Discover the key factors that contribute to lung cancer and preventative steps you can take to minimize your risk.
Lung Cancer: Leading Cause of Cancer Deaths
Two Types of Lung Cancer
Lung cancer begins in the lungs, the essential organs that keep us breathing and supply oxygen to the body. It can sometimes spread to other areas of the body like bones, brain, or liver. Early detection and modern treatments have made significant strides in improving outcomes for many lung cancer patients.
There are two main types of lung cancer, each with its own characteristics: (1) Non-small cell lung cancer (NSCLC) is the most common, making up about 85% of cases. NSCLC includes subtypes like adenocarcinoma and squamous cell carcinoma. (2) Small cell lung cancer (SCLC), although less common, is known for its rapid growth.
Lung cancer remains the leading cause of cancer deaths worldwide, with over 1.7 million lives lost annually. However, there’s hope on the horizon. Advances in research, targeted therapies, and early screening tools are transforming the landscape of lung cancer care, enabling patients to live longer and healthier lives.
Lifestyle
Lifestyle-Related Risk Factors
1. Smoking
Smoking is the single most significant risk factor for lung cancer, contributing to about 80% of lung cancer-related deaths. Previous radiation therapy, especially for cancers like Hodgkin lymphoma or breast cancer, also significantly increases the risk of developing lung cancer, particularly for those who smoke. The good news? Making the decision to quit smoking can dramatically lower the risk of developing this disease. It’s a life-changing step that not only benefits the lungs but also improves overall health and quality of life.
It’s not just direct smoking that poses a risk; exposure to secondhand smoke also increases the chances of developing lung cancer. Protecting yourself and your loved ones from secondhand smoke is an important way to reduce risks and create a healthier environment.
Emerging research suggests that smoking marijuana may also contribute to lung cancer risk. While studies are still ongoing, it’s another reminder of the importance of making informed choices about what we inhale into our lungs. By staying proactive and making positive changes, you can take control of your lung health and embrace a brighter, smoke-free future.
2. Secondhand Smoke
Secondhand smoke, also known as passive smoke or environmental tobacco smoke (ETS), is the smoke that comes from the burning of a cigarette, cigar, or pipe, as well as exhaled smoke from smokers. Exposure to secondhand smoke can significantly increase the risk of developing lung cancer, even for those who do not smoke. According to the National Cancer Institute, secondhand smoke is responsible for an estimated 3,000 lung cancer deaths per year in the United States.
When you breathe in secondhand smoke, you’re inhaling many of the same toxic chemicals that smokers inhale, including carcinogens like benzene and formaldehyde. These harmful substances can damage the cells in the lungs, leading to an increased risk of developing lung cancer.
The risk of lung cancer from secondhand smoke is higher for people who are exposed to it regularly, such as those who live with a smoker or work in environments where smoking is permitted. However, even occasional exposure to secondhand smoke can elevate lung cancer risk. Protecting yourself and your loved ones from secondhand smoke is critical to maintain lung health and reduce the risk of lung cancer.
3. Diet and Nutrition
Diet plays an important role in overall health, and it also can impact the risk of developing cancer. Research suggests that a diet low in fruits and vegetables may increase one’s cancer risk, as these nutrient-rich foods provide essential vitamins, minerals, and antioxidants that help protect the body from cell damage and support immune function.
Incorporating a healthy diet packed with a variety of colorful fruits and vegetables can be a simple yet powerful way to reduce cancer risk. These foods are rich in antioxidants and phytochemicals that help protect lung cells from harmful damage. By choosing a balanced diet and making fresh produce a daily priority, you’re not only supporting lung health but boosting your overall well-being.
Note the importance of obtaining nutrients from whole foods rather than relying on concentrated supplements without medical advice. Some research has shown that high-dose beta-carotene or vitamin A supplements should be avoided in smokers.
Environment
Environmental Risk Factors
1. Exposure to Radon and Carcinogens
Exposure to environmental and workplace hazards can significantly contribute to lung cancer risk. One such hazard is radon, a naturally occurring radioactive gas that can seep into homes and buildings from the ground. Radon is odorless and invisible, making it undetectable without proper testing, yet prolonged exposure is a leading cause of lung cancer in non-smokers. Ensuring your home is tested and mitigated for radon levels is a proactive step toward reducing cancer risk.
Radiation therapy, particularly when applied to the chest area, is another risk factor for lung cancer. Individuals who have undergone such treatment for cancers like Hodgkin lymphoma or breast cancer may face increased risks for developing lung cancer later on.
In addition to radon, carcinogens such as asbestos and arsenic are well-documented contributors to lung cancer. Asbestos, once widely used in construction and insulation, poses a risk when its fibers are inhaled. Arsenic exposure can occur through contaminated water or certain industrial processes. Both substances have been linked to increased lung cancer risk, which emphasizes the importance of minimizing exposure.
