Q&A With Lung Surgeon Malcolm DeCamp, MD
With 1.8 million new lung cancer diagnoses each year, the fight against lung cancer is in still in full effect. Smoking is the most widely known cause, and yet it remains the most prevalent, too. Quitting can be discouragingly difficult for many, but new research into cessation techniques, as well as detection tools aimed at high-risk individuals, underscores the need for awareness and commitment to treating the cause as much as the effect.
Malcolm DeCamp, MD, Chief of Thoracic Surgery at the Robert H. Lurie Cancer Center of Northwestern University, answered some questions about the relationship between smoking and lung cancer – and advice for the big one – how do you quit?
What proportion of lung cancer diagnoses are caused by smoking?
Smoking is responsible for about 75% of all new lung cancers. Even those who have successfully quit should be aware of their increased risk, which persists for at least 15 years. Screening CT scans can help former smokers manage their risk with proactive examinations.
It’s also important to remember that not all lung cancer is caused by active smoking. Even nonsmokers have a 20 to 30 percent greater chance of developing cancer when they are exposed to secondhand smoke – causing approximately 7,330 lung cancer deaths among nonsmokers every year.
Furthermore, many people are exposed to other toxins associated with lung cancer, known as carcinogens, in their workplaces or homes. Radon and asbestos are the most common, and environmental carcinogens account for approximately 9 to 15 percent of new diagnoses. Outdoor air pollution contributes to another 1 to 2 percent of occurrences.
What forms of tobacco consumption cause lung cancer?
All forms of tobacco have been linked with cancer, including cigarettes, cigars, pipes, chewing tobacco—everything. People sometimes mistakenly think hookah is a safe option, but that also contains tobacco and is linked to cancer. Vaping (use of e-cigarettes or other electronic smoking devices) is a new player on the field, but ultimately, all of these electronic smoking devices are considered tobacco products. In addition, studies show a high and often unregulated (partially due to its newness) amount of toxic chemicals in vaping products that lead to cancer. Smoking marijuana is likewise associated with cancer. The truth is, there is no safe option for consuming tobacco or smoking.
What are the warning signs of lung cancer?
If you experience shortness of breath, a chronic cough, coughing up blood, new hoarseness, unexplained weight loss or fatigue, you should make an appointment to see your physician. These considerations are particularly indicative of lung cancer if you are an active or former smoker or have been exposed to environmental risk factors, such as radon or asbestos.
What is the survival rate for people with lung cancer?
While lung cancer has a lower survival rate than other cancers, if it is detected early, while still localized, patients usually have a 60 to 75 percent chance of cure. Unfortunately, only 16 percent of cases are currently found at this early stage, so many awareness and access efforts are focused on encouraging patients to see a specialist sooner. If half of the high-risk population—at least 8.6 million Americans—received a low-dose CT scan, estimates suggest we could triple the number of early-stage diagnoses and reduce lung cancer mortality by 20 percent.
Smoking cessation is hard – can it really make a difference?
Your body starts to repair only 20 minutes after you quit smoking. Within five years, your risk for other smoking-related problems, like stroke or heart disease, approach those of a nonsmoker. Yes, your risk for developing lung cancer will always be higher than that of a nonsmoker, but it’s never too late to improve your health by quitting smoking. Furthermore, two to three weeks of smoking cessation before any kind of surgery reduces the risks of postoperative complications.
Most patients take multiple attempts before successfully quitting, so try not to be deterred if the obstacles seem too high – the rewards are very much worth it. A combination of cessation counseling, pharmacologic aids and nicotine replacement has produced the highest and most durable quitting rates.
Your physician will be a valuable source to help you define your reasons for quitting, understand what to expect and and take advantage of the resources available to you, like a trained cessation counselor, support groups, online programs or family members.
Interested in hearing more from Northwestern Medicine? Sign up for the Healthy Tips E‑Newsletter for everything from health and wellness ideas to patient breakthroughs to academic and medical advancements.