WORLD LUNG CANCER DAY | Tobacco remains a major risk factor for lung cancer

It is estimated that more than 32,700 people will be diagnosed by the end of 2024. lung cancer in our country. According to the Spanish Society of Medical Oncology (SEOM), it is a pathology that on a global scale will exceed one million cases in the world. Among his reasons tobacco remains a major risk factor (both active and passive smoking): experts estimate that 80 to 90% of lung cancer cases affect smokers or former smokers, and that their risk of getting it is 10 to 10 times higher.

Today, November 17, is Memorial Day World Lung Cancer Day Raise awareness of this pathology, its prevention and early detection. Therefore, since Lift-EMVWe spoke to doctors at the Valencian Institute of Oncology (IVO) to find out about the latest data, treatments, advances, prevention and quality of life for patients.

“Anyone can suffer from lung cancer, but main risk factors There are three types of lung cancer: tobaccocontact with radon and long-term exposure chemicals and substances in the workplacesuch as asbestos, arsenic, chromium, nickel and other industrial compounds, not forgetting air pollution“,” says the Dr. Leoncio ArribasHead of the Radiation Oncology Service of the Institute of Military Education.

Since tobacco is a major risk factor, its prevention is vital. Thus, Dr. Sergio Sandiegoassistant doctor of the medical oncology service of the Institute of Military Education, explains to us that “ primary prevention It consists of any action aimed at reducing or stopping tobacco consumption in order to reduce the risk of pathologies such as lung cancer (although we remember that tobacco is also closely associated with other cancers such as bladder, head and neck cancer) and non-oncological pathologies, such as cardiovascular or chronic lung diseases. “Some examples of primary tobacco prevention could be education of children and adolescents in schools

or anti-smoking advertising campaigns“, he adds.

Types of lung cancer

He Dr. Juan Carlos PeñalverDirector of Thoracic Surgery Service at IVO, explains that “lung cancer (LC) is a disease caused by excessive and uncontrolled proliferation of certain lung cells, causing local problems due to space encroachment, compression and invasion.” nearby buildings. In addition, it can spread through the lymph nodes and/or blood vessels to other organs, causing so-called metastasis”

In these circumstances and as explained by Dr. Peñalver, there are two main types of CP depending on the type of cells that form them: “ non-small cell cancer (85% of cases) and small cell carcinoma or small cell lung carcinoma (15% of cases).

The main treatments for lung cancer are operation, chemotherapy, radiation therapy, immunotherapy And targeted therapyor a combination of several of them. However, the type of treatment for each patient will depend on “the characteristics of the tumor (histological type, genetic profile) and the stage at which it is detected. Other factors also influence, for example, general health person and lung functionbecause they will allow us to apply or not apply the treatments indicated in each case,” explains Dr. Peñalver.

Early detection

“Most patients experience advanced diagnostic stagetherefore it is necessary screening effective, allowing us to detect this disease at earlier stages, with a smaller size and extent of spread, and before symptoms appear, allowing us to provide more effective treatments and reduce mortality,” says Peñalver. Although in almost two thirds of cases CP is not present symptomssome of these could be “persistent cough or changes in cough, change in tone of voice, chest pain, difficulty breathing, coughing up blood, feeling tired all the time, weight loss without a known cause.” and recurrent pneumonia.

Advances in treatment

In recent years, there has been progress in various treatment methods such as the use of immunotherapy that “provides survival of 5 years or more in patients with metastatic disease” or new targeted treatmentswhich has made a significant difference to the life prospects of many lung cancer patients since its development began 20 years ago.

Likewise, as IVO professionals explain, various clinical trials

to find new drugs and treatments. “Lung cancer has evolved over the past 10 years from a disease with a poor record of new drug development to a leader in the pharmacological development of new molecules, both in targeted therapy, immunotherapy and adoptive cell therapy. and drug-conjugated antibodies.

For Dr. Leoncio Arribas, breakthrough in treatment there was a combination of radiotherapy with modern systemic treatments, mainly immunotherapy and molecular targets. “This combination has opened up indications for radiation therapy in the metastatic phase of the disease, providing synergistic results between these systemic treatments and radiation therapy delivered using the SBRT technique with higher doses per fraction and with non-traditional fractionations (irradiation given weekly, monthly doses, etc.) d.), since the treatment is very well tolerated by the patient, with less radiation to healthy tissue and with which we can carry out adaptive treatment to reduce the tumor; However, we have improved the results, which should be confirmed in the coming years,” he says.

Side effects

Regarding side effects treatments for CP, Dr. Sergio Sandiego shows that “have improved significantly” “From less aggressive surgeries with fewer postoperative changes, radiation therapy with much less toxicity because the area of ​​treatment is better limited, to less toxic oncology drugs. In the latter case, drugs such as immunotherapy or therapies directed against molecular targets are examples of treatments that are effective and less harmful than more classical chemotherapy,” he states.

Sandiego says side effects such as alopecia, nausea, vomiting and general weakness are becoming increasingly rare. However, these new drugs may cause digestive toxicity (eg diarrhea) cutaneous (rash) or analytical changes “which also needs to be closely monitored.” Thus, the doctor states that “patients diagnosed with lung cancer undergo treatment that allows them lead a life very similar to the one before the diagnosis” At this stage, “interdisciplinary pathology treatment is necessary (services such as rehabilitation, nutrition, psychology, continuing care… are of great importance) to improve the quality of life in this process,” he adds.

IVO services

Dr. Arribas, director of the radiation oncology service, explains that the service “has external beam radiation therapythrough which the patient receives irradiation from the outside in (we practically treat 99% of patients with these devices), we also have brachytherapy system in which we inject radioactive material through tubes that we place around the tumor to irradiate the tumor from the inside out. In terms of technology, they have three state-of-the-art linear accelerators and a high dose rate brachytherapy system.

Dr. Juan Carlos Peñalver, head of the department of thoracic surgery, explains that the fundamental work of his team is “ Surgery for resection of cerebral palsybut within the framework of the same pathology, studies will be carried out to determine diagnosis of this disease, its spread and research cardiorespiratory functions. Robotic surgery has become the newest addition to the technical arsenal of minimally invasive thoracic surgery. Essentially, it involves the use of a robot that, equipped with four arms and controlled remotely, allows the surgeon to access the chest through small incisions and improve visibility of the surgical field, as well as access smaller spaces with greater safety. .

Finally, doctor. Sergio Sandiego, junior doctor at the IVO Medical Oncology Service, notes that this service is focused on quality care for cancer patients. “We are involved in diagnosis, treatment, interaction with other specialties, palliative management of symptoms, support, research and clinical trials, training of students and residents of various specialties and publication of research,” he concludes.