Occupational hazards also play a significant role. People working in industries such as mining, construction, and manufacturing may be exposed to these and other harmful carcinogens daily. Taking protective measures, including proper ventilation, personal protective equipment, and adherence to safety regulations, is essential for reducing exposure and safeguarding lung health.
By understanding and addressing these environmental and occupational risks, individuals and communities can take meaningful steps to lower lung cancer risk and create healthier living and working conditions.
2. Exposure to Asbestos
Asbestos is a group of naturally occurring minerals that were once widely used in construction, insulation, and various industrial applications due to their heat-resistant properties. However, asbestos exposure has been linked to several serious health issues, including lung cancer.
When asbestos fibers are inhaled, they can become lodged in the lung tissue, causing scarring and inflammation over time. This chronic irritation can lead to cellular changes and the development of lung cancer. According to the National Cancer Institute, asbestos exposure is responsible for an estimated 4,800 lung cancer deaths per year in the United States.
Individuals most at risk of developing lung cancer from asbestos exposure include those who have worked in industries such as construction, mining, and shipbuilding, where asbestos use was prevalent. However, anyone who has been exposed to asbestos, even in older buildings with asbestos-containing materials, can be at risk. It’s essential to minimize exposure to asbestos and to take appropriate safety measures if you suspect its presence in your environment.
3. Air Pollution
Air pollution is an increasingly recognized risk factor for lung cancer, with diesel exhaust being a significant contributor. Diesel engines emit a mixture of harmful chemicals and fine particulate matter that, when inhaled, can damage lung cells over time. This exposure is especially concerning for individuals living or working near busy highways, industrial areas, or other sources of heavy diesel traffic. Studies have linked prolonged exposure to diesel exhaust with an elevated risk of developing lung cancer.
Living in areas with high levels of general air pollution also poses risks. Pollutants from vehicles, factories, and even natural sources like wildfires can release harmful particles and gases into the air. These pollutants can penetrate deep into the lungs, causing inflammation and increasing the likelihood of cellular changes that may lead to lung cancer.
Taking steps to reduce exposure is vital for lung health. Strategies include advocating for cleaner energy initiatives, using air purifiers indoors, and staying indoors during times of poor air quality. By staying informed and proactive, individuals can help mitigate the risks associated with air pollution and contribute to cleaner, healthier environments for everyone.
Family History
Personal or Family History of Lung Cancer
Lung cancer is not considered a hereditary disease. Having a close relative with lung cancer slightly increases your risk, but this may also be due to shared environmental factors (e.g., smoking habits). While this does not guarantee you will develop the disease, it’s a reason to stay vigilant with screenings and health check-ups. If you’ve had lung cancer before, there is a higher likelihood of recurrence or developing a new cancer, especially if previous risk factors like smoking or environmental exposures persist.
Interestingly, a family history of other cancers, such as medullary thyroid cancer or papillary thyroid carcinoma, can also increase lung cancer risk. These connections are thought to be related to shared genetic mutations that predispose individuals to multiple cancer types. For example, individuals with a family history of these thyroid cancers may benefit from discussing genetic testing with their healthcare provider, especially if there’s a known mutation in the family. Men are more likely to develop thyroid cancer at an older age, particularly between the ages of 70 and 74.
By understanding your family history and genetic predispositions, you can take proactive steps to reduce risk, such as discussing personalized screening strategies or lifestyle adjustments with your doctor. Advances in genetic research are shedding light on these connections, offering new opportunities for early detection and targeted therapies that improve outcomes for individuals at higher risk.
Genetic Alterations: Main Drivers of Lung Cancer
Genetic alterations such as fusions in the RET gene, play a pivotal role in most cases of lung cancer. These alterations can be caused by environmental factors, such as smoking and exposure to carcinogens, or occur spontaneously due to errors in DNA replication. Genetic testing can help identify these mutations, providing valuable insights for both prevention and treatment planning.
Genetic alterations like EGFR mutations or ALK or RET rearrangements are more common in people who do not smoke, suggesting alternative carcinogenic pathways.
1. Genetic Mutations and Rearrangements in RET
The hallmark of RET-positive lung cancer is a genetic alteration involving the RET (Rearranged during Transfection) gene. This alteration is not inherited but occurs spontaneously, often during cell division. Unlike cancers strongly linked to external factors like smoking, RET-positive lung cancer can occur in people with no significant exposure to traditional risk factors, making it more common in people who do not smoke or never smoked as well as younger individuals.
RET-positive lung cancer shows a slightly different demographic profile compared to other types of lung cancer:
- Age: RET-positive lung cancer is more frequently diagnosed in younger patients compared to lung cancers linked to smoking.
