Lung cancer. Here in eastern North Carolina, it is almost impossible to think of anyone whose life has not been impacted by this disease. It touches us, but are we aware of it in ways that can make a difference in our health and well-being? For most of us, the answer is no. We tend to see cancer as an abstract disease that happens to other people; therefore, real awareness is not necessary.

Unfortunately, lung cancer is killing us, not just in eastern N.C., but worldwide. Each year, 1.6 million deaths across the globe are caused by lung cancer — that is 27 percent of all cancer deaths annually. Lung cancer reigns as the No. 1 cancer killer for both women and men, causing more deaths per year than all colon, breast and prostate cancers combined. With statistics like these, we need as much awareness and education as we can get.

Lung cancer is a relatively quiet disease in the early stages. Tumors often go unnoticed until in advanced stages when they are large enough to obstruct airways. Symptoms such as chronic worsening cough, shortness of breath and/or constant dull chest pain may not appear until then. Because these symptoms mimic the symptoms of other respiratory diseases such as bronchitis and COPD, diagnosis can be difficult. Pain is minimal in the early, more treatable stages due to the limited amount of nerve endings scattered throughout the lungs. As with any cancer, the later it is diagnosed, the more difficult it is to treat.

Smoking is the primary cause of lung cancer in the United States. According to recent studies, approximately 90 percent of all patients with lung cancer are active smokers at the time of diagnosis. The other leading causes of this disease are the passive exposures to second-hand smoke, radon and environmental pollutants. More men than women have lung cancer at any given time, but women tend to survive longer after being diagnosed. In the U.S., fewer black adults smoke than white adults, but their cancer rates are higher. According to the U.S. Preventive Services Task Force, 8.6 million Americans are considered to be at high risk for developing lung cancer.

For the first time in three decades, smoking declined among adolescents 18 and under. While this is good news, the use of e-cigarettes (“vaping”) and hookahs (water pipes) is increasing in the 19- to 25-year-old group. The jury is still out on the safety of e-cigarettes, but it is worth noting that there are still multitudes of chemicals in the inhaled vapor. Hookahs have been shown to produce carcinogens similar to those found in cigarette smoke. Smoking a hookah for one hour is equivalent to smoking 10 cigarettes. Even with these products, the risk of lung cancer is still very real.

One of the most exciting advances in the prevention and treatment of lung cancer is the advent of the low-dose CT scan screening for high-risk adults. Annual screening with this LDCT has proven to be far superior to detecting early stage lung cancer in this target group than any other screening tool. Studies show that the use of LDCT reduces mortality by more than 20 percent compared to the standard use of chest x-ray for diagnosis. The USPS Task Force defines high-risk as “asymptomatic adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit smoking within the past 15 years.” Anyone who falls into this category should ask their doctor if they should get this screening.

Becoming more aware of lung cancer, the symptoms, treatment options and especially prevention makes it easier to combat this horrific disease. There have been more advances in lung cancer treatment in the last five years than there have been in any other disease. With this awareness comes the hope of one day curing it. Current treatments include surgery, radiation, chemotherapy, targeted therapy, immunotherapy, participation in clinical trials and palliative care. Prevention, however, remains the best treatment option.

If you currently smoke and want to quit:

• Talk to your doctor about medications that might be able to help you;
• Start nicotine replacement therapy with the patches or gum available at most all retailers;
• Go to websites such as www.lung.org (American Lung Association) or www.quit.com for more information on breaking free from cigarettes.

Alene Payne, MS, RRT/RCP, is manager of Cardiopulmonary Services at Vidant Beaufort Hospital.