Smoking is a well-known risk factor for developing lung cancer, but what are the other risk factors for people who don’t smoke?
Dr. Villani: Risk factors for lung cancer other than smoking include second-hand smoke, occupational exposures such as radon, air pollution, and asbestos, and having a family history of lung cancer.
Lung cancer cases tend to cluster within families. Does that mean it’s a genetic issue? Not at all. No genes, such as BRCA, have been found to contribute to a family history of lung cancer, as is the case with breast cancer. However, people with a family history of lung cancer have a higher risk of developing lung cancer than the general population.
When it comes to lung cancer in non-smokers, we need to find reliable genes. We also know that mutations in a gene called epidermal growth factor receptor (EGFR) may increase your risk.
What is EGFR? What happens in the body when this mutation occurs?
EGFR is a protein that is present in countless cells in the body and helps them grow. Some cells in our bodies grow and die, or old cells are constantly shed to make way for new ones. The balance between cell division and cell death is important. When EGFR is mutated, the balance is disrupted and constant signals are generated for cells to proliferate. Excessive cell proliferation is one of the factors in cancer development.
According to the American Lung Association, EGFR-positive lung cancer usually occurs in a subtype of non-small cell lung cancer called adenocarcinoma, which is cancer that starts in the lining of the lungs. The American Cancer Society estimates that about 80% to 85% of cases are non-small cell lung cancer.
EGFR mutations are acquired rather than inherited. It is important to understand how this mutation is acquired, but it is still not understood. Studies have shown that this mutation accounts for the largest proportion of lung cancers in nonsmokers, with lung cancer incidence in nonsmoking East Asian women reaching approximately 60% to 74%.
Why do Asian American women have this mutation that ultimately leads to excessive cell proliferation and lung cancer? We don’t have the answer, and research is working to understand it. is.
What are the current lung cancer screening guidelines and how can they be improved?
Lung cancer screening has been shown to reduce the risk of dying from lung cancer by 20%. To be eligible for screening, you must have a history of smoking 15 packs per year and be between 45 and 75 years of age. However, the participation rate for lung cancer screening is extremely low. The number of people eligible for and receiving screening is very small, with approximately 13% of those eligible receiving screening.
But in this scenario, we’re talking about an Asian American woman who isn’t a smoker. And the problem is, there are no guidelines on how to test these women. Research is currently being conducted on Asian American women. We need to focus on risk factors to develop a risk profile that ultimately helps decide who should be tested.
What are the signs and symptoms of lung cancer?
Tell your doctor if your symptoms persist, such as cough, shortness of breath, hemoptysis, weight loss, or chest pain, and tell your doctor if you have any other risk factors, such as exposure to radon or family history. please. You don’t want someone to think they have lung cancer just because they’ve had a cough for a week. But certainly, if something persists, see your GP. We can recommend a low-dose computed tomography (LDCT) scan to find out.
What is the treatment for lung cancer?
Treatment strategies include surgery if the cancer is localized in the lungs, as well as chemotherapy, radiation therapy, and immunotherapy such as immune checkpoint inhibitors. Immune checkpoint inhibitors use the immune system to attack cancer, slow or stop cancer cell growth, prevent cancer from spreading, and help the immune system destroy cancer cells. .
For adenocarcinomas caused by EGFR mutations, the mutation is known to be the cause of the defect. Targeted drugs that target receptors have been developed to prevent cell overgrowth. And those drugs are oral. Can be taken at home, this treatment has minimal toxicity. These drugs may be effective not only in people with advanced disease, but we have now elevated these drugs to help prevent recurrence in people with early-stage disease. So if someone has early-stage lung cancer and has had surgery, we now use those targeted oral drugs to prevent the disease from coming back.
We have come a long way in terms of treatment. And as people participate in clinical trials and contribute to scientific advances, we will discover more treatments. It’s just a matter of working together. There is no need to be afraid to participate in a clinical trial if one is available, for example, a screening trial for Asian women only. I strongly encourage Asian women to participate in screening programs. What we want to do is collect data to ultimately get answers.
