Busting lung cancer myths

(Credit: iStock.com/Nikolay Amoseev)

Although lung cancer is one of the most common cancers in Singapore, there are still many misconceptions about the disease. Lung cancer is the third most common cancer in both males and females locally, and it is the leading cause of cancer deaths in males, accounting for over 4,000 cases from 2019 to 2023, and the third leading cause of cancer deaths in females¹. 

What is lung cancer?

The lungs are a key part of our respiratory system responsible for bringing fresh air into the body and removing waste gases. Lung cancer forms when abnormal cells in the lung grow uncontrollably and interfere with normal lung function. As the disease progresses, these abnormal cells can spread from the lung to other parts of the body, such as lymph nodes and other organs.

Misconceptions about lung cancer can delay the care you need. In conjunction with lung cancer awareness month in November, Clinical Associate Professor Ng Quan Sing, Senior Consultant, Department of Lung, Head & Neck and Genitourinary, Division of Medical Oncology, National Cancer Centre Singapore (NCCS), dispels some of the most common myths.

Clinical Associate Professor Ng Quan Sing, Senior Consultant, Department of Lung, Head & Neck and Genitourinary, Division of Medical Oncology, NCCS, dispels common myths about lung cancer.

Myth 1:  I’ve only had a cough for a long time but have no other symptoms, so there’s nothing to worry about
 

See your doctor if you have a persistent cough or any symptoms that do not go away. (Credit: iStock.com/Weedezign)

Early-stage lung cancer may not cause any noticeable symptoms. This is one reason why it can go undetected until it is at a more advanced stage, making it much harder to treat. When symptoms do present, they may include a persistent or worsening cough, coughing up blood, breathlessness, constant chest pain, unexplained weight loss, fatigue, recurrent chest infection and fever. However, these symptoms can be caused by other conditions and may not necessarily be lung cancer. Prompt medical attention can help to determine whether further tests are needed, which is why it is important see your doctor if you experience any worrying symptoms. 

Myth 2: Only smokers get lung cancer

Lung cancer can affect non-smokers too. Breathing in second-hand smoke is one of several factors that can increase your risk of developing lung cancer. (Credit: iStock.com/Nuttawan Jayawan)

While it is true that smoking remains the greatest modifiable risk factor for lung cancer, as smokers are 15 to 30 times more likely to develop lung cancer than non-smokers, it is not the only risk factor. Lung cancer can and does occur in people who have never smoked. This is particularly common in Asia. In Singapore, nearly half of all lung cancer cases occur in never-smokers, with many developing non-small cell lung cancer (NSCLC), caused by genetic mutations that drive the growth of the cancer.

Other factors that may increase the risk of lung cancer include exposure to second-hand smoke or certain harmful chemicals such as asbestos. Additionally, having a family history of lung cancer may increase the risk of developing lung cancer.   

 
Myth 3: Vaping is safe and does not cause lung cancer

The long-term impact of vaping on lung cancer risk is not yet fully understood. However, vaping devices are known to release harmful cancer-causing chemicals that can damage lung tissue and may contribute to the development of lung cancer over time. Clinical studies have shown that vaping, in combination with tobacco smoking, can significantly increase the risk of lung cancer.

Myth 4: Lung cancer is a death sentence

A lung cancer diagnosis is not always a death sentence. Lung cancer can be cured in the early stages when the cancer has not spread, using a variety of treatment modalities based on the stage and spread of the cancer. This can include surgery to completely remove the tumour and radiation therapy. Your doctor will also advise if additional treatment such as chemotherapy, immunotherapy, or targeted therapy is needed to further reduce the risk of the recurrence.

Late-stage lung cancer, when the cancer has spread beyond the lungs to other parts of the body, cannot be cured, but treatment can help to control the cancer so that patients can live longer and maintain a relatively good quality of life. Patients who carry certain genetic mutations, that causes cancer growth and spread, may be suitable for genetic targeted therapy while immunotherapy is another treatment option for late-stage lung cancer patients. Chemotherapy is also used to treat lung cancer, and modern formulations are more targeted and effective in eliminating cancer cells, with fewer side effects than before.

Myth 5: I should avoid exercise if I have lung cancer as it will make me feel tired and breathless

Appropriate exercise can help lung cancer patients maintain their strength and quality of life. (Credit: iStock.com/Nuttawan Jayawan)

It is understandable to worry that physical activity might worsen breathlessness or fatigue. However, appropriate exercise can help patients maintain their strength, physical function, and quality of life during and after treatment. The key is finding the right balance - the type and intensity of exercise should be tailored to individual health and fitness levels. Remember to always discuss exercise plans with your healthcare team before starting a new regime.

At NCCS, the Lung Cancer Education and Advocacy for Patients (LEAP) support group organises bi-monthly nature walks at locations such as the Botanic Gardens, Gardens by the Bay, Coney Island, and Punggol Waterway. These excursions give patients, their family members, and caregivers the opportunity to enjoy fresh air, build strength and stamina, and connect with one another.

To join the exercise interest group #lungcancerwillnotkeepmedown, lung cancer patients can e-mail leap@nccs.com.sg

¹Singapore Cancer Registry Annual Report 2023