Call for raised awareness as lung cancer ravages young and old

Four year-old Simamukele Somtsewu from Alexandra after an operation for a neuroblastoma tumour, a form of cancer commonly found in young children. It was removed from his right lung. Picture: Dumisani Sibeko

Four year-old Simamukele Somtsewu from Alexandra after an operation for a neuroblastoma tumour, a form of cancer commonly found in young children. It was removed from his right lung. Picture: Dumisani Sibeko

Published Aug 4, 2024

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LUNG cancer is among the top three cancers affecting men and seventh for women in South Africa, yet there was not enough awareness around it.

Health stakeholders last week, as the world commemorated World Lung Cancer Day, said worldwide, this debilitating disease had more than 2 million new cases and almost 1.8 million deaths annually.

“In South Africa, lung cancer ranks as the number 1 cause of cancer deaths,” the Cancer Association of South Africa (CANSA) said.

Speaking on the cancer which affected either one or both lungs, Life Healthcare said the day - August 1, was meant to support the educational drive to raise awareness about lung cancer, its impact, and the steps people could take to minimise their risk.

With this year’s global theme being Stronger Together: United for Lung Cancer Awareness, efforts point to the power of unity in the fight against lung cancer through early screening.

Said the Global Cancer Observatory, lung cancer remained one of the most common and often fatal cancers worldwide.

From Life Eugene Marais Hospital, Dr Rouchelle Marais, said there was need for emphasis on the importance of preventive measures in reducing the incidence of lung cancer.

Doctors in Gauteng removing a cancerous tumour from a child’s lung.

“Smoking is the leading cause of lung cancer, but the good news is that quitting smoking at any age can significantly reduce the risk,” the clinical radiation oncologist at the Pretoria hospital’s Life Oncology unit said.

She said avoiding exposure to second-hand smoke, maintaining a healthy diet rich in fruits and vegetables, and engaging in regular physical activity were crucial steps that everyone could take.

In addition to lifestyle changes, Dr Marais highlighted the importance of minimising exposure to known carcinogens such as radon, asbestos, and air pollution. “Following safety protocols in workplaces and ensuring good indoor air quality can further reduce the risk of lung cancer.”

All employers in South Africa had the legal obligation to provide and maintain a working environment free of risk to the health and safety of employees, she said. “Occupational health services offers comprehensive occupational health and safety services to make compliance easy. For individuals at high risk, such as heavy smokers or those with a family history of lung cancer, regular medical check-ups and screenings are essential.”

CANSA said there was low awareness of lung cancer in South Africa, and because early diagnosis remained key, it was important that people learnt to recognise the signs and symptoms of this serious disease.

Advances in healthcare had resulted in more treatment modalities being put in place to treat lung cancer. “Fewer treatments are necessary to ablate the tumour if the cancer is detected in its early stages,” says Cobie Crawford, radiotherapist at Life Eugene Marais Hospital.

“By raising awareness and promoting preventive measures, we improve the quality of life for many and work towards better health outcomes,” says Crawford.

Lung cancer is a disease characterised by uncontrolled cell growth in tissues of the lung, which, if left untreated, can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body.

Smoking remains the riskiest way to contract lung cancer

CANSA explained that most cancers that started in the lung, known as primary lung cancers, were carcinomas that arose from epithelial cells.

There are two main types of lung cancer - non-small cell lung cancer and small cell lung cancer, and the main cause of both was the intentional smoking of tobacco products, while an approximately 10 to 15% of people who get lung cancer have never smoked.

More men than women smoked, Cancer awareness spreadsheets said, hence the higher risk factor for them, but more women had also started smoking, and as such the number of women developing lung cancer was on the rise.

But, they added, people who did not smoke were also susceptible, and risk factors included the effects of past cancer treatment and exposure to asbestos, radon gas and, in very rare cases, substances such as uranium, chromium and nickel.

“Lung cancer is not infectious and can’t be passed on to other people. The more one smokes, the greater the risk of developing lung cancer. It is also more likely to develop in people who start smoking at a young age. If someone stops smoking, their risk of developing lung cancer reduces over time.

“After about 15 years, the chance of developing the disease is similar to that of a non-smoker,” CANSA added.

The World Health Organisation (WHO) said lung cancer was a significant public health concern. They said smoking tobacco (including cigarettes, cigars, and pipes) remained the primary risk factor for lung cancer, but it could also affect non-smokers, while other risk factors including exposure to second-hand smoke and occupational hazards existed.

Air pollution, hereditary cancer syndromes, and previous chronic lung diseases were also risk factors.

Both young and old were at risk of contracting lung cancer, the world body said, and they spoke on early treatment as an effective means to prevent lung cancer from becoming worse and spreading to other parts of the body, but emphasised on preventative measures, which included primary and secondary prevention measures.

“Primary prevention aims to prevent the initial occurrence of a disease through risk reduction and promoting healthy behaviour. In public health, these preventive measures include smoking cessation, promoting smoke-free environments, implementing tobacco control policies, addressing occupational hazards, and reducing air pollution levels.”

They said secondary prevention for lung cancer involved screening methods that aimed to detect the disease in its early stages, before symptoms become apparent and could be indicated for high-risk individuals.

For this population, the WHO said early detection could significantly increase the chances of successful treatment and improve outcomes.

The most common symptoms of lung cancer include a cough that does not go away, chest pain, shortness of breath, coughing up blood, fatigue, weight loss with no known cause, and lung infections that keep coming back, among others.

“Early symptoms may be mild or dismissed as common respiratory issues, leading to delayed diagnosis,” WHO said.

They said the most effective way to prevent it was to eliminate tobacco - either smoked or secondary inhalation. “Passive smoking-breathing in other people’s cigarette smoke increases the risk of lung disease and cancer.”

In children there existed Pleuropulmonary blastoma, which typically manifested before the age of 5 years. While rare, it was fast-growing in South Africa and worldwide. Removing the whole lobe of the lung with cancer was the main treatment method.

Chemotherapy was also provided.

“Raised awareness on how to spot it - both among family members, guardians and staff in health facilities, is key if this scourge is to be slowed down,” the WHO said.

ntando.makhubu@inl.co.za