Lung Cancer: The Risks of Smoking, Warning Signs

by Food and Drug Administration (FDA)

(Page 3 of 3)

The Radiation Therapy Oncology Group, a federally funded cancer clinical trials cooperative group, which carries out multi-disciplinary research nationwide, recently began a randomized clinical trial that will evaluate whether amifostine, a radio-protective agent, can effectively reduce some side effects in certain lung cancer patients treated with combined radiation therapy and chemotherapy. The trial, which will study patients with inoperable non-small cell lung cancer, is important because lung cancer patients who are treated with radiation and chemotherapy sometimes develop inflammation of the esophagus, making it difficult for them to swallow.

At an American Association for Cancer research meeting in March, E. Premkumar Reddy, Ph.D., director of the Fels Institute for Cancer Research at Temple University School of Medicine in Philadelphia, reported that discovery of a new pathway for tumor growth may help researchers develop new types of diagnostic tests and anti-cancer agents. The new pathway, Src-Stat-3, is believed to play a critical role in the proliferation of cancer cells in the lung, breast, prostate, and ovary.

Meanwhile, lung cancer survivor Ken Giddes, who is also a voting patient representative on FDA's Oncology Drug Advisory Committee, continues to spread a message of hope to people throughout the country. "I want people to know that the diagnosis of cancer is not an automatic death sentence and to inform people of the many options available to them," he says. "I also want people to know that just because they have lung cancer they shouldn't be written off or forgotten. People try to make you feel bad, especially if you smoked, like it's your own fault. But I see plenty of people who have lung cancer and haven't smoked. And even if they did smoke, they didn't plan to get lung cancer."

The Risks of Smoking

You have undoubtedly heard the warnings: if you smoke cigarettes, stop now, and if you don't smoke, don't start. Why? Because cigarette smoke is made up of over 4,000 chemicals, including 43 known to cause cancer. According to the American Cancer Society, tobacco use accounts for 30 percent of all cancer deaths in the United States, and smoking is responsible for 90 percent of lung cancers in men and more then 70 percent in women. The ACS estimates that 28 percent of men, 23 percent of women, and about 30 percent of adolescents smoke.

According to the American Lung Association, the more you smoke and the longer you smoke, the more likely you are to develop lung cancer. But the ACS contends that if you quit smoking when precancerous signs are found, the damaged lung tissue often may return to normal, oftentimes within five years.

There has been some debate, however, on this subject. In 1997, researchers at the University of Pittsburgh Cancer Institute concluded after a preliminary study, that just because people quit smoking doesn't mean they won't develop lung cancer at some point in their lives. The study, which was published in the American Journal of Respiratory and Critical Care Medicine, determined that 77 percent of the people who smoked at least a pack of cigarettes a day for 25 years had irregularities in their lung cells even if they weren't smoking at the time the lung tissue was examined. While those who smoked fewer cigarettes weren't home free, they were less likely to develop abnormal lung cells. Only about 15 percent of the people who smoked for less than 25 years showed similar cellular changes.

More research still needs to be conducted on this topic, and most doctors still recommend that people stop smoking, no matter how long they've been keeping up the habit. This is especially true for people who have been diagnosed with lung cancer. "People with lung cancer who stop smoking live longer and have higher cure rates and lower rates of second cancers, which is a major problem for these patients," says Paul Bunn Jr., M.D., director of the University of Colorado Cancer Center and past president of the International Association for the Study of Lung Cancer. "They also have lowered risk of death from other problems such as heart disease." Bunn says it's a myth that most lung cancer patients don't quit smoking; in fact, they have a much higher quit rate, he says.

Lung Cancer Warning Signs

Detecting lung cancer in its early stages can lead to a cure for some people and extend the life of others, according to the American Cancer Society. So, if you are experiencing any of the following problems or symptoms, seek medical attention at once:

• a persistent cough
• chest pain
• weight loss and/or decreased appetite
• bloody phlegm
• shortness of breath
• hoarseness
• a fever for an unknown reason
• recurring infections, such as bronchitis and pneumonia.

Some of these symptoms may be related to another disease or condition. The only way to know if you have lung cancer is for a doctor to perform the necessary tests.

Stages of Lung Cancer

Lung cancer treatment depends on tumor size and on how far the cancer has spread. To help doctors decide on the best treatment plan for their patients, a system of stages that describes the growth and spread of the cancer has been developed.

There are two stages for small cell lung cancer. In the limited stage, the tumor is usually confined to one lung and lymph nodes on the same side of the chest. In the extensive stage, the cancer has spread to the other lung and to lymph nodes on the other side of the chest, or to distant organs.

The stages of non-small cell lung cancer are:

Occult Stage: Cancer can be detected in patient's saliva, but tumors cannot be found in the lungs.

Stage 0: Cancer is localized in a few layers of cells and has not grown through the lung's top lining.

Stage I: The tumor is only in the lung and surrounded by normal tissue.

Stage II: Cancer has spread to nearby lymph nodes.

Stage III: Cancer has spread to the chest wall or diaphragm near the lung, or to the lymph nodes in the mediastinum (the area that separates the two lungs), or to the lymph nodes on the other side of the chest or in the neck. This stage is divided into IIIA, which can usually be operated on, and stage IIIB, which usually cannot withstand surgery.

Stage IV: The cancer has spread to other parts of the body.

Recurrent: Cancer has returned after treatment.

About the Author

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