Six lung cancer myths debunked

Lung cancer is leading cause of cancer-related death worldwide.

Only life-long smokers are at risk for lung cancer, right?


This is just one of the common misconceptions surrounding the second most common type of cancer. Not only is it common, it’s deadly.

Lung cancer is the leading cause of cancer-related deaths worldwide. Every year, more people die of lung cancer than of colon, breast and prostate cancers combined.

Hirva Mamdani, MD, director of the Lung Screening Program and thoracic medical oncologist at the Barbara Ann Karmanos Cancer Institute, said, “Cancer is a global challenge. What sets cancer apart from other medical conditions is that its impact is not just limited to the health of a person, but it affects families and communities; it has a lot of emotional and economic impact, as well.”

Despite its worldwide prevalence and devastating effects, lung cancer is one of the most preventable cancers. To understand how we can fight it, we must know the truth about this disease. There are many myths about lung cancer. Below are some common misconceptions and the facts you should know.

Myth 1: If I don’t smoke, I don’t have to worry about lung cancer

Lung cancer occurs in both smokers and nonsmokers — no one is exempt from the risk of developing lung cancer. Each year, as many as 20 percent of those who die from lung cancer have never smoked.

“While most people who develop lung cancer were previously smokers, we also see lung cancer patients who have never smoked,” said Becky Loomis, BSN, thoracic nurse navigator. “It’s important to avoid secondhand smoke and to get your home tested for radon, which is an invisible gas that can cause lung cancer.”

Even though nonsmokers can get lung cancer, cigarette smoking is the leading risk factor for lung cancer. The chemicals in cigarette smoke interact with and cause changes in the DNA material of normal lung cells, which cause a mutation in the DNA, leading to a transformation into cancer cells.

However, several other risk factors can increase the chance of developing lung cancer. Environmental exposure to radon, a naturally occurring radioactive gas, is the leading risk factor for lung cancer among nonsmokers. Breathing in radon exposes your lungs to small amounts of dangerous radiation. Additionally, people who regularly work with asbestos in settings such as plants, shipyards and mines, are at a higher risk of getting lung cancer.

Lung cancer in nonsmokers can look different than lung cancers in smokers. It often occurs in younger individuals and may carry a gene mutation that drives cancer.

“We may not be able to control our genetics or change the environmental exposure, but we can prevent the majority of lung cancer cases through smoking cessation. Prevention is better than cure,” Dr. Mamdani said.

Myth 2: Lung cancer cannot be detected early

“What makes lung cancer such a deadly disease is that the majority of patients are diagnosed at the stage four disease (when the cancer has spread to other organs). Only 17 percent of patients are diagnosed when lung cancer is localized, so our goal is to detect the localized cancer when it is still curable, and the way we do it is by lung cancer screening,” said Dr. Mamdani.

Laura Mantha, RN, BSN, OCN, senior research nurse and coordinator at the Karmanos Lung Cancer Screening Program said, “The whole goal is to catch cancer early and to treat it. It’s an important screening tool and we have evidence to support and it helps decrease the incidence of lung cancer deaths.”

The National Lung Screening Trial (NLST), run by the National Cancer Institute, compared two ways of detecting lung cancer: one through three annual low-dose, helical CT scans and the other through standard chest x-rays. The findings revealed that participants who received low-dose CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays.

Based on this study, physicians at Karmanos Cancer Center developed the Lung Cancer Screening Program in 2015, centered around a yearly low-dose CT scan for those who are at an increased risk of lung cancer. Each case is carefully evaluated by a board-certified radiologist and the program director.

Nithin Thummala, MD, clinical assistant professor of oncology and radiology at Karmanos Cancer Institute, specializes in reading scans for screening, diagnosis and evaluation. “One of the most common concerns that patients have is about radiation exposure. The radiation exposure for this examination is five times lower than traditional CT examinations; hence, the term low-dose CT scan. The benefits of getting this exam outweigh the minimal risk of radiation,” he said.

When detected early, lung cancer patients have more treatment options and a far greater chance of survival. While it is very important to begin screening, it is equally as important to continue screening at regular intervals.

Myth 3: Lung cancer only occurs in older people

Lung cancer is typically diagnosed at or above the age of 65; however, this disease can affect anyone of any age. Although less common, lung cancer in young adults requires more extensive, aggressive and advanced forms of treatment.

