is like the timely discovery of a weak yet critical part of a machine. Just as, for instance, your car benefits from fixing the problem early, so does your body.

To learn more information about Lung cancer, check out this booklet:
What do you need to know about lung cancer?