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gross

Lung cancer

Silent, deadly and mostly self-inflicted

Lung cancer is the most common cancer in men in developed countries, and it is definitely one of the cancers with high death rates. Nearly 60 percent of Americans diagnosed with lung cancer die within one year after diagnosis, and 75 percent die within two years. After five years, only 14 percent are still alive. These survival rates have not improved in the past ten years.

Just for comparison: with colorectal cancer (CRC), another common cancer, about 50% of the patients are alive after five years – and CRC patients are usually older when their disease is diagnosed so their natural death rate is higher. In other words, lung cancer kills a much higher proportion of the people diagnosed with this disease than CRC does.

Every year, 1.4 million people worldwide are diagnosed with lung cancer, and 1.2 million will die from this preventable disease.

Small cell versus non-small cell lung cancer

There are basically two types of lung cancer: Small cell lung cancer and non-small cell lung cancer. The distinction is important because the therapy is different. Small cell lung cancer (SCLC) responds to radiation and anti-cancer drugs (chemotherapy), while non-small cell lung cancer (NSCLC) can sometimes be treated with surgery and needs other anti-cancer drugs. NSCLC is the more common kind and accounts for about 85-90 percent of all cases of lung cancer.

Causes of lung cancer

The main cause of lung cancer can be expressed in two words: Tobacco smoke. This poisonous substance contains over 60 known cancer-causing agents (carcinogens). The more cigarettes a smoker consumes per day, and the longer he or she smokes, the higher their risk of lung cancer. In the United States, smoking is estimated to account for 90% of lung cancer cases in men and 80% in women, according to the Centers for Disease Control.

There are some non-smokers who develop lung cancer: People who live or work with a smoker and are exposed to second-hand smoke, so-called 'passive smokers'.

In very rare cases, other possible causes of lung cancer have been described, such as asbestos, air pollution or naturally occurring radioactive radon gas.

Signs of lung cancer, and diagnosis

Early possible signs of lung cancer include coughing and shortness of breath. However, these symptoms are very common in smokers and may also occur in chronic obstructive lung disease, another disease found in smokers. Many lung cancer patients do not have any distinct symptoms, particularly earlier in the course of the disease.

Other symptoms include chest pain, wheezing, coughing up blood, and persistent bronchial infections. All of these signs can also occur in other diseases, so it is important to see a doctor.

Lung cancer is usually diagnosed by taking a chest X-ray. If the X-ray shows a suspicious mass (a round 'shadow' is typical), doctors can take a sample of the suspicious tissue (a biopsy), which may involve inserting a tube into the airways – a procedure called bronchoscopy.

Treatment of lung cancer

Treatment of lung cancer depends on the type and stage of the cancer, on the patient's general health, and on the status of metastasis – if the tumor has already spread or not.

Surgery is an option for localized tumors that have not yet spread. The aim is to remove the tumor completely. If surgery is not possible, radiotherapy (irradiating the tumor with ionizing rays) is often used, mostly in combination with anti-cancer drugs (chemotherapy).

Where surgery, radiotherapy and chemotherapy fail, palliative care is the only option left. This means treating symptoms as they appear, and making the patient as comfortable as possible. Palliative care is often combined with episodes of chemotherapy to improve life expectancy.

New drug under investigation for lung cancer

Bayer is currently investigating an anti-cancer drug for the treatment of lung cancer in patients with advanced NSCLC who have failed two or three previous treatments. The study is being conducted at more than 120 sites in North America, South America, Europe, Africa and the Asia-Pacific region, including Japan. First results of the trial are expected in late 2011 or early 2012.

The drug is applied as a tablet twice a day, and it is already approved in more than 100 countries for the treatment of kidney and liver cancer.

Advice for patients
Everybody reacts differently to medicines. Therefore it is impossible to tell which medicine works best for you. Please consult your physician.