Lung cancer has doubled over past decade – Respiratory Physician | Sunday Observer

Lung cancer has doubled over past decade – Respiratory Physician

21 November, 2021

Lung cancer is considered a major health problem globally and in Sri Lanka. Recently according to reports, there has been a surge in the number of cases has been detected in Sri Lanka. The Sunday Observer spoke to a leading chest specialist Dr. Hiranthe Pathirathne, Consultant Respiratory Physician, Provincial General Hospital, Badulla.

Dr Hiranthe Pathirathne if this was true when compared to a decade ago?

In reply he said, “ Absolutely. If we go by figures; in 2010, there had been 1015 reported lung cancer cases; while the figure in 2020 is 2072. Therefore, the actual number has doubled.

To our question as to who was most at risk for developing it according to age and why , he said, “ Risk for any cancer increases with aging. Therefore, we commonly encounter lung cancer in age group 55-65. The risk rises steeply after age 50. After 65 years we see less number of patients probably because the survival is less. Lung cancer is the leading cause of death out of all cancers in Sri Lanka.

Queried as to whether gender wise more males or females were at risk and why there was a difference in the percentages, he said “ Obviously there is a male preponderance as they are exposed to smoke more than females. Yet, currently we see an increase in non smoking males and females, which is an alarming fact.”

Cigarette smoking has been cited as being the greatest risk factor for lung cancer accounting for roughly 85 percent of all cases in the US. We asked Dr Pathirathne how far these figures were applicable to Sri Lankan smokers. In response he said, “ It is the same. The cumulative results of currently available cohort studies in Sri Lanka show that about 84% of lung cancer patients smoke.

Asked if there were other risk factors as well he said, Yes. Apart from smoking other common risk factors include ageing; exposure to Radon, asbestos and poor quality outdoor air; presence of other chronic lung disorders; family history of lung cancer and dietary factors

Asked if a patient with suspected symptoms came to his clinic, whether he had trained MOH’s and Public Health Midwives to diagnose the symptoms or if they needed to be referred to a specialist, he said, Clinical presentation of a lung cancer could be diverse. Majority will have respiratory symptoms like cough, wheeze, passage of blood with sputum and breathlessness. These symptoms are often accompanied with constitutional symptoms like loss of appetite and loss of weight. Rarely patients may present with non-respiratory symptoms like unexplained weight loss, confusion, memory loss, skin rashes, etc.

As a majority present with respiratory symptoms, many would get initially treated symptomatically. This would rather delay the diagnosis. A careful evaluation of the symptoms/signs and meticulous interpretation of initial chest radiography is the key for an early diagnosis. As many chronic respiratory conditions have similar clinical presentations a specialist opinion is rather mandatory in this scenario.

As readers who fall into any of these risk categories may want to know what symptoms they should look out for as an early warning, we asked him to list a few of the important symptoms. In reply he said:

A long standing cough with constitutional symptoms, passage of blood with sputum or haemoptysis, a recent voice change, new onset wheeze or breathlessness are few of the important symptoms.

Asked if it was curable if detected in the early stages, he said, “Definitely. Early stages of lung cancers can be surgically removed and are curable. ”

On treatment options available for Sri Lankan patients he said, that Treatment options depend on the stage of the lung cancer and other patient factors, noting that all major hospitals (provincial) are equipped facilities for chemo/radiotherapy.

Second hand smoking has also been cited as equally dangerous and a high risk to developing lung cancer. We asked him to explain what second hand smoking was. He said, “Secondhand smoke or passive smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by smokers. It also contains various carcinogens. It is the major risk factor attributed for lung cancer among non-smoking.

Our final question was how we can prevent lung cancer.

In reply he gave us the following advice:

“Quit smoking if you are a smoker and never smoke if you are a non smoker. Avoid being exposed to smoke of any origin. Avoid being exposed to air which is poor in quality. Maintain a good physical fitness. Have a diet rich in natural anti- oxidants i.e, diet rich in fruits and vegetables. If you suffer from a chronic respiratory illness have a good and a regular follow up of your illness with the doctor. If you develop a warning sign as described above, seek medical attention early.’