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Today, 4 February 2019 is World Cancer Day.
LUNG CANCER KILLS more people in Ireland than any other form of cancer and we urgently need a screening programme to detect the disease earlier to save lives.
We need to talk about lung cancer to remove the stigma too – no one should ever be blamed for having cancer. There is a lack of awareness among healthcare professionals as well as the general public in relation to the prevalence of lung cancer in Ireland.
Most people struggle to identify the symptoms of the disease and are not as aware of the need for early medical intervention as they are with other types of cancer.
Smoking is one of the primary causes of lung cancer and some patients feel they are being blamed for having cancer.
This feeling is not without substance, according to the Marie Keating Foundation research, 27% of people surveyed believe that patients with lung cancer who never smoked, should be given treatment priority over patients with lung cancer who do, or did, smoke.
This is a startling finding.
No matter what anyone’s lifestyle choices are, nobody deserves a cancer diagnosis – whether it’s breast, cervical or lung cancer.
Lung cancer kills
Figures from the National Cancer Registry of Ireland (NCRI) last year showed that approximately 2,600 people are diagnosed with lung cancer in Ireland each year. The fatality rates are high and more than 1,800 people died from the disease in 2018.
That means lung cancer is the single biggest cancer killer in Ireland, accounting for more deaths than breast cancer and colorectal cancer combined.
Lung cancer is the single biggest cancer killer among Irish women too but recent research conducted by the Marie Keating Foundation showed that only 9% of respondents correctly identified that fact.
47% of people surveyed thought that breast cancer was the number-one cause of female cancer mortality, while 37% believed it was cervical cancer.
The percentage of these young people (aged 18-24) who correctly identified lung cancer as the biggest cancer killer among women was a startlingly low, at just 1%.
Dark diagnosis
On a personal level, lung cancer, in particular, can be a dark diagnosis for patients to receive — the survival rates are very poor at just 15% to 18% over five years. That makes very difficult reading for patients and their families before they have started their treatment journey.
There is also the stigma that patients have to deal with. This stigma can come in many forms; it can impact when and how often patients engage with the healthcare system not only when they become worried about their symptoms but also throughout the cancer care pathway.
Surveys show that the public expects lung cancer rates to drop in the coming two decades, while actually they are set to increase. Lung cancer is increasing in female non-smokers and the number of women contracting the disease is predicted to rise by 136% by 2040.
On a clinical level, there is a difference in how men’s and women’s biology deals with toxins in the environment.
Women who do have a smoking history are also more at risk of developing lung cancer compared to their male counterparts. Women don’t have to smoke as much, or for as long as men, to be at increased risk of lung cancer. This is a fact that needs to be highlighted as a matter of urgency.
The reasons for the predicted rise in lung cancer cases in Ireland are multifactorial. The National Cancer Registry of Ireland report states that ‘lung cancer rates track smoking prevalence from decades past’, however it is most likely more complex than this.
No matter what the reasons are behind the numbers – it is critical that people are aware that anyone can get lung cancer, as the disease is not confined to smokers.
Screening
At the moment in Ireland, the majority of patients present when they are at the late stage of the disease and so surgery is often not an option. However, we are witnessing a change in survival rates, in select cohorts of patients, due to new targeted treatment options and immunotherapy.
There is still much work left to do and we need vital funding to be invested in research, as well as improving access to new innovative therapies.
Ireland lags behind other Western European countries in terms of timely access to medications and this is extremely frustrating for patients, their families and physicians alike.
While improved education, awareness and treatment options are critical, there is also an urgent need to establish a screening programme. From a number of studies, it is now clear that low dose CT lung cancer screening programmes save lives.
At the moment lung cancer screening is not part of Ireland’s 10-year national cancer strategy 2017-2026. We cannot wait 10 years to have the same conversation about the need for a screening programme this is doing a disservice to all of those at risk of lung cancer.
There now needs to be a coordinated, focused call for action from all the stakeholders in the lung cancer community in Ireland, to come together and work as a team to advocate for the establishment of a screening programme and to make lung cancer a priority.
All cancer types should be treated equally and as lung cancer is the number one killer cancer in Ireland we need a screening programme now.
Dr Anne-Marie Baird is a molecular biologist, Cancer Researcher; Patient Advocate; Board Member at Lung Cancer Europe and member of the European Cancer Organisation Patient Advisory Committee. This opinion piece is based on a speech she gave at a conference on lung cancer which was run by MSD Ireland.
My missus passed away in 2017 she worked till that Christmas in hospital in Dublin when she was diagnosed with cancer she was dead by may of that year aged 75 she never smoked in her life and I miss her so much after 30 odd years of marriage
@liam ward60: sorry for your loss. RIP
@liam ward60: Liam she’ll never be forgotten. Im so sorry for your loss and my thoughts are with you.
Smokers are treated like lepers the heroine uses get more attention cause trouble hog up a@e 7 days a week
Screening would save so many lives. My husband had no symptoms -seemed totally healthy but had an x-ray because of an accident and they spotted a tumour on his lung. He had surgery – no radiotherapy or chemo and he’s still with us and perfectly healthy six and a half years later. The accident saved his life – by the time he would have experienced symptoms, it would probably have been too late.
Screening would identify tumours at a much earlier stage and the prognosis would be do much better.
@Ann Casey: Great that your husband caught his tumor early. Screening is badly needed for young and old to have any chance.
In a health service that has finite resources, how does one choose who to treat first, the patient that never smoked or an ex smoker?
There has to be some criteria for allocating resources and tough decisions have to be made in the public interest.
@Jaycee Laycee: You mean the smokers that have contributed billions through the extream tax on cigarettes for this exact purpose?
