The Tribune

By DR PAUL RAMPHAL

Cardiothoracic Surgeon

AS the Cancer Society of The Bahamas observes August as Lung Cancer Awareness Month, Dr Paul Ramphal, a cardiothoracic surgeon, is answering these questions and more to raise awareness of this deadly disease.

Through increased education, people can become better equipped to lower their risk or detect it early, when treatment is most effective.

Lung cancer, the most commonly diagnosed cancer in the world, usually starts in the airways or small air sacs (alveoli), where the lungs and blood exchange oxygen and carbon dioxide during breathing.

When lung cancer occurs, genetic DNA damage, often due to smoking or inhaling hazardous chemicals, causes cells to grow uncontrollably and form a tumour.

Without treatment, the tumour can spread throughout the lung, destroying healthy tissue and damaging lung function.

Dr Ramphal says eventually the tumour will spread to other parts of the body.

Types of Lung Cancer

The two main types of lung cancer are:

Non-small cell lung cancer (NSCLC): This is the most common type of lung cancer, accounting for approximately 85 per cent to 90 per cent of all cases.

Small cell lung cancer (SCLC): Compared to non-small cell lung cancer, small cell lung cancer grows more quickly and is harder to treat.

Symptoms of Lung Cancer

Lung cancer is referred to as a silent killer, as it doesn’t display any symptoms in its early stages. When lung cancer is advanced, symptoms may include:

•    A new cough that doesn't go away.

•    Chest pain.

•    Coughing up blood, even a small amount.

•    Hoarseness.

•    Shortness of breath.

•    Wheezing.

As lung cancer spreads to other parts of the body, such as the neck or back, it causes other symptoms to appear. Some of these symptoms are:

•    Bone pain.

•    Headache.

•    Losing weight without trying.

•    Loss of appetite.

•    Swelling in the face or neck.

Risk Factors

Whether it's cigarettes, cigars, or pipes, smoking tobacco products is the leading risk factor for lung cancer.

Dr Ramphal said that smoking causes at least 80 per cent of all lung cancer cases. In addition to damaging cell DNA, tobacco smoke can introduce carcinogens (cancer-causing substances) and weaken the body’s immune system.

While smoking is the most well-known and common cause of lung cancer, he states that other risk factors include :

    •    Being exposed to secondhand smoke.

    •    Exposure to harmful substances, like radon, asbestos, uranium, diesel exhaust, silica, coal products, and toxins in the air.

•    Having previous radiation treatments to your chest.

•    Having a family history of lung cancer.

Screening

To check for early signs of lung cancer in patients without any symptoms, doctors employ an annual low-dose computed tomography (LDCT) scan. The screening test is fast and painless. Current guidelines, recommend annual LDCT scans to adults who meet the following requirements:

•    Aged 50 to 80 years old.

•    Heavy smoking history of at least 20 pack-years (such as 1 pack a day for 20 years).

• Current smoker or someone who quit within the past 15 years.

Diagnosis

Diagnosing lung cancer is a multi-step process, typically beginning with an examination of the patient’s medical history and ending with a biopsy.

Initial Evaluations

•    Medical history: Doctors ask about your health and symptoms.

•    Physical exam: Checks for lumps, swelling, or other changes.

•    Lab tests: Blood and urine tests check for abnormal chemical levels or tumor markers

Imaging and Scans

•    CT and MRI scans: Create detailed pictures of the inside of the body.

•    Ultrasound: Uses sound waves to see organs and tissues.

•    PET scan: Uses a safe radioactive material to highlight active cancer cells.

Confirmation

•    Biopsy: Removes a small tissue sample to check for cancer cells under a microscope.

Treatment

Depending on its stage, healthcare providers target lung cancer with a combination of two or more treatments, each designed to either remove the cancerous cells from the body or slow down their growth.

Some of the main treatment options for lung cancer, include the following:

Surgery: When the tumour is localised and hasn’t spread, it can be removed using surgical procedures, the most common being lobectomy, segmentectomy, and pneumonectomy.

Chemotherapy: Uses drugs to shrink the tumour and stop it from growing.

Radiation Therapy: Uses high-energy beams, such as X-rays, to destroy cancer cells.

Targeted Drug Therapy: Uses specialised drugs that block specific genes, proteins, or tissue environments that cancer cells need to grow and divide.

Immunotherapy: Stimulates the body’s immune system to fight cancer.

Prevention

While there is no guaranteed way to prevent lung cancer, you can significantly reduce your risk by making several lifestyle choices, such as:

•Not smoking.

•Avoiding secondhand smoke.

•Limiting workplace toxins.

•Eating healthy foods.

What is the Cancer Society doing to help?

The Cancer Society encourages Bahamians to become more proactive with their health, stop ignoring the warning signs, and seek medical help by getting screened.

The Cancer Society will continue to provide information on our social media platforms, in our weekly newsletter, and at health fairs.

At the Cancer Society, we offer the following programs and services for persons diagnosed with cancer:

• Free accommodations and transportation to the Family Islanders undergoing cancer treatment in New Providence.

• Emotional and mental support at our Adult Support Group.

•  Holding quarterly social events for children aged 2 – 17 years in our Freedom Kids Club.

• Financial Treatment Assistance Program (funded by the Bahamas Hope Challenge) for unemployed or uninsured persons who have been diagnosed with cancer.

• Monthly Free Pap Smears and PSA Screening in the Family Islands.

•  Free mammogram screenings in Nassau for women from various Family Islands through the FIMS (Family Island Mammogram Screenings) program.

To learn more about what the Cancer Society is doing, subscribe to our newsletter at www.cancersocietybahamas.org/newsletter. Call us at (242) 323-4441 or (242) 325-2483 or email us at admin@cancersocietybahamas.org to become a volunteer, spokesperson, or advocate for a healthier Bahamas.