For example, adenocarcinoma is a type of non-small cell lung cancer (NSCLC) that commonly develops in nonsmokers between the ages of 20 and 39. This NSCLC is more likely to occur in younger individuals than all other types of lung cancers.

In some cases, individuals with early lung cancer do present with symptoms. The most common lung cancer symptoms include a cough that does not go away, coughing up blood, chest pain with deep breathing, hoarseness, loss of appetite and unexplained weight loss. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed at an earlier stage, when treatment is more likely to be effective.

Myth 4: Vaping is safe for my lungs

Nearly seven out of 10 smokers admit their need to quit and many consider transitioning to e-cigarettes from regular cigarettes for a safer option. With the sharp increase in e-cigarettes, vape pens and other vaping devices, the global e-cigarette market is expected to grow by nearly 24 percent in the next seven years, according to the World Health Organization.

People who vape have a higher risk of developing lung cancer than those who have never smoked or vaped. The chemicals in the steam inhaled while vaping damage the DNA of the lung cells. As of February 2020, the US Centers for Disease Control and Prevention, the CDC, confirmed 2,807 hospitalizations and 68 deaths in patients with vaping use that lead to fatal lung injuries. Most e-cigarette users were under the age of 24. While these numbers may seem low, vaping is a relatively new phenomenon. As we observe this habit and its outcomes, doctors and scientists will gain a greater understanding of the harm caused by vaping.”

“A strong link exists between vaping and lung damage causing acute and chronic inflammation in the lungs, which can be more debilitating than developing lung cancer. Vaping is not a safe alternative to smoking,” said Dr. Mamdani.

Myth 5: If I’ve been diagnosed with lung cancer, I can continue smoking

Many cancer patients are not just under the influence of chemotherapy but also nicotine. Tobacco smoking is so addictive that 64 percent of smokers diagnosed with cancer continue to smoke after learning of their disease. Smokers have an increased rate of side effects from chemotherapy and radiation; these include fatigue, heart and lung problems or infection. Smoking increases the chance of recurrence and increases the risk for a second cancer.

Therefore, smoking cessation is even more important after a cancer diagnosis. Stopping tobacco use can increase the likelihood of a better chance for success, fewer side effects and a faster recovery from treatment.

“Once you quit smoking, the health benefits start almost immediately -- as soon as 20 minutes after your last cigarette,” said Dr. Mamdani. After just 20 minutes, heart rate and blood pressure drop. After five to 10 years of smoking cessation, the risk of cancers of the mouth, throat and larynx is reduced by 50 percent.

Myth 6: Lung cancer can’t be treated

The Karmanos Thoracic Oncology Multidisciplinary Team includes cardiothoracic surgeons, medical oncologists, pulmonologists, radiation oncologists, radiologists, pathologists, pharmacists, dietitians, social workers and genetic counselors. This team is entirely focused on treating cancers of the chest and shares its collective expertise to create a customized treatment plan for each patient.

Our team of thoracic oncologists is among the best in the world. Team members are national leaders in chest malignancies and recognized experts in the treatment of thoracic cancers among national cooperative groups. The team has been involved in developing recently approved novel drugs for the treatment of chest cancers and continues to be involved in clinical trials evaluating novel drugs.

In addition, our team devotes time to research investigations, including screening and early detection of lung cancer and mesothelioma, detection and treatment intervention in precancerous cells from the sputum of smokers, combined treatments for locally advanced cancers of the chest, clinical trials of combined chemotherapy and radiation therapy, radiation therapy approaches such as intensive modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), gamma knife radiation therapy for brain metastases and studies of novel targeted drugs. They also collaborate with our Phase I Clinical Trials Program.

Karmanos is a National Cancer Institute-designated Comprehensive Cancer Center and the only hospital in Michigan dedicated exclusively to fighting cancer. Our multidisciplinary thoracic cancer team focuses solely on diagnosing and treating lung cancer, ensuring a level of expertise that other centers may not have. In addition, lung cancer screening results may indicate further follow up that requires this level of expertise.

To prevent lung cancer, you need to know the facts and debunk the myths. If you suspect or have been diagnosed with cancer, it’s essential to be evaluated by cancer experts before beginning treatment. In the fight against cancer, Karmanos can offer your best chance.