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Lung cancer is one of the common cancers, yet many myths persist. Parkway Cancer Centre’s Dr Tan Wu Meng gives you the lowdown on lung cancer. According to the Singapore Cancer Registry, between 2010 and 2015, lung cancer was the second most frequently diagnosed cancer and the biggest killer in men. For women, it was the third most frequently diagnosed cancer and second biggest killer. Men are three times more likely to get lung cancer than women.

1) There are two types of lung cancer

Lung cancer is caused by the uncontrolled growth of abnormal cells. It starts from the cells in the tissue of the lung, usually in the air passages. There are two main types of lung cancer, non-small cell lung cancer (NSCLC), the most common type, and small cell lung cancer (SCLC), which makes up about 10 per cent of lung cancer cases. NSCLC also has several sub-types, including adenocarcinoma and squamous cell carcinoma. If discovered early enough, this type of lung cancer can be treated with surgery and/or radiation therapy and chemotherapy. SCLC can also be treated similarly if it is diagnosed early. Unfortunately, it is often diagnosed at later stages. Other treatments include surgery, targeted therapy and immunotherapy. Doctors will recommend different courses depending on the stage of the lung cancer.

2) Non-smokers can develop lung cancer

It is a myth that only smokers get lung cancer. To be sure, in most cases of lung cancer, the patient has a history of smoking or is currently a smoker. Smokers are more than 10 times as likely as non-smokers to get the disease, and tobacco smoke is by far the biggest risk factor for lung cancer; it causes more than 80 per cent of all lung cancer cases worldwide. However, non-smokers can get lung cancer too. In Singapore, about one-quarter of lung cancer patients have not smoked before. Apart from tobacco use, there are other risk factors such as family history and prolonged exposure to certain chemicals.

3) Younger people can get lung cancer

Most lung cancer patients tend to be diagnosed after they have crossed 40 years old, which has given rise to the myth that only the elderly can get lung cancer. In fact, the disease can start at a younger age, although the number is small. According to the Singapore Cancer Registry, between 2010 and 2014, some 210 people under the age of 45 were diagnosed with lung cancer. About 2.5 per cent of men and 4.2 per cent of women with lung cancer were below 45 years old.

4) There are few symptoms

As with all cancers, early detection and diagnosis of lung cancer will increase the chance of successful treatment. Unfortunately, there may be few symptoms when lung cancer first develop; these tend to emerge only as the cancer grows. Look out for:

• Shortness of breath
• Persistent cough, sometimes coughing up blood
• Loss of appetite
• Sudden unexplained weight loss
• Chest and shoulder pain
• Persistent chest infections

  While these symptoms may not necessarily be due to lung cancer, you should see your doctor if you have any of them.

5) You can lower the risk

While there is no guaranteed way to prevent lung cancer, you can reduce the risk of getting the disease:

• Stop smoking. No matter how long you have been smoking, quitting the habit at any age can lower your risk of getting lung cancer.
• Do not start smoking if you are not.
• Avoid breathing in second-hand smoke from other people’s cigarettes. Studies suggest that passive smoking can increase a non-smoker’s risk of getting lung cancer by 25 per cent.
• Maintain a healthy, balanced diet. Eat more low-fat, high-fibre foods, and more fruits and vegetables.
• Stay active. Do at least 30 minutes of aerobic exercise per day, five days a week. However, if you have not been exercising, start slow and do not overexert yourself.

  Written by Kok Bee Eng