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Lung cancer symptoms even non-smokers should know

Lisa Fogarty

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Lisa Fogarty

Lisa Fogarty has written numerous articles for USA Today, The Stir, Opposing Views and other publications. She has covered everything from red carpet events to the discovery of toxic PCBs on school windows. She lives on Long Island, N.Y....

Just because you don't smoke, doesn't mean you can't get lung cancer

Lung cancer is the No. 1 cancer killer in women — here's everything you need to know when it comes to symptoms and signs of the deadly disease.

If you've never smoked or you can still remember that day in senior year when you put out your last cigarette and vowed to never touch them again, lung cancer is a disease you probably assumed you'd never need to worry about — but it should actually be on everyone's radar. The assumption among most of us is that it's a cancer that affects only those people who have been faithfully smoking for decades and have no plan on quitting. The truth of the matter is that it is a far more pervasive illness than many of us think.

"Lung cancer in female non-smokers is rapidly increasing for reasons that are still unclear," says Dr. Jack Jacoub, medical oncologist and director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, California. "Cancer in smokers is associated with a 20-30 year latency period, so it often takes a long time from when someone starts smoking and when cancer develops. Also, the risk of lung cancer never goes to zero if one smokes and then quits, but the risk steadily decreases."

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In addition to smoking, other causes of lung cancer that some might not be aware of include secondhand smoke, radon gas, asbestos and even air pollution, says Dr. Robert McKenna, Jr., thoracic surgeon at Providence Saint John’s Health Center in Santa Monica, California. "Twenty percent of people with lung cancer have never smoked," McKenna says. "I recently published a paper a couple years ago about this very topic. I studied the time interval between stopping smoking and diagnosing lung cancer. [It took] 38 percent of people with a smoking history and lung cancer more than 20 years before developing their lung cancer."

A low-dose CT lung cancer screening is highly recommended for people ages 55-80 who have smoked or previously smoked one pack per day for 30 years, Jacoub says. And doctors hope lung cancer is detected way before symptoms begin showing up, because once they do, it usually means the cancer is advanced.

Symptoms of lung cancer vary depending on the stage of the disease, says Dr. Andrea McKee, chairman of radiation oncology at Lahey Hospital and Medical Center at Sophia Gordon Cancer Center and a member of the American Lung Association’s Lung Force lung cancer expert medical advisory panel. "Some patients may present with shortness of breath, new cough, coughing up blood, arm or shoulder pain, or fever with pneumonia," McKee says. "In the absence of screening, lung cancer is diagnosed in the later stages of the disease in 7 out of 10 individuals, with a spread of the lung cancer cells to parts of the body outside of the lung. In these situations, patients might present with symptoms described above as well as possible headache, nausea, focal numbness or weakness, seizure, back pain, bone pain, fatigue, or weight loss."

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Although McKee says it can be difficult to know lung cancer is present without the onset of symptoms, there is some good news: "We now know screening with a low dose CT scan of the chest in those at high risk for lung cancer affords an opportunity to detect lung cancer in the early stage of disease such that one in five deaths due to lung cancer can be prevented in this patient population through early detection," McKee says.

And it sounds like insurance companies may be onto the idea that an early screening is the best prevention. "Medicare has recently approved screening so we want high risk people to get screening CT scans because they are shown to reduce the mortality rate for lung cancer by 20 percent," McKenna says.

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If you are a smoker, you already know what I'm going to say. But it sounds like it might be a solid idea for all of us to speak to our doctors when we turn 55 about whether we are good candidates for a lung cancer screening.

"Your physician can help you to understand your risk for developing lung cancer, as can a number of online risk calculators, including one available at the American Lung Association’s LUNGFORCE.org," McKee says. "If you feel you might be at high risk for developing lung cancer, now is the time to become educated about the potential risks and benefits of screening and early detection."

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