askthedoctor Lung Cancer M
Consult Your Doctor If you are at high risk of developing lung cancer, talk with your health care provider to determine whether a screening CT scan would be helpful.
Many people don’t think about lung cancer until a friend or family member receives a diagnosis. But about 7 percent of the population will be diagnosed with lung cancer during their lifetime. Most people know smoking is a risk fac- tor for lung cancer: The longer someone smokes and the more he or she smokes, the greater the risk. However, lung can- cer also aff ects nonsmokers. According to the Lung Cancer Alliance (
www.lungcan
ceralliance.org), more than 60 percent of new lung cancer cases occur among those who have never smoked or who have quit smoking. Exposure to asbestos and radon contributes to lung cancer, as does expo- sure to arsenic, silica, and chromium. The risk of developing lung cancer is higher if close blood relatives have had the disease. Almost 90 percent of those diagnosed with lung cancer are over age 55. African-Americans, especially African- American men, are at greater risk of de- veloping lung cancer than people of other ethnicities, and more women die from lung cancer than from breast cancer. As with other cancers, the earlier lung cancer is diagnosed, the better the out- come. Unfortunately, most lung cancer is not diagnosed until after it has spread and metastasized. Only about one in six people diagnosed with lung cancer is diagnosed early, when tumors are localized and more treatable. Five-year survival rates are very low, and nearly 60 percent of those with lung cancer die within a year of diagnosis.
Despite being the most common cause of cancer deaths in the U.S., lung cancer often is forgotten. Rear Adm. Joyce Johnson, D.O., discusses risk factors and screening options.
Diagnosis of lung cancer often is de-
layed until a patient complains of symp- toms such as a cough, shortness of breath, wheezing, a change in voice, or pain or swelling in the chest, the back, an arm, a shoulder, or the neck. These symptoms are the eff ects caused by a tumor taking up space in the body — for example, causing pain by putting pressure on a nerve. By the time these symptoms occur, a tumor is generally quite large and the disease is advanced. In addition, because these symptoms can be caused by many other ailments, a lung cancer diagnosis initially might be overlooked. Clinical trials are under way to deter- mine what screening procedures might contribute to early diagnosis, so treatment can begin sooner and be more eff ective. Strong initial evidence suggests that, in high-risk people, CT scans of the lungs can identify tumors early. However, these scans also identify lesions that are not lung cancer, and it might require an invasive procedure to determine whether a particular lesion is cancerous. At this time, experts have not agreed on clear recommendations as to who should receive screening CT scans for lung cancer.
MO
— Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www
.moaa.org/wellness. For submission information, see page 20.
*on the web: Visit
www.cancer.gov to learn more about lung cancer and other cancers. 44 MILITARY OFFICER APRIL 2011
PHOTO: STEVE BARRETT
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