Lung cancer has always been the most fatal cancer in Hong Kong. In 2016, it was responsible for over 3,500 deaths¹, which was 28 times² the number of deaths from traffic accidents. This high fatality rate was due to the fact that over half of the diagnosed patients were already at their late stage, where the cancer cells had spread from one lung to another or even other organs and patients had missed out on the golden treatment period. With World Lung Cancer Day on 1 August in the back of our mind, let’s keep our memory fresh with an old saying “Know your enemy, know yourself” - understand and be prepared for lung cancer before it strikes first.
Non-smokers are of no exception?
There are 2 types of lung cancer: small cell and non-small cell lung cancer. The former is mainly caused by smoking and only accounts for 15% of all lung cancer cases. The remaining 85%³, caused by non-small cell lung cancer, can further be categorized as lung adenocarcinoma, large cell lung carcinoma and squamous cell carcinoma.
In the past, a general perception lingered that smoking was the only cause of lung cancer. But the advancement of lung cancer research tells us otherwise. For instance, lung adenocarcinoma caused by ALK gene mutation is mostly found in young non-smoking female in the Asia-Pacific region.
7 symptoms of possible early-stage lung cancer
Even though lung cancer shows no obvious symptoms, you should seek medical advice if:
Late-stage is not necessarily the end
Needless to say, early diagnosis and treatment result in a better chance of recovery. Applying surgery and radiotherapy with chemotherapy as preventive treatment, the 5-year survival rate of early-stage lung cancer can reach 50% to 60%⁴ ⁵. The rate would drop below 10% for late-stage cases.
1. Targeted Therapy
Nevertheless, don’t despair over late-stage lung cancer, thanks to the new drugs and treatment developed in recent years. In general, the doctor will first conduct a tissue biopsy for genetic mutation. If the result is positive, targeted therapy that fights the mutated gene in question will be used to stop cancer cells from sending messages to each other for self-reproduction.
Since drugs used in targeted therapy are designed to fight against cancer cells, they exert fewer side effects than traditional therapies. But we must understand that the cancer cells would develop drug resistance and the drugs would lose their effectiveness after a certain period of time due to the ever-evolving nature of cancer cells.
Immunotherapy is an up-and-coming treatment for late-stage lung cancer besides targeted therapy. When the attack begins, cancer cells will disguise as normal cells to confuse the immune system. The function of immunotherapy is to reboot the system so as to identify and destroy cancer cells.
Can lung cancer be prevented?
The said 2 therapies are effective in extending patients’ lifespan and maintaining their living standards, but they are costly - several tens of thousands of dollars are required every month. It is undoubtedly a heavy financial burden on the patients and their family.
Although the medical industry still doesn’t have a full grasp of the cause of lung cancer, prevention is always better than cure, ie. we should establish a healthy lifestyle to lower the risk of becoming a lung cancer victim. Data shows that the chances of smokers having lung cancer are 10 times that of non-smokers⁶. Considering smoking is the top risk factor, quitting smoking is apparently the best way to prevent the disease.
Besides, regular exercise and healthy living help lower the risk to a certain extent. For high-risk individuals, taking low-dose radiation scan in the chest on a regular basis is recommended to diagnose and cure the disease at an early stage for a greater chance of recovery.
Dr. Tsang Wai Kong, Maverick
Specialist in Clinical Oncology
¹ Lung cancer in 2016: http://www3.ha.org.hk/cancereg/pdf/factsheet/2016/lung_2016.pdf
² Traffic Branch Headquarters Hong Kong Police Force - Traffic report 2016: https://www.police.gov.hk/info/doc/statistics/traffic_report_2016_en.pdf
³ Lung Cancer booklets from Cancer Fund:
⁴ Lung Cancer Survival Rates from America Cancer Society:
⁵ Leaflet from The Hong Kong Anti-cancer Society (Chinese version only)：https://www.hkacs.org.hk/ufiles/LUNG.pdf
⁶ Hong Kong Council of Smoking and Health – Risks of active smoking: