Lung cancer is considered the malignant tumour that causes the most deaths in the world, above other cancers with a higher incidence in the general population, such as colon or breast cancer, since its detection in early stages is complex and in 90 % of cases are diagnosed in advanced stages where treatment is no longer as effective.

However, despite its high mortality, it is one of the most preventable cancers because its origin is directly linked to tobacco consumption and quitting or not smoking is the best possible prevention.

Causes of lung cancer

The leading cause is exposure to tobacco smoke due to inhalation of carcinogenic substances in tobacco smoke. 90% of lung cancer cases occur in smokers since smoking increases up to 30 times the chances of developing lung cancer. Among passive smokers, the risk of suffering from it is almost twice as high as that of an unexposed person.

The number of cigarettes smoked and the years of consumption also significantly influence the increased risk. The greater the amount and for more years smoked and gradually decreased when quitting the tobacco habit.

Incidence

In Spain, approximately 20,000 cases are diagnosed each year. It occurs more in men than in women in a ratio of 9 to 1, representing 20% ​​of tumours in men compared to 3% in women. However, in recent years, due to an increase in tobacco consumption among women, its incidence grows annually at a rate of 2.4% while in men it has stabilised.

Most cases are diagnosed after 65-70, although it is not uncommon to detect them from 40 in early-onset tobacco smokers.

Female mortality has multiplied by eight since 2001

The incidence in women has grown in recent years due to the change in tobacco consumption habits over the last 20 years.

Public bodies are working to curb this upward trend, especially among the youngest, to prevent tobacco consumption by starting campaigns to stop smoking.

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Lung cancer prevention

There are no diagnostic techniques for the early detection of lung cancer as there are for other types of cancer. Only 10% of cases are detected in the early stages in which the cancer is curable by surgery. They are usually casual findings on a chest X-ray in general medical examinations or studies for other pathologies.

The only effective prevention is to stop smoking or not smoke at all. Carrying out a control chest CT scan on all smokers to detect incipient lung nodules is a method that has been discussed and is still being evaluated, so encouraging and helping smokers to quit smoking is the most effective means of reducing the incidence of this pathology where 90% of patients die in the first five years after diagnosis.

Symptoms

The main symptom is persistent cough accompanied or not by expectoration. It occurs in 3 out of 4 patients. Still, it is not a specific symptom of lung cancer because tobacco produces bronchial irritation with respiratory symptoms that can lead a smoker diagnosed with acute bronchitis or chronic obstructive pulmonary disease to rest importance to the aggravation of their symptoms.

• Persistent cough or changes in usual chronic cough
• Hemoptysis (blood with cough)
• Dyspnea (feeling short of breath)
• Wheezing (whistling in the chest)
• Dysphonia (voice changes)
• Chest pain and pain when inhaling (when taking in the air)

In addition to these respiratory symptoms, advanced lung cancer produces a series of symptoms common to any cancer that affect the general condition: weight loss, lack of appetite, tiredness, low defences and fever.

If cancer has spread, affecting other distant organs (metastasis), it may be accompanied by local symptoms where it has spread. These organs are the brain, liver, adrenal glands and bones, manifesting in headaches, vomiting, seizures, neurological deficits, extreme weakness and bone pain.

Diagnosis

To confirm the suspicion of lung cancer, imaging tests such as chest radiology and chest CT are necessary to see the exact location and its extension. Still, it is essential to perform a tumour biopsy using the required technique in each case, depending on whether the tumour is more or less deep, to identify the histological type of cancer because this will condition the treatment to be followed later.

Other tests such as PET, bone scan or brain MRI are reserved for searching for distant metastases to rule out or suspect a possible spread to other body organs.