The link between smoking and lung cancer is deeply ingrained in the American psyche. Despite this awareness, many of us have some preconceived ideas about lung cancer that don’t quite add up. Here we examine eight common myths about lung cancer and uncover the truth about this devastating disease.
By Julianne Hale
While cigarette smoking is the single greatest predictor of lung cancer, people who do not smoke can still get the disease. In fact, up to 20% of lung cancers are in nonsmokers.
Exposure to radon gas, which sometimes becomes concentrated in homes built on soil with natural uranium deposits, accounts for more than 20,000 deaths from lung cancer each year. Exposure to secondhand smoke accounts for an estimated 7,000 deaths each year.
Occupational exposures to carcinogens – such as asbestos, diesel exhaust, or certain other chemicals – can significantly increase your risk of lung cancer. Nonsmokers who work around asbestos are five times more likely to develop lung cancer than those who don’t.
One particular kind of lung cancer—bronchioloalveolar carcinoma (BAC)—is more common among nonsmokers. BAC accounts for 2 to 14% of all lung cancers and is more likely to impact younger non-smoking women. This disease, nicknamed “the masquerader” because its symptoms often resemble pneumonia, is on the rise.
It doesn’t matter if you’ve smoked for 30 days or 30 years, quitting helps reduce your lung cancer risk and can dramatically improve your overall health. According to the Centers for Disease Control (CDC), your risk of heart attack drops dramatically just one year after you quit smoking. Within two to five years, your risk of stroke will be the same as if you had never smoked, and within five years your risk of a handful of other cancers—mouth, throat, esophagus and bladder—drops by half.
A study published in the New England Journal of Medicine reports that quitting smoking by the age of 40 can reduce your chances of dying from a smoking-related disease by 90%. If you’re over 40, take heart: you can still reduce your chances by two-thirds if you quit by the time you’re 54. The National Cancer Institute advises smokers to quit no matter what age they are, reporting that quitting by age 60 can add years to your life.
While there is no question quitting is good for your health, it doesn’t abolish your risk. Risk of developing lung cancer still remains higher in former smokers than in nonsmokers. “There are actually more new lung cancers diagnosed in ex-smokers than in active smokers,” says Dr. Hisham Qutob, pulmonologist with CHI Memorial Lung Care Associates. “If you’ve had a large enough inhalation, lung cancer can appear two or three decades later.”
Your individual risk depends on the length of time you smoked and how heavily you smoked. The CDC defines heavy smoking as a history of 30 or more pack years. A pack year is an average of one pack per day. So if, for example, you smoked two packs a day for 15 years or three packs a day for 10 years, you would be considered a heavy smoker. Heavy smokers or those who started young should have an annual screening for at least 15 years after quitting.
Even though the typical lung cancer patient is 70 years old, the disease impacts adults of all ages. Each year, around 30,000 people under the age of 50 are diagnosed with lung cancer and about 66% of those diagnosed will die from the disease. Up to 6% of people diagnosed with lung cancer each year are under the age of 40.
Medical history, genetics, and other factors contribute to a person’s risk of developing lung cancer at a younger age. “Generally, mutations from smoking take several decades to cause cancer, but with certain genetics it can occur earlier in life,” says Dr. Harsha Shantha, pulmonologist with Parkridge Medical Group—Diagnostic Center. “I personally have had the unfortunate experience of caring for patients in their 40s with lung cancer, as well as one young man in his mid-20s with two types of lung cancer at the same time.”
Cigarettes tend to be the focus of the association between lung cancer and smoking that has entered the American collective consciousness, but they aren’t the only culprit. Light cigarettes, pipes, hookahs, cigars, and e-cigarettes all contain cancer-causing substances and have been shown to cause lung cancer to varying degrees. Studies show that smokers who choose light cigarettes in the hopes of reducing their cancer risk tend to try to compensate for the lower levels of nicotine and tar by smoking more or inhaling more deeply. Cigars and hookahs may actually be more harmful than cigarettes because of the length of time it takes to smoke these products.
E-cigarettes, while considered “smokeless,” contain excessive levels of a known carcinogen, formaldehyde. The U.S. Food and Drug Administration (FDA) began applying provisions of the Family Smoking Prevention and Tobacco Control Act to the sales, marketing, and manufacturing of e-cigarettes in August of this year.
We all know the importance of a yearly mammogram and the significance of a pink ribbon, but it may surprise you to discover that lung cancer, not breast cancer, is the leading cause of cancer death in U.S. women. In fact, the number of annual lung cancer deaths in women exceeds those from all gynecological cancers combined.
“The rate of lung-cancer related deaths continues to increase in women, and especially in nonsmoking women,” says Dr. Shantha. “In nonsmoking women, the incidence of lung cancer is much higher compared to nonsmoking men.”
“For every two and half breast cancer diagnoses, there is one lung cancer diagnosis in women, but lung cancer is more deadly,” says Dr. Qutob. “Awareness of this statistic is the first step toward prevention.”
Smoking is a devastating habit that impacts nearly every system of the body. In addition to lung cancer, smoking can cause cancer of the larynx, esophagus, mouth, kidney, throat, bladder, liver, pancreas, stomach, cervix, colon, and rectum. It can also contribute to acute myeloid leukemia. “It’s the causative agent in numerous cancers and a contributor for nearly a third of all cancer deaths,” says Dr. Shantha.
Smoking is also responsible for an array of other diseases and conditions, including stroke, heart disease, diabetes, osteoporosis, rheumatoid arthritis, cataracts, asthma, and more. Inhaling smoke introduces dangerous chemicals into the bloodstream, which is why the habit causes so many diseases. It’s also why quitting can have such an incredibly positive impact on overall health and wellbeing.
The disease tends to be discovered at a late stage when it has spread to other parts of the body, making it difficult to treat. However, there are multiple treatments available depending on the stage of the cancer. As with most cancers, early detection makes all of the difference, and there have been significant improvements in detection and treatment of lung cancer in recent years.
An annual low-dose CT lung cancer screening is recommended for anyone between the ages of 55 to 80 who has a smoking history of 30 or more pack years and has quit within the past 15 years. This technology helps increase the rate of early detection and can improve the lung cancer mortality rate by up to 20%. Additional hope can be found in new and improved treatment options, including the use of immunotherapy, which shows great promise in the treatment of lung cancer.
For more information, visit LungAction.org, Lung.org/community or LungForce.org.