Q&A: Lung cancer and treatment options by Dr. Vaida

  • Dr. Alexandru Vaida

Published: 8/6/2022 2:51:22 PM
Modified: 8/6/2022 2:48:04 PM

Dr. Alexandru Vaida of Concord Hospital Cardiothoracic Surgery discusses lung cancer causes and the various treatment options available.

What causes lung cancer?

The primary cause of lung cancer is smoking, both in smokers themselves and individuals consistently exposed to it secondhand. The second most common cause of lung cancer, and the primary cause of it in non-smokers, is exposure to radon gas. Other causes include exposure to certain chemicals and particle air pollution. The WHO classifies lung cancer as a global epidemic. There are roughly 160,000 deaths per year in the United States alone; more than breast, prostate and colon cancers combined.

What is radon?

Radon is a naturally occurring radioactive gas that is tasteless, odorless, and invisible making it impossible to detect without the proper equipment and tests. It is extremely important to know the dangers of radon here in New Hampshire, as there is an abundance of granite in the ground, which releases the gas over time. The gas seeps into homes though basement cracks and builds up indoors posing great health risks, including lung cancer. Get your home and basement tested and enact the necessary mitigation to protect yourself and loved ones. Fifteen percent of lung cancers are found in patients who never smoked.

What are the symptoms?

Symptoms of lung cancer include coughing, shortness of breath, chest pain and fatigue, among others. Unfortunately, these symptoms can easily be mistaken for something far less concerning. In fact, only about a third of lung cancers are detected before metastasizing.

How can you detect it earlier?

Obviously, the best thing we can do is avoid lung cancer all together by not smoking, mitigating any radon risk, and avoiding harmful environmental exposures. In the effort to detect lung cancer early, two things stand out. Firstly, hospitals and physicians need to be aware of incidental findings and not let those fall through the cracks. For example, if a patient receives a chest CT for an entirely different reason, but a potential problematic area is flagged in the lungs, follow-up with the appropriate physician or surgeon is paramount. Secondly, lung cancer screening programs are vital. A yearly low-dose CT scan can be offered to patients preemptively if they meet certain qualifications such as age between 55 and 79 and previous or current history of smoking.

What are treatments available?

The only cure for lung cancer is surgical resection, meaning removing it and surrounding lymph nodes. However, really only about a third of the cases can be offered this potential cure as other various treatments will be necessary if the cancer has spread. Fortunately, there are a number of treatments available including chemotherapy, immunotherapy, and radiation. Some lesser known options and tools in the battle against lung cancer and all the problems that accompany it are photodynamic therapy, endobronchial stents, and navigated bronchoscopy. Photodynamic therapy is a minimally invasive procedure that involves inserting a laser fiber through a bronchoscope into a patient’s airway. The fiber then emits light waves at a specific frequency to target a tumor, killing it in place without the need for surgery. Endobronchial stents can be placed using a bronchoscope and are used to open an airway. Navigated bronchoscopy uses an endoscope placed inside the airway and computer software that maps out a track to the tumor needing attention.

Alexandru Vaida, M.D., is board-certified in surgery and thoracic and cardiac surgery. Dr. Vaida recently presented on lung cancer at the April Concord Hospital Trust “What’s Up Doc?” Donor Lecture Series. The monthly series, supported by the Walker Lecture Fund, features members of Concord Hospital’s medical staff speaking to Concord Hospital Trust donors about new and innovative medical treatments and services. You can watch Dr. Vaida’s presentation on Concord Hospital’s YouTube channel at: youtube.com/concordhospital.

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