DOVER –– November is Lung Cancer Awareness Month and is a good time to reduce your risk factors and to learn your status when it comes to lung cancer.

Vikas Batra

“It’s most important for high-risk individuals between the ages of 55 and 75 to be screened,” Dr. Vikas Batra, a pulmonologist at Beebe Healthcare said. “So that’s what this month is really about, getting these people screened.”

High-risk individuals are those who have smoked for 30 or more years and still smoke or quit less than 15 years ago. A screening can be done using a low-dose radiation CT scan. The screening is covered by all insurers and can be prescribed by a primary care doctor.

A 2104 cancer study issued by Delaware Health and Social Services reported that although lung cancer remains a leading cancer in the state, accounting for 14.7 new cancer cases in Delaware between 2006 and 2010, instances of the cancer reduced by 9 percent between 1996 and 2000 while the national rate decreased only 7 percent.

DHSS attributes the reduction to the lower smoking rates in Delaware that have gone from 30 percent in 1980 to 17 percent in 2012.

Smoking remains one of the highest risk factors for lung cancer and is the easiest risk to eliminate. Smoking tobacco in any form is estimated to cause more than 80 percent of all lung cancer cases.

In Delaware, the age group most likely to be diagnosed with lung cancer is 75 to 84. Very few cases are found among individuals under 65 years of age. In all age ranges and all races, men are significantly more likely to be diagnosed with lung cancer than women.

According to the Lung Cancer Alliance, lung cancer is typically caught only in later stages because there aren’t many pain receptors in the lungs so symptoms do not become apparent right away. And when lung cancer symptoms do show themselves, they can be mistaken for symptoms are similar to those of other common illnesses.

The Lung Cancer Alliance states that symptoms of local disease (early stages, before the cancer has spread) are persistent coughing, coughing up blood, shortness of breath, wheezing, chest pain, fatigue, weight loss and pneumonia.

Symptoms of locally advanced disease (when the cancer has spread to nearby tissue or lymph nodes) include hoarseness, difficulty or pain in swallowing, high-pitched wheezing while breathing, excess fluid in the lining of the lung and excess fluid in the lining of the heart.

“You don’t want to wait until you see symptoms because by then, the cancer is typically in the advanced stages,” Dr. Batra said. “That’s why the outlook isn’t very good for many people diagnosed with lung cancer.”

To diagnose lung cancer, several tests need to be conducted, usually starting with a chest x-ray or a screening CT scan.

“Sometimes, an x-ray can miss a lung mass that can be detected wit a CT scan,” Dr. Batra said. “A CT scan is just about as effective as a mammogram when it comes to the number of lives saved.”

A CT scan can detect small tumors and gives a 3-D image of the tumor. It can also show if the cancer has spread to lymph nodes. If cancer is seen on a CT scan, a biopsy follows to test for cancer and the type, Non-Small Cell Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLC).

NSCLC, the most common type of lung cancer, makes up between 80 and 85 percent of all cases. NSCLC grows and spreads slowly and is staged (between I and IV) based on the size of the tumor and where the cancer has spread (stages I, II, III, IV).

SCLC makes up the remaining 15 to 20 percent of lung cancer cases. The cells in SCLC cases are smaller than typical cancer cells. SCLC spreads quickly to other parts of the body. Unlike NSCLC where the cancer is staged between I and IV, SCLC is staged as limited or extensive, depending on if and where the cancer has spread.

According to the American Lung Association, lung cancer patients have treatment options similar to most cancer patients like surgery, radiology therapy and chemotherapy, but the treatment route is dependent on which type of lung cancer the patient has and the stage the cancer has reached.

“Surgery is the best option because we can just take out the tumor, but if the cancer has spread we would need to use chemotherapy or radiation,” Dr. Batras said.

Radiation is a localized treatment to shrink tumors and kill cancer cells and can be used before or after surgery or on its own.

“Chemo is the best if the cancer has spread, especially to the lymph nodes, because chemo covers the whole body and in some cases, the cancer may have spread to areas where we haven’t detected it yet,” Dr. Batras said.

In Delaware and the United States, lung cancer is the number one cause of cancer-related deaths. Between 2006 and 2010, there were 2,786 deaths from lung cancer, accounting for 30.3 percent of all cancer deaths in the state during that time.

The key to increasing survival rates for lung cancer patients is not only cutting out risk factors like smoking tobacco, but early detection, through an elective, insurance-covered screening.