Journalist Mila Ximénez died this Wednesday of lung cancer that was diagnosed a year ago. It is the type of tumor that causes the most deaths in the world and in Spain. In our country it was responsible for 22,930 deaths in 2020 (20.3% of all tumors), followed by colorectal cancer (16,470; 14.6%), and pancreatic cancers (7,568; 6.7%), breast (6,606; 5.8%) and prostate (5,798; 5.1%), according to the SEOM report “Cancer figures in Spain”.
It is a more frequent tumor in men, being responsible for a quarter of deaths from cancer (17,346 deaths; 25.6%), but the report highlights that in women it went from being the fourth most diagnosed tumor in the estimates for the year 2015, the third most incident already in 2019. A fact that oncologists relate to the increase in tobacco use in women from the 70s.
«Lung cancer is a potentially avoidable pandemic, which has been progressing unstoppably in recent years, without us paying the attention it deserves. It is the cancer that causes the most deaths in Spain and has been the second cause of death in men, after Covid-19. If Covid-19 had not appeared, it would remain the leading cause of mortality among men and is also significantly affecting women. In addition, one of the effects of the COVID-19 pandemic is the underdiagnosis of new cases of lung cancer, among other cancers, “said Dr. Juan Carlos Trujillo, thoracic surgeon and coordinator of the area of Thoracic Oncology at SEPAR, in February. .
The expert also recalled that there is a ‘vaccine’ against lung cancer: quit smoking. “We have known it for many years and it is available to everyone, but we do not emphasize it enough. Lung cancer can be prevented, so SEPAR pulmonologists and thoracic surgeons regret this epidemiological situation and demand public health measures and the citizens themselves, individually, to combat the main risk factor for this disease, smoking ”, emphasizes Dr. Trujillo.
Along with prevention, the role of the pulmonologist is key in the detection and screening of lung cancer in early stages, since it can be better addressed if it is detected in these initial stages, I and II, when the tumors are still asymptomatic and barely visible. have spread. The problem is that, currently, around 75% of lung cancer cases are diagnosed in advanced stages -60% in stage IV and 15% in stage III- and only 16% of these tumors are diagnosed confined to their primary site, according to data from the medical literature.
“The diagnosis of stage I and II lung cancer is rare because tumors are asymptomatic or give very unspecific symptoms. This leads to a delay in the diagnosis of these tumors and, when they are diagnosed, the prognosis is worse and explains why survival is only 15% of cases at five years in the world. For this reason, we must emphasize the importance of carrying out a screening program, to be able to detect tumors when they are still operable and therefore the survival of patients can be lengthened. Undoubtedly, the pulmonologist plays a crucial role in the diagnosis of these primary tumors, while the thoracic surgeon plays a crucial role in their surgical treatment, ”says Dr. Trujillo.
In this sense, SEPAR is developing together with other medical societies the Cassandra project (Cancer Screening Smoking Secession and Respiratory Assessment), for the screening and detection of both lung cancer as well as other diseases derived from smoking.
Some of the symptoms that should alert us to see a doctor:
-Loss of appetite.
-Dry cough with or without phlegm.
-Cough with blood in sputum (hemoptysis).
-Difficulty breathing (dyspnea), which may be caused by a collapsed lobe of the lung (atelectasis) or because on some occasions when the tumor invades the pleura, it reacts by generating fluid (pleural fluid) that oppresses and causes dyspnea.
-Pain when it affects bone structures.
Within lung cancer, there are two types: non-small cell (non-small cells) and microcytic (small cells). The latter represents 15% of lung tumors and is more aggressive, with high metastatic potential and a poor prognosis (the mean overall survival of patients from diagnosis is 9.5 months).