Lung Cancer Screening

What is Lung Cancer? Lung cancer is a type of cancer that begins in the lungs, the organs responsible for taking in oxygen and expelling carbon dioxide as we breathe. It is the leading cause of cancer-related deaths worldwide. Lung cancer occurs when cells in the lung grow uncontrollably, forming a tumour that can invade nearby tissues and spread to other parts of the body. Early detection and treatment are crucial to improving survival rates.

Types of Lung Cancer

• Non-Small Cell Lung Cancer (NSCLC): The most common type, accounting for about 85% of cases. It includes several subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. NSCLC generally grows and spreads more slowly than small cell lung cancer.
• Adenocarcinoma: The most common subtype of NSCLC, often found in the outer regions of the lungs. It is more common in non-smokers, women, and younger people.
• Squamous Cell Carcinoma: Often linked to smoking, this type typically develops in the central parts of the lungs, near a main airway (bronchus).
• Large Cell Carcinoma: Can appear in any part of the lung and tends to grow and spread more quickly than the other subtypes.
• Small Cell Lung Cancer (SCLC): A less common but more aggressive type, accounting for about 15% of lung cancer cases. It often starts in the bronchi and spreads rapidly to other parts of the body, including lymph nodes, liver, brain, and bones. SCLC is strongly associated with smoking.

Statistics

• Global Statistics: Lung cancer is the leading cause of cancer death worldwide, responsible for nearly 1.8 million deaths each year.
• Australian Statistics: In Australia, lung cancer is the fifth most commonly diagnosed cancer but the leading cause of cancer death. Each year, around 13,000 Australians are diagnosed with lung cancer, and more than 8,500 die from the disease.
• Survival Rates: The five-year survival rate for lung cancer in Australia is approximately 18%. Early detection significantly improves the chances of survival.

Symptoms Lung cancer symptoms can vary depending on the type and stage of the disease. Early-stage lung cancer often has no symptoms, which is why screening is so important. Common symptoms include:

• Persistent cough that does not go away
• Chest pain that worsens with deep breathing, coughing, or laughing
• Shortness of breath
• Hoarseness or changes in voice
• Unexplained weight loss
• Loss of appetite
• Coughing up blood or rust-colored sputum (spit or phlegm)
• Recurring infections such as bronchitis and pneumonia
• Fatigue

Causes Lung cancer is caused by genetic mutations in the cells of the lung. These mutations can result from a combination of genetic and environmental factors.

• Genetic Factors: Family history of lung cancer can increase the risk. Genetic predispositions can make some individuals more susceptible to the effects of carcinogens.
• Environmental Factors:
• Tobacco Smoke: The leading cause of lung cancer, responsible for about 85% of cases. Both smokers and those exposed to secondhand smoke are at high risk.
• Radon Gas: A naturally occurring radioactive gas that can accumulate in homes and buildings. Radon exposure is the second leading cause of lung cancer.
• Asbestos: Exposure to asbestos fibers, often in occupational settings, significantly increases the risk of lung cancer.
• Other Carcinogens: Exposure to other hazardous substances such as arsenic, diesel exhaust, and certain chemicals used in various industries.

Risk Factors

Smoking Smoking is the single most significant risk factor for lung cancer, contributing to approximately 85% of cases. The risk increases with the number of cigarettes smoked and the duration of smoking. Even low levels of smoking or exposure to secondhand smoke can increase the risk. Quitting smoking at any age can significantly reduce the risk of developing lung cancer.

Exposure to Radon Gas Radon is a colorless, odorless radioactive gas that can seep into homes and buildings from the ground. Prolonged exposure to high levels of radon gas can increase the risk of lung cancer, particularly in smokers. Testing and mitigating radon levels in homes can reduce this risk.

Exposure to Asbestos and Other Carcinogens Asbestos, once commonly used in construction and manufacturing, is a known carcinogen. Inhalation of asbestos fibers can cause lung cancer and mesothelioma. Other occupational exposures to carcinogens such as arsenic, chromium, nickel, and diesel exhaust can also increase the risk of lung cancer.

Family History of Lung Cancer A family history of lung cancer may indicate a genetic predisposition to the disease. Individuals with a first-degree relative (parent, sibling, or child) with lung cancer have a higher risk, especially if the family member was diagnosed at a young age.

