Lung cancer takes one life every 18 seconds. In Romania, 28 people lose the battle with this disease every day, and the life expectancy is often reduced, doctors say, because of the disease in advanced stages.
Dr. Răzvan Ovidiu Curcă, primary oncologist at Alba Iulia County Emergency Hospital, explains to the readers of the Doctor of the day how serious this disease is and what causes it, but also talks about the innovative treatment that doubles the survival chances of patients with this type of affection
Lung cancer is the most common cancer in men and fourth in frequency in women. In Romania, according to the Globocan study, an incidence of 30 cases per 100,000 inhabitants is registered. It is, in fact, one of the types of cancer detected and diagnosed in general far too late. Dr. Răzvan Ovidiu Curcă, primary oncologist at the Alba Iulia County Emergency Hospital, says that the main cause of this type of cancer is smoking.
– Dr.Z .: What are the symptoms that should make us think and make us go to an oncologist?
– Dr. Răzvan Ovidiu Curcă: Lung cancer or bronchopulmonary cancer is known as one of the most aggressive forms of cancer, which is often found late and has a lower survival rate compared to other cancers. Thus, when talking about the chance of diagnosing this disease in its early stages, a series of symptoms are suggestive, which may indicate a delayed medical consultation: repeated pulmonary infections that do not respond to antibiotics over three weeks, increased cough intensity and sputum that the patient produces, red sputum, loss of voice, chest pain, weight felt during breathing, weight loss, lack of appetite or unexplained fatigue.
90% of the patients are or have been smokers
– Are the causes of this type of cancer known?
– Smoking is the main cause of bronchopulmonary cancer. Over 90% of people with this disease were or are regular smokers. For example, in Romania, 85% of patients diagnosed with lung cancer are chronic smokers, and the most affected age group is people aged 45-65. In addition to smoking, exposure to certain chemicals, such as radon or asbestos, or ionizing radiation, as well as air pollution, can significantly increase the risk of developing bronchopulmonary cancer.
– What are the risk factors we should avoid? What, from what we do in our daily life, can cause, trigger or contribute to the development of lung cancer?
– As mentioned earlier, smoking, including passive smoking, is the main risk factor that we should avoid to prevent the onset of this disease. From my point of view, I believe that we can prevent the occurrence of bronchopulmonary cancer if we substantially reduce smoking through appropriate restrictive legislation, which has already started to be applied in Romania.
"Immunotherapy, the most promising solution for these patients"
– Dr.Z .: Treatment? If caught early, what are the chances of survival?
– Dr. Răzvan Ovidiu Curcă: The chances of survival for patients diagnosed with operable stage bronchopulmonary cancer are approximately 40-50%. For stage III patients, inoperable, but without distant metastases, radiotherapy is one of the best and most effective treatment methods, used in combination with chemotherapy. In recent years, radiotherapy has progressed significantly, and at this time there is the possibility that these patients also have a modern radiotherapy in Romania, with a net toxicity lower than in previous years.
– Apart from the oncological treatment, let me tell you, classically, I know that in the last years innovative therapies have appeared, some that seem to be even miraculous. Are they efficient? I'm talking about immunotherapy. Is it accessible to Romanian patients?
– Immunotherapy has undergone a remarkable evolution lately and, in my view, is the most promising solution for patients with metastatic lung cancer. For example, recent studies have shown that pembrolizumab treatment is significantly superior to chemotherapy – it not only improves the quality of life of these patients, but can also double their chances of survival, used in the first line of therapy in the subgroup of patients expressing PDL1 as a percentage of over 50%.
In addition, targeted molecular therapy has made substantial progress, providing significantly better survival prospects for patients who have certain specific molecular changes in the tumor, which are the target of these treatments, such as EGFR and ALK activating mutations.