By Henrylito D. Tacio
Perhaps not too many Filipinos are aware that the Philippines observes the National Lung Cancer Awareness Month every November.
Data from the Department of Health showed more people die of lung cancer each year, as compared to other types of cancers like colon, breast and prostate cancers combined. “Lung cancer is one of the common types of cancer in the Philippines, with a high mortality rate,” Dr. Dean Zenarosa told Philippine Information Agency last year.
The health department strongly advised Filipinos, particularly the younger generation, to stop smoking, as research disclosed that smoking and exposure to secondhand smoke continue to be the leading cause of lung cancer.
Smoking is not the lone culprit. Other risk factors that may increase the chances of getting lung cancer include, as mentioned, secondhand smoke, as well as other substances found at workplaces, like asbestos, arsenic, diesel exhaust, and some forms of silica and chromium.
Genetics may also play a role: if a father, or mother, or any distant relative has the disease, the next generation seems to have a greater chance to develop it. Radiation exposure to the chest, as well as diet, and lifestyle, may also contribute to acquiring the disease.
Epidemiology and Prevalence
The Global Cancer Statistics 2020 stated that lung cancer is the most common cancer worldwide, affecting 2.2 million people in 2020. In the Philippines, lung cancer is the second leading cancer site, and leading cause of mortality among all types of cancer in the Philippines.
“More and more Filipinos are dying of lung cancer,” deplores the Philippine Society of Medical Oncology (PSMO).
According to the PSMO, 8,143 men out of 100,000 men are diagnosed with lung cancer, and 6,473 die. Among women, 2,500 are diagnosed with lung cancer out of 100,000, and 2,043 die. “As more people smoke cigarettes, the number of Filipinos with lung cancer is most likely to rise,” it said. Lung cancer claims 25 lives each day, according to the Cancer Facts and Estimates of the Philippine Cancer Society (PCS). Some 240 Filipinos die each day due to tobacco-related diseases, PCS said.
Many Filipinos think that only ordinary people die of lung cancer. But what they don’t know is that many famous men and women in history died of it. To name a few: Desi Arnaz, Yul Brynner, Joe DiMaggio, George VI, Betty Grable, George Harrison, Bob Marley, Ray Milland, Claude Monet, Jesse Owens, Patricia Neal, Boris Pasternak, and Harry Vardon.
Lung Anatomy, Physiology, and Pathology
The lungs are two spongy organs found in the chest. They are responsible for delivering oxygen to the bloodstream. When you take a breath in, air moves into the lungs causing them to expand.
“Most lung cancer originates in the cells of the lungs; however, cancer may also spread (metastasize) to the lung from other parts of the body,” explains Dr. Gary Sy in his column published in a national daily.
Metastatic cancers, according to The Merck Manual of Medical Information, spread to the lungs most commonly from the breast, colon, prostate, kidney, thyroid gland, stomach, cervix, rectum, testis, bone, and skin (melanoma).
“There are many different types of growth or tumor that can occur in the lungs,” Dr. Sy says. “It is conventional to divide growths into benign and malignant, and primary and secondary. A benign tumor is one that is unlikely to spread to become life threatening, whereas a malignant tumor grows rapidly, and spreads, thereby threatening life. This happens by direct invasion of surrounding structures or by spreading through the blood or lymphatic system.”
A primary tumor of the lungs is one that has arisen first within the lung tissue; a secondary tumor is one that has arisen elsewhere in the body but has then spread, or metastasized, to the lungs.
Signs and symptoms
The symptoms of lung cancer are very non-specific. “This is the reason many patients with lung cancer present at an advanced stage of the disease,” Dr. Sy writes. “One factor hindering or delaying the early diagnosis of lung cancer is that the symptoms, such as cough, are common to other conditions.”
These symptoms include breathlessness, cough, chest pain, lethargy, and weight loss. All these symptoms are very common, and may be present in numerous other conditions. Even coughing up blood (hemoptysis), which is thought by many to be a defining symptom of the condition, is not present in most patients diagnosed with lung cancer.
“Catching the disease early is the key to successful treatment,” Dr. Diana Edralin, country medical director of Roche (Philippines) Inc., told Manila Standard’s Alena Mae Flores. “Symptoms do not show up until the later stages of lung cancer, but yearly testing can help achieve earlier diagnosis. This is why yearly testing is recommended for smokers or ex-smokers older than 55 years of age, who are the most at-risk for lung cancer.
“It is best to consult your medical oncologist for more information on lung cancer and learn more about the available and emerging treatment options,” she added.
Prevention and treatment
According to Dr. Edralin, treatment options for patients with lung cancer vary, depending on how it has grown and spread in the body. The main treatment for early-stage lung cancer is surgery to remove the tumor itself, or the area where cancer has developed.
Chemotherapy, sometimes coupled with radiation therapy, is another treatment of choice.
Like other forms of cancer, lung cancer can also be prevented. “Lung cancer prevention involves proper diet and adequate exercise, avoiding pollution, and most importantly, avoiding smoking and second-hand smoke,” Dr. Edralin said.
But “there is no way to totally prevent lung cancer,” Dr. Edralin pointed out, “and the fight against it is challenging.” – ###