@Jaycee Laycee: Seems clear cut to me then no? I mean if it’s all about resources and whatnot then the tax gained from smokers is a gold mine.
Just got to make sure tax gained from smoking is equal to or greater than the cost of treating smoking related illnesses and then smokers would actually be funding their own care.
What about a smoker that has worked all their life and paid their fair share vs a non smoker that has not contributed much In the way of tax – who gets priority there?
Two non smokers, one on 200k a year and paying his or her share in tax, vs someone on 30k
Who gets priority there?
Or…you know… we could treat everyone as a living person and not try to break people down into sub groups to assign priority to begin with.
Slippery slope and all of that.
@Jaycee Laycee: Except it’s impossible to tell if the patient who smoked got their lung cancer from smoking, it could still be from environmental effects. And where do you draw the line with this frankly evil and eugenicist approach? Diabetes? Again, can’t prove if it’s caused by lifestyle or genetics in many cases. How about heart disease from drinking over heart disease from diet? How about a smoker with lung cancer compared to a non-smoker with lung cancer who murdered someone. The murderer didn’t get cancer from their murderous lifestyle so by your reasoning they should get treatment first. What about prioritising cancer treatment for people who get it from environmental factors over HIV treatment? After all, the latter would fall into your same group. Who’s the judge of morality here?
@Jaycee Laycee: what’s with that ‘own fault’ attitude, that is like saying gays deserve aids or a woman with cervical cancer should have kept her legs together. We are a mix of lifestyles, it’s not the doctor’s job to moralise.
@Jaycee Laycee: only half the tax revenue from smokers is spent treating smoke related illnesses. So it’s a net gain
Lets face facts…people are getting cancer because of damage to the environment, over medication, micro plastics in the food chain and fluoride in the water etc etc….the act of smoking and tobacco itself is just the scapegoat used by government and the corporate world to kick the can on down the road for another couple of years.
@Frank Lee: I’m still waiting for the ‘facts’
@Frank Lee: Fluoride in the water supply doesn’t cause cancer. Stop reading pseudo science on facebook and spreading misinformation
@Frank Lee: As a survivor I know you have little understanding of this disease. I hope it never knocks on your door.
A female very close friend died of the disease recently, she smoked but that doesn’t make it easier!
My man passed away nov ‘17 ages 63 from lung cancer 4 weeks after diagnosis screening is definitely needed
As a survivor of cancer I would like to say that there should be no stigma associated with being diagnosed with this horrible disease.
My cancer was multi organed and included my lungs, brain and other places.
Cancer is as individual as the person who is unfortunate enough to be diagnosed with it.
I was a smoker, still am , but my cancer simply cannot be attributed to that sole reason.
The human body renews cells billions of times every minute , cells split, die and are reborn every moment of ones life.
Some people who live a very healthy life can and do get cancer, someone I know who ran over 25 Dublin Marathons was diagnosed of cancer, and is longer with us.
To simply lay the blame on smoking, or the multitude of other excuses pawned as reasons for a cancer diagnosis is disingenuous in the extreme and very annoying.
I wouldn’t wish cancer upon anyone, it rapes you physically and emotionally, it does the same to your friends and loved ones.
Nobody wants to have a diagnosis of cancer, but thats not going to stop people from being diagnosed, in fact diagnosis of cancer will continue irrespective of not smoking, drinking or living an unhealthy life.
These factors however can affect the way your body protects itself from cancer. A weak immune system will very quickly be overrun by cancer, as was my case.
So, lets not start pointing figures at people who have been diagnosed with cancer who smoke, or indulge in other perceived life choices that may lead to cancer.
This disease, in my view, will over the next 20 years be treated like any other chronic disease, with the use of medications. Vaccines are now being developed, tested, and hopefully will be rolled out for many cancers but unlikely for all, due to the type of cancer, there are over 200 human cancers known, and more will be discovered.
As a survivor please dont stigmatize any cancer patient its tough enough.
Hopefully screening will get there but it’s not adequate to screen for lung cancer at present. Thankfully there’s a lot of international research happening in this area.
Screening with chest xray does not work for the greater population.
The general public believe that screening tests pick up all serious illnesses but it does not work like that. eg. Breast mammogram will miss 15% of cancers.
A normal chest xray today does not mean you do not have cancer in 6 months. There are often false positive tests also when after months of testing its turns out you don’t have a cancer or other illness but had a terrible time eventually finding that out.
Screening tests and programmes need to be fulfill certain criteria to be valuable. Look up Wilsons criteria if you are interested.
Prevention of illness is where the huge reward for improving health is at and there is minimal energy put into it.
@Ranty McCrank: Yes, screening is great but has been oversold as all positive in the past. There’s a false assumption that all screening is good / needed. It can also lead to over diagnosis and unnecessary proeedures (see DCIS in breast screeening). Hopefully they’ll have something that works for lung cancer soon (and a reliable test for prostate cancer would be great too!).
@Ranty McCrank: Screening isnt perfect we know that, I was misdiagnosed myself twice. But its one of many diagnostic tools available, it was never meant/nor could be the panacea of detecting cancer accurately, but it has helped in so many ways and is responsible for early detection and by association helped save lives.
It has its flaws, evidence surrounds us, but like treatment it too will improve.
A few years ago , and now , there was a cordinated attempt by the HSE and our cancer charities to get people of a certain age to take and return, for free, a poo sample to help in the early detection of bowel cancer, a cancer with a good survival rate if recognised early. 500000 sticks were sent, I believe, and am open to correction, less than 35% are returned.
Screening has a hard time being more accurate with those figures
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