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Lung Cancer: Risk, Symptoms & More

November 20, 2014 11:00 AM with Dr. Thomas Hensing

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Lung cancer is the leading cause of cancer death in both men and women in the United States. Smoking and exposure to secondhand smoke is one of the main causes of lung cancer; however, it is not the only risk factor. As a part of Lung Cancer Awareness Month this year, Thomas Hensing, MD, Medical Oncology at NorthShore, will answer questions on lung cancer, from risk and symptoms to treatment options and prognosis.

Brenna (Moderator) - 10:49 AM:
Our chat will begin at 11 am. You can submit questions now or at any point during the chat. Until we begin, please visit our Kellogg Cancer Center to find out more about Lung Cancer

  Yvette (Chicago) - 11:01 AM:
If my father's lung cancer is being called inoperable, does that mean there is nothing that can be done? He seems to think that is the case.
Dr. Thomas Hensing (NorthShore)
No, if a lung cancer is being called inoperable, it still may be treated with radiation and/or chemotherapy depending on the final stage.

  Audra (Evanston) - 11:02 AM:
Does screening for lung cancer even exist? Should long-term smokers get screened? If so, how often?
Dr. Thomas Hensing (NorthShore)
Hi Audra. Yes, screening for lung cancer with an annual low dose CT scan of the chest was recently shown to reduce the risk of dying from lung cancer by approximately 20%. The individuals screened for this trial were between the ages of 55 and 74 with a significant smoking history (defined 30 "pack-years" (i.e. average 1 pack per day for 30 years), including current smokers or people who quit within the last 15 years). The US Centers for Medicare and Medicaid services (CMS) recently supported a proposal to reimburse low dose CT screening for individuals with these characteristics.

  Mac (Wilmette) - 11:08 AM:
Catching lung cancer early seems to be pretty important for treatment and hopefully survival, but since screening isn't widely recommended, how are you supposed to do that? Are there early symptoms people should aware of?
Dr. Thomas Hensing (NorthShore)
Hi Mac. Thank you for your question. Please see my previous answer about screening. Lung cancer often dose cause symptoms such as cough or shortness of breath, but people can also present without any symptoms. Ultimately, it is important to work with your primary care physician to address risk factors for developing lung cancer, such as a smoking history or a family history of lung cancer. Screening may be indicated for asymptomatic individuals with the characteristics I mentioned in my previous post. For individuals with risk factors and new symptoms, such as cough or shortness of breath, a work up with a CT scan of the chest may also be indicated.

  Susan (Oak Park) - 11:15 AM:
What's the difference between small cell and non-small cell lung cancer? Is one caused by smoking and the other isn't?
Dr. Thomas Hensing (NorthShore)
Abouth 90% of lung cancer is non-small cell lung cancer. 10% of patients will have small cell lung cancer, which is associated with a heavier smoking history. Small cell lung cancer is usually (but not always) treated with chemotherapy with or without radiation, rather than surgery. About 10% of patients with lung cancer will be never smokers. Most of those patients will have a subtype of non-small cell lung cancer called adenocarcinoma.

  Jose - 11:20 AM:
I'm 20 and I've been smoking for 5 years. I want to quit but eveything you hear makes it sound like it is already hopeless like you are sure to get lung cancer no matter what. If I quit now will I still get lung cancer?
Dr. Thomas Hensing (NorthShore)
Hi Jose. Thank you for your question. It definitely pays to quit. The risk for developing lung cancer in individuals who used to smoke drops significantly over time, and in individuals with a limited smoking history such as yourself, the risk can get close to that of a never smoker.

  Anthony (Skokie) - 11:23 AM:
Why are survival rates for lung cancer so low? Is lung cancer just a more aggressive kind of cancer?
Dr. Thomas Hensing (NorthShore)
Hi Anthony - A significant "driver" of the low survival rates is that most individuals are still diagnosed with an advanced stage of lung cancer. As is true with cancer in general, the survival rates are much higher if lung cancer is diagnosed early. Hopefully the combination of finding lung cancer earlier through screening, reducing tobacco consumption and the continued development of new therapies, we will see significant improvement in lung cancer survival rates over time.

