Expert shares what you should know

X-ray of lungs showing lung cancer

Read on to learn more about lung cancer, its causes, and major warning signs. (Photo via Getty Images)

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Contact a qualified medical professional before engaging in any physical activity or making changes to your diet, medication, or lifestyle.

For years, more and more Canadians have faced the often fatal diagnosis of lung cancer. The condition can be difficult to detect and therefore difficult to treat.

Nearly 100 people each day are expected to be diagnosed with lung cancer in Canada, which is a worrying statistic.

For Lung Cancer Awareness Month, which is celebrated in November, yahoo canada spoke with Dr. Susanna Yee-Shan Cheng, a medical oncologist at the Sunnybrook Health Sciences Center, about the condition and how she could prevent it.

Read on to learn more about lung cancer, its causes, and major warning signs.

doctor pointing at a photo of a lung x-ray

Lung cancers are generally grouped into two main types called small cell and non-small cell. (Photo via Getty Images)

What is lung cancer?

Cancer is a disease in which cells in the body grow out of control.

According to the Canadian Cancer Society, “lung cancer begins in the cells of the lung,” and when it begins in the cells of the lung, “it is called primary lung cancer.”

Lung cancers are generally grouped into two main types called small cell and non-small cell.

Non-small cell lung cancer usually starts in the glandular cells on the outside of the lung, and small cell lung cancer usually starts in the cells that line the bronchi in the center of the lungs. Non-small cells are more common.

According to Cheng, while lung cancer might not be as common as skin or breast cancer, for example, it’s the mortality rate that is of concern.

“Lung cancer is actually the number one cause of cancer death. It’s common, but actually mortality is the biggest problem.”Dr. Susana Cheng

“Lung cancer is actually the number one cause of cancer death,” Cheng says. “It’s common, but it’s really the mortality that’s the biggest problem. Lung cancer, stage by stage, has a worse prognosis than most cancers.”

What causes lung cancer?

Cheng says that smoking is “the number one cause” of lung cancer. According to Lung Cancer Canada, the majority of lung cancer cases, about 85 percent, are directly related to tobacco smoking, particularly cigarettes.

Smoking increases the risk of lung cancer by:

• Cause genetic changes in lung cells

• Impair the normal cleansing process of the lungs by which foreign and harmful particles are removed.

• Harbor cancer particles in the mucus and develop into cancerous tumors.

However, Cheng reveals that there is a “growing number of patients who do not smoke.”

man smoking a cigarette outside

Smoking is “the number one cause” of lung cancer, according to Cheng. (Photo via Getty Images)

“In particular, we are now seeing patients who have never smoked or have never been exposed to secondhand smoke develop lung cancer, which is interesting because smoking is usually a key cause,” Cheng explains. “There are a number of patients who have never smoked and may not have a reason to have lung cancer, so that’s the concerning part.”

Cheng says “we don’t know why” non-smokers develop lung cancer, so more research is needed. However, the best guess of it is that it is “related to certain hormones”.

That being said, the main focus in lung cancer screening is for people with a history of smoking and who are between the ages of 55 and 70.

Unfortunately, Cheng adds, “the system doesn’t allow never-smokers to be tested.”

“We are now seeing patients who have never smoked or have never been exposed to secondhand smoke develop lung cancer.”Dr. Susana Cheng

What are the signs and symptoms of lung cancer?

In its early stages, lung cancer may not cause any signs or symptoms. As the tumor grows and causes changes in the body, it usually causes coughing and shortness of breath.

However, if you have any of the following signs and symptoms related to lung cancer, it’s important to see a doctor or medical professional as soon as possible:

  • A cough that gets worse or does not go away

  • Difficulty breathing

  • Chest pain that you can always feel and that gets worse when you take a deep breath or cough

  • Blood in mucus coughed up from the lungs

  • wheezing

  • Weightloss

  • Fatigue

  • Hoarseness or other voice changes

  • Difficulty to swallow

  • Swollen lymph nodes in the neck or above the collarbone

  • Headache

Cheng notes that he typically sees “cough, infection, or pneumonia” as precursors to lung cancer.

However, she reveals that “COVID put a season on.”

“Nowadays when someone has COVID, they can be coughing for weeks and weeks,” she says. “Some really can’t tell what the symptoms are for sometimes, which can make diagnosis difficult at first.”

Male doctor examining patient in hospital gown who is coughing

A cough that gets worse or does not go away is a key sign of lung cancer. (Photo via Getty Images)

He adds that coughing, shortness of breath (especially when moving around), unexplained weight loss, loss of appetite, chest pain, and a hoarse voice are other possible warning signs of lung cancer.

“In smokers, they may always have a chronic cough, but in non-smokers they may never have a cough or may develop a cough over time. This can delay the diagnosis of lung cancer,” Cheng adds.

How is lung cancer diagnosed and treated?

Lung cancer is usually diagnosed after a visit to your GP, who will ask about your health history, symptoms, and perform a physical exam. You may also have a blood test or have an X-ray, MRI, or CT scan.

If lung cancer is diagnosed, other tests are done to find out how far it has spread through the lungs, lymph nodes, and the rest of the body. This process is called staging.

Screening for lung cancer is another important step that can help detect the condition early. With lung cancer, early detection is vital. The sooner the disease is diagnosed, the better the chances of survival.

“It’s unfortunate that there are no screening tests for people who don’t smoke yet, but hopefully soon.”Dr. Susana Cheng

“It’s unfortunate that there are no screening tests for non-smokers yet, but hopefully soon,” Cheng says.

When it comes to treatment, Cheng believes he’s headed in a positive direction.

“In the last 20 years things have changed significantly. We used to have only chemotherapy, but now it is based on their pathology and their genetic mutations, which predicts what kind of treatment they receive, such as immunotherapy and targeted drugs,” Cheng explains.

Woman smoking against a black background holding a sign with black lungs.

Quit smoking to reduce the risk of lung cancer. (Photo via Getty Images)

How can I prevent or reduce the risk of lung cancer?

Unfortunately, not all lung cancers can be prevented. However, there are things you can do to help prevent the condition from developing, such as changing risk factors that you can control.

Cheng says the first thing you can do is avoid smoking.

“Really, don’t smoke, and try not to be around a loved one who smokes because the risk of secondhand smoke is very real, too,” she says.

Cheng adds that there aren’t many risk factors related to diet or alcohol, but keep an eye on “occupational exposure.”

“Look at occupational exposure like Ephesus. You can also check your house for radon, but other than that there’s not much you can do,” he explains.

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