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Lung Cancer is amongst the top 3 cancer in both males and females :
2013-2017 - 14.5% of all cancer in men were lung cancers and 7.6% of all cancer in women were lung cancers.
It is the leading cause of death in cancer patients in Singapore, accounting for 26.6% of cancer deaths in males and 16.1% in females
What is Lung Cancer?
Lung cancer is the uncontrolled growth of abnormal cells in the lungs. As the cancer cells grow, they can interfere with the normal functioning of the lungs.
They can also spread from the original part of the lung to lymph glands around the airway, the opposite lung, bones, brain and liver, as well as to other parts of the body.
Two major types of lung cancer
Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). The diagnosis is made by how the cells actually look under the microscope.
Small cell lung cancer (SCLC)
SCLC makes up about 10 – 15% of all lung cancer cases worldwide. It is an aggressive cancer which grows quickly and spreads early to other parts of the body via the blood stream and lymphatic system.
Due to the rapid spread, they are often diagnosed late and treatment is mainly chemotherapy alone or in combination with radiotherapy for symptom control.
This type of lung cancer is strongly associated with cigarette smoking.
Non-small cell lung cancer (NSCLC)
NSCLC which includes squamous cell, adenocarcinoma, large cell carcinoma, are not as aggressive as SCLC but it is more common. It accounts for 85-90% of all lung cancer worldwide.
It tends to grow and spread less quickly than SCLC. If discovered early, surgery and/or radiation therapy, chemotherapy may offer chance of cure.
1) Cigarette smoke
is the number one risk factor for lung cancer. It is responsible for almost 80% of all lung cancer in the world, especially the western part of the world.
In fact second hand smoke is also a major risk factor of lung cancer among non smokers.
Second hand smoke actually increases the risk of lung cancer by 30%.
2) Age: lung cancer
is more common in people above the age of 40
3) Personal or family history of lung cancer
your risk of lung cancer is higher if someone in your family have had lung cancer. A lung cancer survivor is at a higher risk of developing recurrences of lung cancer
4) Air pollution
The WHO estimates that there are about 4 million excess deaths per year worldwide due to air pollution. Those who live in more polluted cities have a higher risk of lung cancer than those who live in less polluted cities.
5) Radiation exposure like radon ( radioactive gas )
Radons are actually all around us in low levels. They are generally found in the ground, soil and rocks.
6) Industrial exposure to harmful agents
like asbestos, arsenic, chromium, nickel, soot and tar.
In Singapore, we have a strikingly high proportion of lung cancer detected among non-smokers or never-smokers
As high as 47.7% of all lung cancer from 2011 data are in non or never smokers as compared to the western countries where lung cancer in never smokers were only about 10-15%. and almost 70% of lung cancers in never-smokers in Singapore are females.
Often no symptoms in the early stages.
In the later stages, you may get
- Unexplained weight loss and tiredness.
- Loss of appetite
- Persistent cough with blood in sputum
- Chest pain
- Frequent chest infections
- Quit smoking
- Avoid second hand smoke
- Avoiding carcinogens at work
- Consuming more fruits and vegetables
- Adopt a healthy lifestyle by managing your stress, exercise, sleep early.
There is a screening tool for high risk patients in Singapore using low dose CT scan of the lungs.
For patients who satisfy the below three criteria can have their lungs scanned with low dose CT – scan
The criterias are:
- Smoking history of 30 pack years or more, where 1 pack year equates to smoking 1 pack of cigarette a day for one year, or 2 packs a day for 1/2 a year
- currently smoking or have quit within the past 15 years
- age 55-75
- Newer therapies : immunotherapies and targeted therapies
or a combination of the above.
Please do not think that cancer is uncommon - it may be more common than you think. In fact it may be as common as hypertension. Do not ignore your symptoms and please consult your doctor should you feel unwell.
Lung cancer is pretty common in Singapore. You need not be a smoker to be at a higher risk of getting lung cancer. Manage your lifestyle to minimise the chance of cancer : stop smoking, reduce stress, sleep early, eat well.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)