Lung Cancer: A Persistent Threat in Korea
By [Your Name], Medical Journalist
In Korea, lung cancer remains a formidable adversary, ranking as the fifth most prevalent cancer and claiming the dubious title of the leading cause of cancer-related deaths. As of 2020, the mortality rate stood at a staggering 18.6 individuals per 100,000 population. Lung cancer primarily originates from the cells that compose the lung tissue and can be categorized into two types: primary lung cancer and metastatic lung cancer, the latter being the result of cancer spreading from another organ to the lungs.
Understanding Primary Lung Cancer
Thanks to the invaluable insights from Professor Kyung Seon-young, a renowned respiratory medicine expert at Gachon Gil University Medical Center, we have gained a deeper understanding of primary lung cancer.
Direct and Indirect Factors
- Smoking remains the most common cause of lung cancer. Historically, the disease predominantly affected male smokers. However, there has been a troubling rise in female lung cancer patients, constituting approximately 35% of all cases. Strikingly, 87.8% of these female patients reported no history of smoking, highlighting the significance of non-smoking-related causes. These include exposure to radiation, radon, arsenic, chromium, nickel, asbestos, and fine dust due to occupational or environmental factors. Additionally, respiratory diseases such as chronic obstructive pulmonary disease (COPD) and lung fibrosis can contribute to the development of lung cancer.
Identifying Lung Cancer Symptoms
In the early stages, lung cancer symptoms are often nonspecific. The most common signs include cough, hemoptysis (coughing up blood), difficulty breathing, and unintentional weight loss. These symptoms can be divided into those directly caused by the primary lung cancer and those that arise from metastasis to other organs. For instance, central airway involvement may lead to cough, hemoptysis, and breathing difficulties. On the other hand, peripheral lung cancer can cause pain as it spreads to the pleura or chest wall. Metastasis to specific organs produces unique symptoms: brain metastases may result in headaches, dizziness, and paralysis; bone metastases cause bone pain; and laryngeal nerve metastasis can lead to tremors and dysphagia.
Promising Anticancer Treatments
Cutting-edge anticancer treatments for lung cancer primarily encompass three categories: cytotoxic anticancer drugs, targeted anticancer drugs, and immunotherapies. Cytotoxic drugs, such as anti-metabolism agents, plant derivatives, and alkylating agents, not only attack cancer cells but also harm normal cells, leading to debilitating side effects. In contrast, targeted therapy capitalizes on the distinctive genetic characteristics of cancer cells, selectively attacking them while sparing healthy cells. Epidermal growth factor receptor inhibitors (EGFR TKIs) serve as significant examples of targeted treatments. Additionally, immunotherapy utilizes the patient’s immune system to combat cancer cells by activating specialized immune cells known as T cells, which possess the ability to recognize and eliminate cancer cells.
Supplementary Treatment Approaches
Beyond anticancer drugs, lung cancer can be addressed through surgical interventions and radiation therapy. The choice between these treatment modalities depends on factors such as tumor stage, lung function, age, and the anticipated post-surgery quality of life. Surgical treatment is typically recommended for patients with stage 1 to 2 non-small cell lung cancer, and in some cases, early stage 3 cancer. Adjuvant therapy, involving chemotherapy administered 3 to 4 times, may be utilized post-surgery to prevent micrometastasis and reoccurrence. Induction therapy with anti-cancer drugs before surgery may also be employed in certain cases where positive response is observed.
Preventing Lung Cancer: A Call to Action
Prevention plays a crucial role in the battle against lung cancer. Avoiding smoking and secondhand smoke is paramount, considering that cigarette smoke contains over 4,000 chemicals, including more than 60 known carcinogens. Remarkably, an overwhelming 70% of lung cancer cases are attributed to smoking. In occupations where exposure to harmful agents is inevitable, protective gear, proper ventilation, and regular health check-ups are vital. Moreover, minimizing exposure to fine dust and radon, practicing good ventilation during cooking, maintaining a physically active lifestyle, and adopting a balanced diet are essential preventive measures.
