WHILE lung cancer is not the most common cancer in Ireland, it is the one that is most common to kill.
There are about 2,500 cases every year, and 1,800 deaths. These numbers are predicted to double in the next 20 years or so, due to the ageing populations.
The high number of deaths is due to the lateness of presentation, with symptoms often being put down to just a cough or a virus, and several cough bottles tried before going any further with investigations.
Since our first lockdown in March, referals for lung cancer testing by GPs have reduced, probably because the older cohorts are not seeing their healthcare professionals as often, and are not bringing these symptoms to their attention.
The typical profile for lung cancer is changing. Smoking is certainly a risk factor, with 80% of presentations being smokers. But it’s not exclusive to those who smoke, and we need to be just as vigilant with non-smokers.
It has also often been a disease associated with men, but this is no longer the case; by 2045 it will be a predominantly female disease. Why is this? It’s not certain what the reason is, but the thought is that up to the 1960s women didn’t really smoke — it wasn’t considered socially acceptable. Over time these views changed, women became liberated, and many chose to smoke alongside their male counterparts.
At the time, the detrimental effect that smoking had on our health was unknown. It wasn’t until the 1970s and ’80s that this became common knowledge. These women are now ageing, and are gradually approaching the age at which lung cancer tends to present, median of 70-74 years.
Radon occurs naturally in our environment, it’s released by rocks, stones and soil, as well as a small percentage coming from medical sources. The level of radon in your area can be viewed at www.epa.ie.
So what sorts of symptoms are we talking about when we speak about lung cancer? It can be tricky to easily identify, as some symptoms are quite vague. But the acronym CANCER from the National Centre for Cancer Protection serves as a useful guide to follow:
C – Cough that is different to the usual cough that you may have, or that has become suddenly persistent. Anything that isn’t normal for you in this area, bring it to your healthcare provider’s attention.
A – Appetite reduced, or any sign of weight loss. This warrants a chat with your doctor to get to the root cause.
N - New onset of cough in somebody that has never previously coughed, particularly if it’s not shifting after two to three weeks. This cough can be either chesty or dry, there is not one typical presentation. IT doesn’t need to have blood in it either to be suspicious.
C – Chest or shoulder pain, particularly if it can’t be attributed to a physical injury.
E – Easily breathless, may present as struggling to climb the stairs or walk to shop, or to carry out other activities that were once not an issue
R – Really tired. We’re all tired some of the time, but any type of unexplained fatigue should be investigated.
Should your GP feel that any of these most common symptoms or other alarm bells are present and warrant investigation, they can refer you to a Rapid Access Lung Clinic, where patients are usually seen for an initial Xray within a couple of weeks.
There is massive reluctance amongst many to get checked, for fear of judgement for smoking, or of what may be found. The moral of the story here however is to be aware of what’s normal for you, speak up if unsure, and don’t be afraid to investigate because you’re greatly improving your chances of successful treatment by acting early. Encourage loved ones that you might be worried about to bring their symptoms to the attention of their pharmacist or GP, because timely help is very accessible and could be the difference between stages and outcomes.
If you’re looking for more information, you can go to www.hse.ie and search for lung cancer resources, or speak to your healthcare professional.
Stage 1 lung cancer, the earliest presentation, has the best survival rate, but this drops significantly for Stage 2.
Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally. See www.intuition.ie and @intuitionhealthandwellness