What we know about lung cancer evolves day by day. In the past, lung cancer was considered to be associated with only smoking; but today, thanks to the advances in the scientific diagnosis and treatments, many subtypes of the lung cancer have been discovered and many other factors such as genetic mutations and exposure to environmental carcinogenic materials have been found to cause cancer development.

Lung cancer is one of the most common solid organ tumors and is the leading cause of cancer-related deaths worldwide. Every year approximately more than 2.2 million people are diagnosed with lung cancer. Lung cancer remains the most common cause of cancer-related deaths (18%) and accounts for 1 in every 5 deaths.

Cancer in the lungs results from the uncontrolled proliferation of abnormal cells. Although lung cancer often starts with a single focus in a lung, it can also develop from more than one focus. Cancer cells can spread to the lungs, neighboring tissues, or other parts of the body. The most common metastasis areas of lung cancer are lymph nodes, liver, central nervous system (brain), bone and adrenal glands. Lung cancer can also metastasize to different lobes or to the opposite lung.

Basically, it can be classified into two groups as small cell and non-small cell lung cancers. The most common symptoms are bloody cough, weight loss, shortness of breath, fatigue and chest pain, being mostly seen in the advanced and metastatic stage. 

  • Smoking

  • Occupational exposure (contact with asbestos, etc)

  • History of contact with radiation 

  • Genetic predisposition 

  • Diet

  • History of lung diseases

It is estimated that 80-90% of lung cancer mortality in men and 75-80% in women is due to smoking. It appears that 20 pack/years of smoking increases the risk of death from lung cancer 20-60 times in men and 14-20 times in women. Starting smoking before age 15 doubles the risk. The number of cigarettes smoked per day leads to a linear increase in risk; prolonged smoking time leads to an exponential increase in risk.

Approximately 85% of lung cancer patients initially present with regional or metastatic disease. 5-year survival times by disease type is 65% when lung cancer is diagnosed in the early (localized) stage, 37% in the regional stage, and only 9% in the distant (metastatic) stage. Therefore, early diagnosis of lung cancer is extremely critical.

The process in lung cancer starts with consultation to a pneumologist with any complaint and requires multidisciplinary work of many medical branches such as radiology, pathology, thoracic surgery, medical oncology and radiation oncology during the patient's journey.

While methods such as chest radiography (X-ray) are primarily used for imaging in diagnosis, imaging techniques such as Computed Tomography (CT), MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography) are used for more detailed imaging and staging processes. By these methods, it is intended to determine the tumor size, lymph node involvement and whether there is metastasis to other organs.

Taking a tumor biopsy for histological subtyping and determining the definitive diagnosis is a critical process. With the biopsy sample taken, pathologists perform subtyping by examining the shapes of the cells under the microscope and images of the cells stained with special dyes. This histopathological diagnosis is of critical importance in determining the treatment process.

In recent years, with the development of targeted therapies, use of molecular diagnostic methods following histopathological diagnosis have gained great importance. 

In the treatment of lung cancer; surgery, chemotherapy, radiotherapy, immunotherapy, targeted drug therapy and/or palliative therapy can be administered alone or in combination. Factors affecting which treatment will be applied: The stage of the disease, the patient's performance status, the histopathological type of the tumor , mutation and biomarker analysis.

While lung cancer was a rare disease at the beginning of the current century, today it has become the deadliest cancer type in the world.

As Roche Türkiye, we prepared three different films for Lung Cancer Awareness Month in 2018-2020 with the slogan “Bak Ciğerim, Akciğerim” to draw attention to the risk factors and symptoms of lung cancer and launched a campaign to raise awareness of lung cancer in our society.

While drawing attention to the uniqueness of each lung cancer together with Kansersiz Yaşam Derneği with the motto of “Senin Hikayen Farklı/Your Story is Different” in 2021, we underlined the importance of early diagnosis and treatment with the slogan “Are You Ready to Write New Stories in Lung Cancer?” in cooperation with the Turkish Lung Cancer Society in 2022.

All campaign films are available onorwebsite.