Previous Radiation Therapy Patients who have undergone radiation therapy to the chest area for other cancers, such as breast cancer or lymphoma, have an increased risk of developing lung cancer later in life.

Screening and Early Detection

Importance of Screening Early detection of lung cancer through screening can significantly improve survival rates by identifying the disease at an early, more treatable stage. Screening is particularly important for high-risk individuals, such as long-term smokers and those with a history of significant exposure to lung cancer risk factors.

Types of Screening Tests

• Low-Dose CT Scan (LDCT): The most effective screening test for early detection of lung cancer. LDCT scans use low doses of radiation to create detailed images of the lungs, allowing for the detection of small nodules or abnormalities that may indicate lung cancer. This test is quick, non-invasive, and has been shown to reduce lung cancer mortality in high-risk populations.

Benefits of Early Detection

• Increased treatment options: Early-stage lung cancer can often be treated with surgery, leading to better outcomes.
• Improved survival rates: Detecting lung cancer at an early stage significantly improves the chances of successful treatment and long-term survival.
• Reduced treatment intensity: Early detection may result in less aggressive treatments, reducing the risk of side effects and improving the patient's quality of life.

How to Get Screened Learn how to access lung cancer screening services through Lungscreen Foundation and our partner radiology companies. We provide information on eligibility, how to schedule a screening, and what to expect during the process.

Treatment Options

Surgery Surgical removal of the tumour is a common treatment for early-stage lung cancer. Types of surgery include:

• Lobectomy: Removal of an entire lobe of the lung.
• Pneumonectomy: Removal of an entire lung.
• Segmentectomy or Wedge Resection: Removal of a small part of the lung.

Radiation Therapy High-energy rays are used to kill cancer cells or shrink tumours. It can be used as a primary treatment or in combination with surgery or chemotherapy.

Chemotherapy Drugs are used to kill cancer cells, often administered intravenously or orally. Chemotherapy can be used before surgery (neoadjuvant) to shrink tumours or after surgery (adjuvant) to eliminate remaining cancer cells.

Targeted Therapy Medications target specific genetic mutations in cancer cells, interfering with their growth and spread. Examples include drugs that target EGFR mutations or ALK rearrangements.

Immunotherapy Boosts the body’s immune system to fight cancer. Immune checkpoint inhibitors are a type of immunotherapy that helps the immune system recognize and attack cancer cells.

Clinical Trials Participation in clinical trials can provide access to new and innovative treatments. Clinical trials are essential for advancing cancer treatment and may offer additional options for patients with advanced or resistant lung cancer.

Living with Lung Cancer

Coping Strategies Managing the emotional and physical challenges of a lung cancer diagnosis can be overwhelming. Coping strategies include:

• Seeking support from friends, family, and support groups.
• Maintaining a healthy lifestyle with a balanced diet and regular exercise.
• Practicing stress-reduction techniques such as meditation and mindfulness.
• Staying informed about the disease and treatment options.

Support Resources Access to support groups, counselling, and other resources can help patients and their families navigate the challenges of lung cancer. Resources include:

• Patient advocacy organizations
• Online support communities
• Counselling services
• Financial assistance programs

Palliative Care Palliative care focuses on improving the quality of life for patients with serious illnesses. It includes managing symptoms, providing emotional support, and helping patients and their families cope with the disease.

Quit Smoking

Why Quit Smoking? Quitting smoking significantly reduces the risk of developing lung cancer and improves overall health. Benefits include:

• Lowering the risk of lung cancer and other smoking-related diseases.
• Improving lung function and respiratory health.
• Enhancing overall well-being and life expectancy.

Tips for Quitting Practical advice and strategies to help individuals quit smoking include:

• Setting a quit date and preparing for it.
• Seeking support from friends, family, and healthcare professionals.
• Using nicotine replacement therapies (NRT) or prescription medications.
• Avoiding triggers and managing cravings through healthy activities.

Resources and Support for Quitting Links to support groups, quitlines, and other resources to assist in quitting smoking include:

• National Quitline: A telephone service providing support and advice.
• Online resources and mobile apps for quitting smoking.
• Local smoking cessation programs and support groups.