What do singer Nat King Cole, actor Steve McQueen, Beach Boys member Carl Wilson, New York Yankees Roger Maris, reporter Edward R. Murrow and King George VI have one thing in common?
They all died of lung cancer.
In the Philippines, one of the disease’s popular victims was broadcast journalist Angelo Castro Jr. The main man of The World Tonight was diagnosed with lung cancer in 2008 and given three months to live.
But with his and his family’s faith in God, determination and the loving support of family and friends, he lived beyond three months. After taking a hiatus for over two years, he returned to work in 2011. A day after Christmas, he said on air: “Move on. It is just a chapter in the past, but don’t close the book—just turn the page.”
Although lung cancer strikes mostly men, women are not spared from it. Among those who died of lung cancer were modeling pioneer Wilhelmina Cooper, Hollywood actress Betty Grable and Senator Miriam Defensor-Santiago. In the Philippines, lung cancer is the third leading cause of cancer among women—after breast and cervical.
Unknowingly, more and more Filipinos are now dying of lung cancer. According to the Philippine Society of Medical Oncology, lung cancer leads among the top 5 cancers leading to death in the country. Out of 100,000 Filipinas diagnosed with lung cancer, 2,500 of them die.
Among men, lung cancer ranks as the number one cause of cancer among Filipino men, the Philippine Cancer Society, Inc. claims. “Lung cancer is killing more Filipino men than ever before,” the society deplored. Every year almost 2 million people around the world are diagnosed with the disease. “Only about 250,000 of them will remain alive, five years later,” claimed Dr. Ted Hamilton, medical director of Florida Hospital Central Care in Orlando.
Like most cancers, no one really knows what causes lung cancer. But several studies cited smoking as the primary culprit. In fact, smoking has been identified as a contributory factor in eight to nine out of 10 cases of diagnosed lung cancer. Before the advent of cigarette smoking lung cancer was uncommon. In fact, it was not even recognized as a distinct disease until 1761.
“Cigarette smoking is the cause of about 90 percent of lung cancer cases in men and about 80 percent of cases in women,” The Merck Manual of Medical Information pointed out. The greater the quantity and duration of smoking a person undergoes, the greater his or her risk of developing lung cancer.
The Geneva-based World Health Organization, the UN health agency, agreed: “Seventy-one percent of lung cancer deaths are caused by tobacco smoking.”
“Three out of 10 Filipino adults smoke, and this translates to more than 17 million Filipinos whose risk to develop lung cancer and many other smoking-related diseases is significantly increased,” Castillo said.
Even those who don’t smoke are also at risk of getting lung cancer—especially if they are living with someone who smokes. Experts call this as second-hand smoke or passive smoking. It is estimated that 17 percent of cases of lung cancer in nonsmokers are caused by second-hand smoke exposure in childhood and adolescence.
“Nonsmoking spouses of smokers are 30 percent more likely than spouses of non smokers to get lung cancer,” explained Drs. Christopher Dolin sky and Christine Hill-Kayser of the University of Pennsylvania Medical School.
Not all cases of lung cancer, however, are due to smoking. A small proportion of lung cancers (about 10 percent in men and about 5 percent in women) are caused by substances encountered or breathed in at work.
“Working with asbestos, radiation, arsenic, chromates, nickel, chloromethyl ethers, mustard gas and coke-oven emissions has been linked with lung cancer,” the Merck manual informed. “The risk of contracting lung cancer is greater in people who are exposed to these substances and who also smoke cigarettes.”
The Merck Manual also mentioned that about 1 percent of lung cancer cases are caused by air pollution. Long-term exposure to the air pollution in some of America’s biggest metropolitan areas significantly raises the risk of dying from lung cancer and is about as dangerous as living with a smoker, according to the researchers from Brigham Young University and New York University.
Studies of the American Cancer Society also cohort directly link the exposure to particulate matter with lung cancer. For example, if the concentration of particles in the air increases by only one percent, the risk of developing a lung cancer increases by 14 percent.
The lungs are two spongy organs found in the chest. They are responsible for delivering oxygen to the bloodstream. When a person breathes in, air moves into the lungs, thereby causing the lungs to expand.
“Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs; usually in the cells that line the air passages,” explained Peter Crosta in article he wrote for Medical News Today. “The abnormal cells do not develop into healthy lung tissue; they divide rapidly and form tumors. As tumors become larger and more numerous, they undermine the lung’s ability to provide the bloodstream with oxygen.”
“Most lung cancer originates in the cells of the lungs; however, cancer may also spread (metastasize) to the lung from other parts of the body,” explained Dr. Gary Sy in his column published in a national daily.
Metastatic cancers, according to the Merck manual, spread to the lungs most commonly from the breast, colon, prostate, kidney, thyroid gland, stomach, cervix, rectum, testis, bone and skin (melanoma).
- Glenn Orion, former associate editor of Health and Lifestyle who attended the European Society for Medical Oncology Congress in Vienna, said there are two main types of lung cancer: small cell lung cancer (SCLC) and nonsmall cell lung cancer (NSCLC).
“SCLC comprises about 14 percent of lung cancers,” Orion wrote. “It is almost always caused by smoking, and is generally aggressive—spreading quickly at an early stage; hence, the poor prognosis.”
On the other hand, “NSCLC is the most common type of lung cancer, found in about 85 percent of lung cancers,” Orion added. “Histologically, it may be identified as adenocarcinoma, squamous cell carcinoma, large cell carcinoma or NSCLC with unspecified histology.”
Treatment for lung cancer can also be very prohibitive. Chemotherapy, sometimes coupled with radiation therapy, is the treatment of choice. This is because the cancer has almost always spread to distant parts of the body by the time of diagnosis. In about 25 percent of people, chemotherapy prolongs survival.
Chemotherapy alone may cost P50,000 to P120,000 per month. This figure does not include the medicines, which may cost as much as P100,000 or more a month.
“Lung cancer has a poor prognosis,” the Merck Manual pointed out. “On average, people with untreated lung cancer survive eight months. Overall, even with therapy, the 5-year survival rate is only 13 percent.”
However, lung cancer can be prevented. “Cancers that are closely linked to certain behaviors are the easiest to prevent,” Crosta pointed out. “For example, choosing not to smoke tobacco or drink alcohol significantly lowers the risk of several types of cancer—most notably lung, throat, mouth and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.”
Indeed, the most important preventive measure you can take to avoid lung cancer is to quit smoking. “Quitting smoking will also reduce your risk of several other types of cancer, including esophagus, pancreas, larynx and bladder cancer,” Crosta added. “If you quit smoking, you will usually reap additional benefits such as lower blood pressure, enhanced blood circulation and increased lung capacity.”