- Gender: Some studies suggest a higher prevalence of RET-positive lung cancer among women, although the reasons for this are not entirely understood.
- Smoking History: Many RET-positive lung cancer patients have little to no history of smoking, further distinguishing it from other forms of the disease.
2. Implications of Genetic Testing
Since RET-positive lung cancer is closely associated with specific genetic changes, identifying these mutations through genetic or biomarker testing is critical. People with a family history of cancer or a history of rare tumor types might be more likely to benefit from early genetic screening, even if other traditional risk factors are absent.
3. Early Detection is Still Key
The risk factors for RET-positive lung cancer underscore the importance of genetic testing and a deeper understanding of individual health histories. For individuals with no significant exposure to traditional lung cancer risks, unexplained symptoms or diagnoses should prompt discussions about genetic testing. With advancements in targeted therapies specifically designed for RET-positive cases, early identification can make a critical difference in outcomes, offering hope and tailored treatments for those affected by this unique form of lung cancer.
Prevention and Risk Reduction Tips
- Don’t Smoke
- Smoking is the leading cause of lung cancer.
- Quitting can reduce your risk by 30-50% within five years, depending on the duration and intensity of prior smoking habits.
- Use resources like nicotine replacement therapy, prescription medications, counseling, support groups, acupuncture, or hypnosis.
- Avoid Secondhand Smoke and Carcinogens
- Stay away from places where smoking is allowed.
- Ask smokers to smoke outdoors.
- Use a HEPA air purifier to minimize indoor air pollution.
- Follow workplace safety guidelines to avoid exposure to asbestos and other carcinogens.
- Eat a Healthy Diet and Exercise Regularly
- Focus on fruits, vegetables, and whole grains to support your health.
- Limit processed and high-fat foods.
- Engage in regular physical activity like walking or jogging to maintain a healthy weight and fitness level.
By making these proactive lifestyle changes, you can lower your risk of lung cancer and improve your overall well-being.
References
-
-
- https://www.cdc.gov/lung-cancer/risk-factors/index.html
- https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/basics/what-causes-lung-cancer
- https://www.cancer.org/cancer/types/lung-cancer/causes-risks-prevention/risk-factors.html
- HopkinsMedicine.org
- https://pubmed.ncbi.nlm.nih.gov/35302182/
- Wang R, Hu H, Pan Y, et al. RET fusions define a unique molecular and clinicopathologic subtype of non-small-cell lung cancer. J Clin Oncol. 2012;30(35):4352-4359. doi:10.1200/JCO.2012.44.1477
- Qiu Z, Ye B, Wang K, Zhou P, Zhao S, Li W, Tian P. Unique Genetic Characteristics and Clinical Prognosis of Female Patients with Lung Cancer Harboring RET Fusion Gene. Sci Rep. 2020 Jun 25;10(1):10387. doi: 10.1038/s41598-020-66883-0. PMID: 32587276; PMCID: PMC7316706.
- Feng J, Li Y, Wei B, Guo L, Li W, Xia Q, Zhao C, Zheng J, Zhao J, Sun R, Guo Y, Brcic L, Hakozaki T, Ying J, Ma J. Clinicopathologic characteristics and diagnostic methods of RET rearrangement in Chinese non-small cell lung cancer patients. Transl Lung Cancer Res. 2022 Apr;11(4):617-631. doi: 10.21037/tlcr-22-202. PMID: 35529790; PMCID: PMC9073740.
- Zhang T, Joubert P, Ansari-Pour N, et al. Genomic and evolutionary classification of lung cancer in never smokers. Nat Genet. 2021;53(9):1348-1359. doi:10.1038/s41588-021-00920-0
- de Alencar VTL, Figueiredo AB, Corassa M, Gollob KJ, Cordeiro de Lima VC. Lung cancer in never smokers: Tumor immunology and challenges for immunotherapy. Front Immunol. 2022 Aug 24;13:984349. doi: 10.3389/fimmu.2022.984349. PMID: 36091058; PMCID: PMC9448988.
- Middha P, Weinstein SJ, Männistö S, Albanes D, Mondul AM. β-Carotene Supplementation and Lung Cancer Incidence in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study: The Role of Tar and Nicotine. Nicotine Tob Res. 2019 Jul 17;21(8):1045-1050. doi: 10.1093/ntr/nty115. PMID: 29889248; PMCID: PMC6636175.
- https://www.yalemedicine.org/conditions/lung-cancer-in-nonsmokers
- https://www.cancer.org/cancer/latest-news/why-lung-cancer-strikes-nonsmokers.html
- https://www.cancer.gov/news-events/press-releases/2021/lung-cancer-never-smokers
-
Your donation matters. Please make a gift today to support lung cancer research and save lives.