Lung cancer: Your questions answered

Lung cancer is caused by the uncontrolled growth of abnormal cells within the lungs. Cells can change from normal to abnormal as result of mutations that arise in the DNA of a cell. We know that certain environmental factors can cause these mutations to occur, such as cigarette smoke, asbestos fibres, and radon gas.

Lung cancer can start in the lungs and spread to your lymph nodes and other parts of your body. When cancer spreads from one organ to another, this is known as metastatic cancer. Smoking is one of the leading causes of lung cancer, but, as mentioned above, there are several other factors that can result in the disease.

While living with lung cancer can be scary, there are many effective treatment options and advancements in medicine that can help you get better and manage the symptoms of lung cancer.

According to Cancer Research UK, your general fitness levels significantly impact how the disease affects you. The more fit and generally healthy you are, the more manageable you will find the cancer and treatment.

It helps to know more about lung cancer and treatment option through the eyes of experts, so we sat down with two of our consultant oncologists to answer some of the most frequently asked questions about lung cancer.

• Dr Qamar Ghafoor is a consultant clinical oncologist at The Priory Hospital
• Dr Sarah Khan is a consultant oncologist at The Park Hospital

What are common lung cancer symptoms?

Dr Qamar Ghafoor: Lung cancer can manifest with a variety of symptoms. These often include:

• A persistent cough
• Coughing up blood
• Persistent breathlessness
• Unexplained tiredness and weight loss
• An ache or pain when breathing or coughing

Dr Sarah Khan: Common symptoms can be a cough, recurrent chest infections, feeling short of breath, coughing up blood, chest pain, and more general symptoms such as weight loss and fatigue. If you experience any of these symptoms it is important to seek medical advice. Some people may not have any symptoms at all – cancerous cells can lie dormant for years, meaning you might not know you have cancer for a long time before you’re diagnosed.

Who is most at risk of lung cancer?

Dr Qamar Ghafoor: In 85% of patients who develop lung cancers, smoking is believed to be the cause. That being said, lung cancer can occur in people who have never smoked. There are much rarer causes including chemicals such as arsenic, asbestos, cadmium, nickel and radon. Genetic predisposition is not believed to be a strong risk for lung cancers, but further ongoing research is looking at this. Another cause is exposure to radiation gas.

Dr Sarah Khan: The risk of developing lung cancer is strongly associated with smoking. There are different types of lung cancers, some of which are more strongly associated with smoking than others. Inhalation of asbestos is associated with an increased risk of developing certain lung cancers. There are a small number of people that are non-smokers that will develop lung cancer. Lung cancer is not hereditary, although some people that develop lung cancer may have other family members who have been diagnosed with cancer, lung or otherwise.

What impact does smoking have on the lungs?

Dr Qamar Ghafoor: Tobacco smoke has many chemicals and particles that irritate your airways and lungs. This can lead to chronic obstructive pulmonary disease (COPD). Furthermore, cigarette smoke contains a number of cancer-causing substances (carcinogens) which damage normal lung tissue. At first, your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually become cancerous.

Dr Sarah Khan: Approximately 90% of lung cancers are smoking related. We know that by stopping smoking, one can immediately reduce their risk of developing lung cancer.

Between 20% - 30% of lung cancers are caused by second hand smoke either at home or at work. Smoking is also associated with many non-malignant conditions of the lung such as chronic bronchitis, emphysema, and pulmonary hypertension – all of which can cause significant symptoms.

Cigarette smoke is a carcinogen (a chemical that causes cancer). By affecting the DNA of cells within your lung it can cause a normal cell to develop into an abnormal or cancerous cell. This cell will continue to divide uncontrollably, thereby causing cancer to develop and potentially spread to other parts of your body. Eventually, you will experience symptoms of lung cancer, which can vary in intensity depending on the individual.

Does smoking cause permanent damage to the lungs?

Dr Qamar Ghafoor: Even for lifelong smokers there is clear benefit to stopping smoking. Smoking can cause permanent inflammation and scarring of the lungs, but with time there can be improvement once an individual has stopped smoking.

Dr Sarah Khan: Smoking can cause permanent damage, particularly if people continue to smoke throughout their lives. However, for people that stop smoking after many years, there is evidence that their risk of developing lung cancer reduces. For people who have stopped smoking for 10 or more years, there is a significant reduction in their risk. Stopping smoking can significantly reduce an individual's risk of developing lung cancer. Smoking is also associated with an increased risk of developing other cancers and heart disease. Smoking is associated with other illnesses and conditions more generally, including problems with your immune system, rheumatoid arthritis, chronic bronchitis, and many more. As mentioned above, people with generally better health can manage lung cancer more easily, so it’s important to try to maintain as healthy a lifestyle as possible.

Can diet affect the risk of lung cancer?

Dr Qamar Ghafoor: There is no strong evidence to show that diet affects lung cancer. Nevertheless, a balanced nutritious diet will help maintain an individual’s general health and wellbeing.

Dr Sarah Khan: There are no proven associations between diet and lung cancer. Everyone should ensure that they have a healthy balanced diet containing fresh fruit and vegetables and carry out regular exercise.

What treatments are available for lung cancer?

Dr Qamar Ghafoor: There are many effective treatment options including chemotherapy, immunotherapy, and targeted molecular inhibitors. Furthermore, radiotherapy can sometimes cure if not control lung cancer. There are various types of radiotherapy including conformal, intensity-modulated radiation therapy (IMRT) and stereotactic ablative radiotherapy (SABR).

Dr Sarah Khan: There are different types of lung cancer. The treatment will depend on the type of lung cancer. They are broadly divided into two groups, non-small-cell lung cancer and small-cell lung cancer.

Treatment of lung cancer depends very much on the stage of the cancer. For people with cancer that has been detected early, radical or curative treatments are considered, such as surgery and radiotherapy. If the cancer is advanced or has spread outside the lung to involve other organs, palliative treatments such as chemotherapy, immunotherapy and biological agents are used.

There is a lot of research into lung cancer and patients should discuss what clinical trials are available with their doctor.

Get help with Circle Health Group

At Circle Health Group we offer tailored treatment plans for people with lung cancer, as well as rapid access to oncology specialists where lung cancer (or any other cancer) is suspected.

If you want to know more about our treatment options, book your appointment online today or call a member of our team directly.