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Lung cancer ranks 5th in cancer incidence and 1st in cancer deaths in Korea, with 18.6 people per 100,000 dying from lung cancer (as of 2020). Lung cancer refers to a malignant tumor (cancer) that arises mainly from the tissue cells that make up the lungs. This is called ‘primary lung cancer’, and cancer that occurs when cancer originating in another organ spreads to the lungs is called ‘metastatic lung cancer’.
We learned about ‘primary lung cancer’ with the help of Kyung Seon-young, professor of respiratory medicine at Gachon Gil University Medical Center.
―Direct and indirect factors of lung cancer.
▷The most common cause of lung cancer is smoking. Until now, lung cancer occurred mainly in male smokers, but recently, the number of female lung cancer patients has increased, accounting for approximately 35% of all lung cancer patients, and 87.8 were not % of them smoke. For this reason, there is a lot of interest in non-smoking causes of lung cancer as well. Non-smoking causes of lung cancer include exposure to radiation, exposure to radon, arsenic, chromium, nickel, asbestos, and fine dust due to occupational or environmental factors, and respiratory diseases such as chronic obstructive pulmonary disease (COPD) and fibrosis the lungs.
-What are the symptoms of lung cancer?
▷In the beginning, the symptoms are few and there can be a variety of non-specific symptoms. Common symptoms of lung cancer include cough, hemoptysis, difficulty breathing, and weight loss. Lung cancer symptoms can be broadly divided into symptoms caused by the primary lung cancer itself and symptoms that appear when the lung cancer metastasizes. If lung cancer is located within the central airway, cough, hemoptysis, and difficulty breathing may occur, and if lung cancer occurs in the periphery, pain may occur first as it progresses to the pleura or chest wall. Lung cancer that has metastasized has different symptoms depending on the organ it has metastasized to.
If there are brain metastases, you may experience headaches, dizziness, and paralysis. If there are bone metastases, you will experience bone pain. Laryngeal nerve metastasis can cause tremors due to vocal cord paralysis, or it can spread to the esophagus near the trachea and cause dysphagia.
―Anticancer drug treatment for lung cancer.
▷ Anticancer treatments for lung cancer mainly include cytotoxic anticancer drugs, targeted anticancer drugs, and immunotherapies. Cytotoxic anticancer drugs include the anti-metabolism class, the plant derivative class, and the alkylating agent class. They have the property of attacking not only cancer cells but also normal cells, causing damage to cells such as skin, mucous membranes, and hair, and causing side effects such as nausea, vomiting, stomatitis, and hair loss. Targeted therapy uses the molecular genetic characteristics of cancer cells to attack only cancer cells without attacking normal cells. This reduces the side effects of anticancer drugs and increases the effectiveness of anticancer treatment. Epidermal growth factor receptor inhibitors (EGFR TKIs) are the most well-known representative targeted treatments. Immunotherapy is a treatment that uses the patient’s immune system to kill cancer cells. T cells, which are immune cells, have the function of recognizing cancer cells when they occur in the body and killing them.
-Treatments other than anti-cancer drugs.
▷ In addition to anticancer drugs, there are surgical treatments and radiation treatments. Treatment and regimen are used depending on the degree of tumor progression and the patient’s physical condition. Surgery is decided upon taking into account the stage of the cancer, lung function, age, and expected quality of life after surgery. Patients with stage 1 to 2 non-small cell lung cancer and some patients with early stage 3 cancer are indicated for surgical treatment. To prevent micrometastasis and recurrence after surgery, chemotherapy is given 3 to 4 times as adjuvant therapy. Sometimes, surgical treatment is carried out if the response is good after induction therapy with anti-cancer drugs before surgery.
―How can we prevent lung cancer?
▷ Stop smoking and avoid secondhand smoke. Cigarette smoke contains around 4,000 types of chemicals, more than 60 of which are carcinogens. Around 70% of lung cancer cases are linked to smoking. If occupational exposure cannot be avoided, you must wear protective gear when working, provide good ventilation, and undergo a thorough special health examination. It is important to avoid exposure to fine dust and radon, provide good ventilation when cooking food, regular check-ups with low-dose CT of the chest, regular exercise, and proper eating habits.
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