A: When discussing lung cancer, doctors tend to lump smokers and non-smokers together, but lung cancer in non-smokers is really a different disease with, obviously, different causes. The incidences of lung cancer in non-smokers are significant, making up 10-15% of lung cancers, with two-thirds of these found in women.
Besides smoking, what else can cause lung cancer? Many of the other causes are environmental. In fact, the number one suspected cause of lung cancer, other than smoking, is radon gas in the homes. Other environmental causes include second-hand smoke, which accounts for 3000 lung cancer cases a year; fumes from wok cooking, thought to be a cause of lung cancer in Asian countries; and asbestos exposure, which can cause a special type of lung cancer called mesothelioma. Other than environmental causes, genetics often play a role. Having a first-degree family member (parent, sibling, or child) with lung cancer roughly doubles the risk. Having a second-degree relative (aunt, uncle, niece, or nephew) with lung cancer raises the risk by around 30 percent.
Currently, whether smokers or non-smokers, lung cancer patients are treated the same. In the future, treatments could become more specialized based on the fact that these cancers are different on a genetic level. Until then, the most important things to do to lower the risk of lung cancer as a non-smoker are to check homes for radon and avoid secondhand smoke.
A: Small cell lung cancer accounts for 15% of all lung cancers and usually is caused by smoking. Without any treatment, small cell lung cancer grows rapidly and spreads quickly, usually taking the person’s life in two to four months. However, small cell lung cancer is the most responsive type of lung cancer, which means it’s very sensitive to chemo and radiation. When patients are given chemotherapy, life expectancy can jump up to one year. Unfortunately, in more than half of the people with small cell lung cancer, the cancer also spreads to the brain. Because of this possibility, for people whose lung cancer has responded to chemotherapy, doctors may additionally prescribe radiation therapy to the brain to help prevent this spread. This procedure is known as prophylactic cranial irradiation, which may add another six months to the patient’s life expectancy. Therefore, yes, treatment for small cell lung cancer does exist and can give the patient considerably more time with friends and family.
A: When you are referred for radiation therapy, you will meet your radiation oncologist and her nurse. After they review your records, reports, and x-rays, your doctor will perform an exam. Your radiation oncologist should offer to review your x-rays and scans with you. During this visit the doctor must decide whether or not you require radiation treatment and discuss with you all the risks, side-effects, and benefits of the treatment. You, the patient, will then decide to proceed or not with radiation treatment.
Once treatment is decided, the next step is simulation. Simulation is typically a CT scan used to obtain data for designing your radiation plan. All patients have a unique radiation plan that has been customized just for them, their bodies, and their cancers. Your plan will be unique to you. After completion of the simulation, you will leave with positioning marks on your skin (made with a sharpie marker or a paint pen) and an appointment to return for treatment. When you arrive at your next visit, your plan will have been completed. Radiation therapists will be ready to deliver your treatment. Usually lasting 5-10 minutes administered once a day for 2-7 weeks, radiation therapy is painless: you will not feel anything.