Texas Tech Physicians : Smoking Cessation

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Source: Lubbock AJ | New cases of lung cancer to exceed 200,000 this year

Saturday, November 14, 2009

TTUHSC Academic Classroom Building A man in his 40s came to our lung clinic with a persistent cough that started to contain blood. He was otherwise healthy.

Our tests revealed a mass confirmed as lung cancer. His only risk for developing cancer was smoking a pack of cigarettes per day for 20 years. Fortunately, the cancer was at an early stage and was cured with surgery.

More than 200,000 new cases of lung cancer will be diagnosed in 2009. Approximately one in 14 men and women will be diagnosed with lung cancer. It is expected to claim more than 150,000 lives in 2009. Lung cancer leads to more deaths than breast, colorectal and prostate cancers together.

In spite of the advances in treating lung cancer, the mortality rate remains high. The key to improving survival is based primarily on prevention and early detection.

The main risk factor for lung cancer is tobacco smoking, including secondhand smoke.

Smoking cessation is therefore the most important way to reduce the risk of lung cancer.

A number of methods are used to get kick this highly addicting habit, including medication, cognitive and other behavior modification programs.

The ability to detect the cancer at an early stage is the best hope of cure rather than only controlling the disease.

Lung cancer is usually discovered late because of lack of symptoms in the majority of patients, which gives the tumor time to grow and spread.

Some symptoms of lung cancer are:

A persistent cough.
Pain in the chest, shoulder or back unrelated to pain from coughing.
Shortness of breath.
Changes in the voice or being hoarse.

If lung cancer has spread, a person may feel symptoms in other places in the body.

Other symptoms of lung cancer may include:

Loss of appetite or unexplained weight loss.
Fatigue.
Headaches, bone or joint pain.
Neck or facial swelling.

A routine screening for lung cancer is not available. However, the search for an effective screening tool is ongoing at cancer research centers around the country and around the world.

Chest X-rays were evaluated in multiple studies and were not found to be very useful. Low-dose chest CTs are promising tools.

The largest national study will have results published in 2011 and is expected to clarify the effectiveness of low-dose chest CT in diagnosis. The other promising studies are based on blood tests to identify reactions to the presence of a tumor at a very early stage even before it is visible on CT.

We expect to learn more in the next five to 10 years. This emphasizes the value of smoking cessation as it is the most reliable method of preventing the disease.

The various screening and preventive measures are aimed at reducing the incidence and improving survival but are not expected to eliminate the disease.

Once the presence of an abnormality is confirmed or strongly suspected, a multidisciplinary approach in a cancer center becomes essential.

The key to a positive outcome is a team-based approach that includes pulmonologists, oncologists, radiation oncologists, interventional radiologists and thoracic surgeons. The multidisciplinary approach helps identify the best diagnostic and treatment options as well as follow-up care customized to the individual patient.

The last few years have seen major advances in both diagnosis and treatment.

_{DR. RAED ALALAWI is an assistant professor of pulmonary and critical care medicine at the Texas Tech Health Sciences Center.}