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In Singapore, overall mortality has declined
from 5.2 per 1,000 in 1972 to 4.5 per 1,000 in 1995. Nevertheless,
cancer-related deaths have increased from 14.8% between 1968
to 1972, to 25.6% currently. Overwhelming presence of lung
cancer contributes to this increase. It is the leading cause
of cancer deaths in males with ASR (Age Standardized rate
per 100,000 per year) of 43.0, and the third leading cancer
but leading cause of cancer death in females at ASR of 16.0
(1993 to 1997 figures).
Grim
mortality figures underlined the need for new approaches.
There is a need to reduce factors, take chemoprevention measures,
adopt early diagnostic strategies and improve treatment by
having a better understanding of the pathogenesis. Epidemiological
studies have shown that most lung cancer cases are attributable
to smoking. Only 5 % to 10% of lung cancers occur in patients
with no prior history of smoking. Compared with non-smokers,
smokers have a 10-fold greater risk of dying from lung cancer
and in heavy smokers, this risk increases to 15-25-fold. As
such, smoking cessation is important in lung cancer prevention
and in Pharmacy Tips, some pharmaceutical interventions are
presented.
Cancer
can be treated curatively with surgery in the early stage
cancer. Recent developments in scanning technologies have
made early diagnostic screening a reality. Over 80% of lung
cancers are attributed to tobacco, yet only some smokers develop
lung cancer. Inheritance-pattern studies suggest that a small
number of lung cancer cases are a result of lung cancer genes
that are likely to be of low frequency, but high in penetration.
Multiple genetically determined factors might abrogate the
effects of environmental carcinogens and thus explain differences
in susceptibility.
In
this day and age of genomics and proteomics, we are beginning
to understand the origin of this cancer and improve preventive
and treatment strategies. So read on and take with us a ‘zooming
trip’ for an overview of management lung cancer management
and some state- of-the-art, multi-disciplinary management
approaches.
Dr
Sandeep Rajan
Editor
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