References

  1. Estimated Incidence, Mortality and Prevalence Worldwide in 2012. International Agency for Research on Cancer. Available from: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Last accessed: Temmuz 2023

  2. What is Non-Small Cell Lung Cancer? American Cancer Society. Available from: https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/what-is-non-small-cell-lung-cancer.html. Last accessed: Ağustos 2023

  3. Li Q et al. Neoplasma 2016; 63(3): 342-350. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26925794. Last accessed: Ağustos 2023.

  4. World Cancer Report 2008. World Health Organization. Available from: http://www.iarc.fr/en/publications/pdfs-online/wcr/2008/wcr_2008.pdf. Last accessed April 2018. [Calculation: 960,000 (new cases per year in men) + 390,000 (new cases per year in women) = 1,350,000 (new cases per year) /1,350,000/100 = 13,500 (1% of cases diagnosed each year) / 13,500 * 20 = 270,000 (new cases per year not linked to smoking)]

  5. Centers for Disease Control and Prevention (CDC) (December 2001). "State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke—United States, 2000". Morbidity and Mortality Weekly Report (Atlanta, Georgia: CDC) 50 (49): 1101–1106.

  6. 3EpiCast report: NSCLC Epidemiology Forecast to 2025. GlobalData. 2016.

  7. Taylor, R; Najafi F; Dobson A (October 2007). "Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent". International Journal of Epidemiology 36 (5): 1048–1059.

  8. Schick, S; Glantz S (December 2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke". Tobacco Control 14 (6): 396–404.

  9. O'Reilly, KM; Mclaughlin AM; Beckett WS; Sime PJ (March 2007). "Asbestos-related lung disease". American Family Physician 75 (5): 683–688.

  10. Tobias, J; Hochhauser D (2010). "Chapter 12". Cancer and its Management (6th ed.). Wiley-Blackwell. p. 199.

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  12. What's the difference? Small cell and non-small cell lung cancer. Cancer Treatment Centers of America. Available from: https://www.cancercenter.com/discussions/blog/whats-the-difference-small-cell-and-non-small-cell-lung-cancer/. Last accessed May 2018

  13. Miller, WT (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 486.Lu C, Onn A, Vaporciyan AA, et al. (2010). "78: Cancer of the Lung". Holland-Frei Cancer Medicine (8th ed.). People's Medical Publishing House.

  14. Kumar, V; Abbas AK; Aster JC (2013). "12". Robbins Basic Pathology (9th ed.). Elsevier Saunders. p.

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  16. Kelley AS, Meier DE (August 2010). "Palliative care--a shifting paradigm". N. Engl. J. Med. 363 (8): 781–2.

  17. Prince-Paul M (April 2009). "When hospice is the best option: an opportunity to redefine goals". Oncology (Williston Park, N.Y.) 23 (4 Suppl Nurse Ed): 13–7.

  18. World Health Organization: GLOBOCAN 2020 – Lung Cancer: Estimated cancer incidence, mortality and prevalence worldwide. [İnternet; Temmuz 2023 tarihinde alıntılanmıştır] Erişim Adresi: https://gco.iarc.fr/today/data/factsheets/cancers/15-Lung-fact-sheet.pdf.

  19. Cancer Stat Facts: Lung and Bronchus Cancer. National Cancer Institute. Available from: http://seer.cancer.gov/statfacts/html/lungb.html. Last accessed May 2018.

  20. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. NCCN 2023 v3.Palmer R, et al. Biochem J. 2009 Jun 15; 420 (Pt3): 345-361

  21. Ferlay, et al. Int J Cancer 2019: May 2023

  22. TC Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, 2018 Türkiye Kanser İstatistikleri

  23. SEER Cancer Stat Fact Sheets Lung and Bronchus Cancer: Mayıs, 2023

  24. American Cancer Society, May 2023 (https://www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-staging/signs-symptoms.html)

The information provided on this site is not for diagnostic or medical advice, but for informational purposes. If you have or think you have a disease to be treated, consult a specialist physician.

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