  Cameron (Chicago) - 11:29 AM:
My dad is about to start radiation treatment for stage 3 local non small cell lung cancer. He is 54 years old. I just want to know what to expect. What are the side effects? Will he look and feel terrible all of the time?
Dr. Thomas Hensing (NorthShore)
Hi Cameron - The side effects will depend also on whether or not he will be receiving chemotherapy with radiation and the specific agents that he will receive. However, in general, the most common risks associated with radiation to the chest include "esophagitis" (pain after swallowing) and "pneumonitis" (inflammation of the lung that can result in cough or shortness of breath). The risk of both side effects depends on the dose of radiation and the size of the radiation field. Typically, esophagitis occurs towards the end of radiation (a few weeks after starting) and pneumonitis is usually a delayed side effect that can develop a couple months after radiation is complete. I would make sure that he addresses all of the risks with his treatment team before starting. I would say, however, that most people feel ok initially and the risk for the side effects increases towards the end of the planned radiation course. I hope this helps - best of luck to your father.

  Robbie (Evanston) - 11:37 AM:
How could someone develop lung cancer from not smoking? why does this happen?
Dr. Thomas Hensing (NorthShore)
Hi Robbie - yes, about 10% of patients with lung cancer are never smokers. Some of those patients may have been exposed to 2nd hand tobacco, but many have not. In general, never smokers with lung cancer tend to be younger and a higher proportion are women for reasons that are unknown. There are many theories about why lung cancer may occur in a never smoker, but we don't yet have an answer for most patients.

  Jose - 11:41 AM:
Hi again Dr. Hensing. I had another quick question. I know you are an oncologist and so you see people once they already have cancer but do you have recommendations for how to stop smoking? Are there people you can see? Methods that work best?
Dr. Thomas Hensing (NorthShore)
Thanks Jose. If possible, I would typically advise someone to start with their primary care physician to see what resources are available in the community. We started a smoking cessation clinic for our patients several years ago and we've learned that it often takes multiple different approaches to help someone stop smoking (i.e. nicotine replacement (patch, etc), occasional medications, counseling, etc). There is no one standard approach for all individuals. Many primary care physicians can get the process started and then refer to local resources if available.

  Tom (Chicago) - 11:45 AM:
This is probably a stupid question but okay. So are "natural" cigarettes like American Spirit or if you roll your own less likely to cause cancer because they are not supposed to have the chemicals of regular cigarettes?
Dr. Thomas Hensing (NorthShore)
Hi Tom - There are no stupid questions here... I would say that there are no "safe" cigarettes. Regardless of how they are produced, there are a number of carcinogens in all cigarettes that can increase the risk for many cancers, including lung cancer.

  Brittany - 11:49 AM:
Can e-cigs or vapor cigarettes cause lung cancer? Are they safer than cigarettes?
Dr. Thomas Hensing (NorthShore)
Hi Brittany - I would emphasize that the safety of e-cigs has not been established and there is no evidence that I am aware of that they are safer than cigarettes.

Brenna (Moderator) - 11:49 AM:
There are 10 minutes left in our chat. Please submit final questions.

  Candice (Chicago) - 11:54 AM:
Do you always recommend second opinions if a biopsy comes back as lung cancer?
Dr. Thomas Hensing (NorthShore)
Hi Candice - I would say that in general, if someone is asking about whether or not to get a 2nd opinion, I typically advise them to go ahead and get one. 2nd opinions can be helpful to increase overall understanding of the diagnosis, as well as the prognosis and available treatment options. They can usually be done quickly so as not to delay starting treatment. Most centers will typicically get someone in for a 2nd opinion within a week.

Brenna (Moderator) - 12:00 PM:
Thank you Dr. Hensing for your time and thank you to all our participants for your questions.

Brenna (Moderator) - 12:01 PM:
For more information on the Kellogg Cancer Center, click here.

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