Lung cancer deaths are increasing among those who have never smoked. In the US, it is the sixth cause of death among cancer, and in the world – seventh – warns “New Scientist”.
Lung cancer has been the leading cause of death in cancer for many years. It is far ahead of colon, breast, pancreatic and prostate cancer. But in the next place is the separately counted lung cancer in people who are not and were not smokers.
In the USA, this type of cancer already accounts for 17,5 percent. all lung cancer cases. There are even more of them in Southeast Asia, where over 50 percent. women with lung cancer have never smoked.
Mick Peake of the University of Leicester points out that non-smokers die of lung cancer three to four times more often than women with cervical cancer.
In his opinion, lung cancer in non-smokers should be treated as a separate oncological disease, because its specificity is different and requires a different diagnosis. It was also then that the effectiveness of his treatment could be improved.
“New Scientist” gives an example of American Stephania Dunn Haney, who initially experienced a sharp pain on the right side of her chest, which appeared after sneezing or coughing. It was 8 years ago. She thought then that she must have broken a rib, which could not be helped anyway. So she decided to wait.
She did not report to the doctor until one and a half years later, because the symptoms still did not go away. She received a referral for a chest X-ray, but the tests showed nothing. Over the next 18 months, she was examined with magnetic resonance imaging, and she was referred to physiotherapy and chiropractic. The pain in the chest, however, persisted.
Haney began to suspect that she might have cancer, but the doctor reassured her that it was rather impossible, because she had never smoked cigarettes, and no one in her family had suffered from this cancer. When computed tomography was performed, a shadow was detected in the lungs, which was interpreted as post-infection calcification. But she was still persuaded that it couldn’t be a tumor. At her request, an operation was performed to take a specimen from the lungs for histopathological examination. And only then was it confirmed that she had cancer.
Some people may have a genetic predisposition to lung cancer. They can get sick even when they do not smoke, they are not exposed to the so-called passive smoking or atmospheric pollution. And when they develop disturbing symptoms, they are often neglected by doctors, as in Stephanie Dunn Haney’s. They are also less often referred to oncologists compared to patients with suspected other neoplastic diseases, e.g. breast cancer.
Meanwhile, the effectiveness of treating these patients may be even twice as high as in cigarette smokers who have developed lung cancer. This is indicated by research carried out a few years ago by Paul Paik from Memorial Sloan-Kettering Cancer Center in New York. This year he showed that non-smokers with lung cancer are more likely to have a genetic mutation that makes them more responsive to treatment.
Three genes influence the development of lung cancer: EGFR, ALK and KRAS. The worst prognosis is patients with the KRAS mutation, which occurs ten times less often in patients with lung cancer who did not smoke. In people who were addicted to tobacco for several years and then got rid of the addiction, the prognosis is intermediate between these two groups of patients.
Lung cancer patients who have never smoked tend to have fewer genetic mutations, so they generally respond better to drugs in the so-called targeted therapy. When the disease is already advanced, there is no chance of a cure, but this can extend the life of the patient by 18 months or even more.
Stephanie Dunn Haney has been successfully treated for over 4 years, although no oncologist wanted to treat her because they believed that there was no chance of a successful treatment. “I told them that I was only 39 years old, had two young children, 2,5-year-old Allie and 4,5-year-old Libby. And that I have to overcome this disease, she recalled in an interview with New Scientist. Doctors admitted that it is good to treat patients who are determined to fight cancer, but sometimes they do not know when further treatment does not make sense.
She visited several specialists before finding an oncologist in Pennsylvania who decided to treat her. She was ordered to undergo chemotherapy and then received two new-generation drugs, erlotinib and evacizumab. When the disease came back, she was given crizotinib. It is hoped that when this drug ceases to work, it will be switched to a new preparation, still tested in clinical trials, marked with the symbol LDK 378. (PAP)
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