LUNG CANCER IN WOMEN
Although lung cancer is mostly seen in men, it has started to be seen in women at an increasing rate over the years. Worldwide, lung cancer is the third most common cancer in women after breast and colon cancers. In our country, according to 2017 data, it is seen in the fourth place after breast, thyroid and colorectal cancer.
Due to developments in the diagnosis and treatment of breast cancer, awareness of women on this issue and early diagnosis, deaths due to breast cancer have decreased, and deaths due to lung cancer have risen to the first place relatively.
In parallel with the increasing smoking rates in women after the Second World War, the incidence of lung cancer has also increased.
For example, in the United States, the rate of smoking among women increased dramatically from 1930 to 1960, followed by an increase in lung cancer cases from the 1960s. Tobacco bans and awareness raising efforts, which started in the 1990s, bore fruit as of 2003, and a decrease of approximately 1 percent in cancer numbers each year began.
Comparison of men and women: Lung cancer has been and continues to be more common in men than women. Among non-smokers, the incidence of lung cancer is higher in women (14.4 to 20.8 per 100,000 per year) than in men (4.8 to 13.7 per 100,000 per year), according to large studies. Also, in the United States, about 19 percent of lung cancer in women occurs in never-smokers, compared to just 9 percent in men.
Cell types:It has long been known that the adenocarcinoma subtype is more common in women.
Tobacco exposure: Although all tobacco products have been shown to be the most important risk factor for the development of lung cancer in both women and men, it raises the question whether the relative increase in non-smokers affects the development of lung cancer with endocrine factors. For example, women who smoke have a higher risk of developing lung cancer than men who smoke. In other words, smoking can cause more lung cancer in women. The risk remains significantly higher in women who have smoked and quit, compared to those who have never smoked. The development of lung cancer in passive smokers is approximately 2.5 times higher than in non-smokers.
Radon gas:It is a colorless, odorless, radioactive gas heavier than air. to lung cancer why could it be. It is seen in some areas of the earth. Radon in the soil moves upwards and seeps into the cracks in the floors or walls of the houses. It can accumulate more intensely, especially in basements and lower floors. Radon and smoking have a “synergistic” effect; that is, the damage to be caused by exposure to both is greater than the damage to be caused by the two separately. Radon exposure is estimated to be responsible for approximately 10-15% of all lung cancers. In order to be protected from radon, especially newly constructed buildings and lower floor houses should be ventilated frequently (by making mutual currents), and attention should be paid to covering the floor and wall cracks.
Air pollution:As in China and some other countries in Asia and Africa, the incidence of lung cancer has increased in women exposed to coal, wood or dung smoke used for cooking in poorly ventilated stoves in our country.
Radiation therapy:The incidence of lung cancer has increased in atomic bomb survivors many years after exposure to radiation.
It has been shown that patients with lymphoma or breast cancer who receive radiotherapy to the chest area have a higher risk of developing lung cancer years later than those who do not receive RT. This risk is even higher among smokers.
However, today, the use of modern techniques such as intensity modulated radiation therapy (IMRT) is expected to reduce the incidence of radiation-related lung cancer.
Endocrine factors: The results of large studies suggest that estrogen and progestin therapy lead to an increased risk of lung cancer. The most comprehensive data comes from two studies: It has been shown that the risk of developing lung cancer increases in proportion to the duration of exposure to the hormone in estrogen plus progestin users. In women diagnosed with lung cancer, discontinuation of postmenopausal hormone therapy, if any, should be considered.
Genetic Factors: Differences in the development of cancer in individuals who smoke a similar amount suggest a genetic predisposition to cancer. However, familial transmission is much less common than breast and colorectal cancer.
Previous lung disease:The development of cancer in the healing scar tissue of tuberculosis has been shown as a risk factor in women as well as in men.
Diet, vitamins and minerals: Large-scale studies of selenium and beta carotene to reduce the effects of smoking resulted in disappointment and were terminated prematurely. In recent years, publications on the protective effect of vitamin D have attracted attention.
Prevention: Since about 85 to 90 percent of lung cancer cases are related to smoking, the most effective intervention would be to stop people smoking altogether. However, convincing individuals to quit smoking is not an easy task. Despite overwhelming evidence that smoking causes lung cancer and other deadly health problems, smoking rates remain unacceptably high. The prevalence of smoking is high among young girls and less educated. Research into other methods of lung cancer prevention, including the role of diet and vitamins, should also continue.
Early diagnosis:Data from clinical studies examining screening and the description of specific populations for which this approach is useful are also discussed.
TREATMENT: There is no separate algorithm for the treatment of lung cancer in women than in men. Staging is done for the extent of the disease after the cell type is identified first. The treatment scheme is determined by a multidisciplinary committee, taking into account the patient’s condition and wishes. in treatment
- Chemotherapy (Drug therapy)
- Targeted therapies
- One or more of the supportive treatment options can be used together or sequentially.