Lung cancer: one of the deadliest


Lung cancer is a disease that is very frightening, because it really is one of the most lethal.

However, there is also great hope in the treatment of this pathology, since advances have made it possible to increase survival.

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We explain what it is, what the symptoms are and how it is treated.

What is lung cancer?

the lung cancer It is responsible for the highest number of deaths among all types of tumors and its incidence has been increasing among women in Western countries due to the increase in female smokers. Worldwide, this tumor appears in 1.6 million people each year and leaves 1.3 million deaths. In our country, more than 400,000 people have died because of it in the last twenty years. And for the future, it is estimated that the numbers will continue to rise.

There are basically two types of lung cancer : small cells and non-small cells. But in the era of personalized medicine, there are many more that are defined by genetic changes that we can treat with targeted therapies or immunotherapy. In the very distant future, each tumor will be treated differently depending on its molecular profile.

Tobacco, one of the causes

Unlike most cancers, in this type one of the causes is known: smoking. In fact, if you stopped smoking, up to 90% of lung cancers would disappear. In this sense, one of the necessary actions in 2019 according to the GECP is the primary prevention of tumors and the fight against smoking. At a social level, it should not be forgotten that the most effective action against lung cancer is primary prevention, avoiding or reducing smoking and the increase in tobacco consumption is worrying, especially in the adolescent population and in women. Therefore, new specific actions are necessary to reduce the incorporation of the smoking habit in this group.

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Other risk factors

  • Exposure to radon, a radioactive gas found in Earth’s rocks and soil, formed by the natural decay of radium
  • Exposure to carcinogens such as asbestos, uranium, arsenic and certain petroleum products,
  • Genetic predisposition, as it is known that cancer can be caused by mutations (changes) in DNA, which activate oncogenes or inactivate tumor suppressor genes. Some people inherit DNA mutations from their parents, greatly increasing their risk of developing cancer.

Lung cancer symptoms

Among the most common symptoms are:

  • Cough or chest pain that does not go away and may be accompanied by expectoration.
  • Wheezing, shortness of breath.
  • Coughing or sputum of blood.
  • Hoarseness or swelling in the face and neck.
  • Dyspnea or feeling short of breath

How is it treated?

Until recently, treatment consisted of surgery for some (approximately 30%) with or without additional treatment combined with radiation and/or chemotherapy. “Conventional chemotherapy is used in the majority, as 40-50% of patients start with extensive disease. However, for some years now we have targeted therapies, including TKIs (tyrosine kinase inhibitors) that are very effective in patients with EGFR gene mutations (10-15%), drugs targeting tumors that have ALK gene translocations, and more recently , immunotherapy, an innovative concept that is based on the recovery of the immune response against the tumor”, explains physician Luis Seijo.

Immunotherapy in lung cancer

In the last five years, lung cancer was the tumor that showed the most improvement in terms of survival, thanks to the development of new immunological drugs, biomarkers and personalized therapies. However, with an overall survival of 10%, we are still far from what has been achieved in the breast or colon.

Therefore, for this research group made up of 470 experts from all over the country, 2019 will be a key year in terms of research and action against the tumor, but for that, more public resources are needed to promote the development of clinical trials and specific actions. for primary prevention.

“Lung cancer is the tumor that can benefit most from immunotherapy discoveries, but more resources need to be allocated to its research,” says Dr. Mariano Provencio. And is that lung cancer is responsible for 21.5% of all cancer deaths in Spain and receives only 4.1% of public funding for cancer research.

In this sense, as explained by Dr. Bartomeu Massuti, “immunotherapy has established itself as a therapeutic alternative for many patients with metastatic and locally advanced lung cancer and opens the expectation of prolonging survival in groups of patients, to a greater extent than cytotoxic chemotherapy and treatments aimed at genomic alterations” . For the secretary of the GECP, “the next challenges that are already being investigated are the combinations of immunotherapy with other immunomodulatory drugs, with chemotherapy and with radiotherapy”.

What does the prognosis of this disease depend on?

The prognosis largely depends on the stage of the tumor, which is defined as in many other tumors by the location and size of the tumor, the presence of lymph node involvement, and metastasis. Lately it is being seen that “the molecular profile also influences. Some patients with very extensive disease can live for years if the tumor has a favorable mutation that allows us to use any of the drugs mentioned. Gender, age, smoking and status also influence the patient.

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