Smoking is the main factor in lung cancer cases. About 70% of the occurrences are of people who have or have had contact with cigarettes, according to the scientific publication in the United Kingdom. The BMJ. The expressive number means that most campaigns are aimed at this audience.
When looking at the remaining 30%, however, there is a group that also requires attention: cases of lung cancer due to modifiable factors. Examples are workers exposed to silica, asbestos and heavy metals, as well as people from regions with high levels of atmospheric pollution.
“At least 10% of lung cancer cases in men are of occupational origin. In women, this fraction is much smaller due to the work profile, which is less frequent in these activities with exposure. But there is also environmental exposure, air pollution is responsible for about 5% to 10% of lung cancer cases”, points out pulmonologist Gustavo Faibischew Prado, coordinator of the Pulmonology Commission of the Brazilian Group of Thoracic Oncology.
He recalls that there is also exposure to radon, a gas that emanates from the soil in regions rich in ores that give rise to it, such as uranium and radium. This is common in countries in the Northern Hemisphere and northern North America.
“All [os fatores] could have more control. Even radon, which we cannot prevent from emanating from the ground, the exposure reduction strategy is the concreting of basement slabs in commercial or residential buildings,” he explains.
Gas monitoring is done in the same way as carbon monoxide concentration is monitored, as is done in São Paulo. “The only non-modifiable are genetic factors”, highlights the pulmonologist.
Pandemic
Psychologist Lenise Amorim, 41, is one of these cases. “In October 2020, in the midst of a pandemic, I was diagnosed with lung cancer, which was already locally advanced and at that time I was only 39 years old. I was completely asymptomatic and had no history of smoking and I also never lived with people who smoked,” she reports.
The discovery took place during an MRI to investigate a lump in the neck that had been there for ten years.
According to Prado, this type of cancer is usually found unintentionally by a test ordered for another reason.
“We saw a lot during the pandemic, because, in a way, we lowered the thresholds for requesting imaging tests, such as chest tomography, for patients with suspected respiratory symptoms for covid. As a result, we had a lot of incidental diagnosis of pulmonary nodules and many of these small lesions were investigated and diagnosed as lung cancer.”
He adds that it is common for these diseases to be discovered in advanced stages. In Lenise’s case, it was a stage 3, on a scale that goes up to 4. However, the tumor was still located only in the lung.
The doctor warns, however, that there is no recommendation for screening in people who do not have risk factors. “It is still unlikely that we will propose lung cancer screening programs for people without risk factors, without a history of smoking, without exposure to carcinogens at work and, in these cases, the diagnosis is often incidental”, explained.
Lenise was treated with medication for seven months and then surgery to remove the tumor. She had the genetic alteration of the tumor mapped through a genomic analysis and the result allowed her to be treated with a targeted therapy indicated for her profile and then undergo surgery.
“[Hoje] I don’t take any medication. I am cured,” she told her to Brazil Agencynoting that it will still be followed up for regular monitoring.
The pulmonologist also recalls that there are currently several options for the treatment of lung cancer, “bringing patients closer to a cure, which was a much more challenging scenario until recently”.
