Hope for the future: Dr Anand says he believes in the potential for AI to assist in the early detection of lung cancer.
KUALA LUMPUR: The number of non-smoking lung cancer patients who are mostly women continues to rise, says cardiothoracic surgeon Dr Anand Sachithanandan.
Based on his own clinical experience, he said 25% to 30% of his lung cancer patients are non-smoking women.
He said the majority of cases still involve male smokers.
“From 2012 until 2016, there were 7,686 cases of men with an age-standardised incidence rate (ASR) of 13.2 per 100,000 of the population. In the same period, there were 3,570 cases with an ASR of 5.9 per 100,000 of the population in women,” he told Bernama at Sunway Medical Centre, Sunway City, recently.
He said lung cancer is the most common cause of cancer death in men and second most fatal cancer in women, and that air pollution and second-hand smoke exposure are the culprits, coupled with a genetic predisposition.
“Air pollution and exposure to second-hand smoke are thought to create an inflammatory process mediated by chemical messengers called ‘interleukins’ that activate dormant driver mutations or pre-existing cancer-causing genes, like the epidermal growth factor receptor mutation in some vulnerable individuals.
“Also, having a family history of lung cancer is a significant risk factor,” he added.
However, Dr Anand said tobacco smoking remains the most common and preventable risk factor for lung cancer and there is growing evidence that vaping significantly increases the risk of taking up cigarette smoking due to nicotine addiction.
He said the usual symptoms that people should look out for as an indicator of possible lung cancer include recurrent chest infections, a persistent cough, difficulty breathing, coughing up blood (haemoptysis), chest wall or back pain, and unexplained weight loss.
The less common symptoms include shoulder pains or a droopy eyelid.
“All these symptoms depend on the size and location of the tumour. Symptoms like back, chest or bone pain, unexplained weight loss, or difficulty breathing are indicative of more advanced lung cancer,” he said.
In conjunction with World Lung Cancer Day which falls on Aug 1, Dr Anand, who is also the founding president of Lung Cancer Network Malaysia, said screening is essential to spot early-stage lung cancer, which can be successfully treated with curative surgery, sometimes with varying combinations of immunotherapy, targeted therapy, chemotherapy and radiotherapy.
“The gold standard of screening is low-dose computed tomography, which is painless, accurate and a single breath test without needles.
“Also, AI (artificial intelligence) is currently being explored to improve diagnostic accuracy and may be a useful triage tool. It is being deployed on simple chest X-rays as it is much cheaper, making it more accessible and many practitioners are using it as a pre-screening tool.”
Dr Anand also recommends current and former smokers aged 45 to 75 who have been smoking at least one pack a day for 20 years or more, even without any symptoms and those with a family history of lung cancer, go for screening.
“The goal of screening is to effect ‘stage shift or stage migration’ and pick up more cases at an earlier stage when the cancer can be treated more effectively, less invasive and more cheaply – with vastly better outcomes,” he said.
