World Lung Cancer Day
August 1st is World Lung Cancer Day, a day to raise awareness, educate and advocate for patients with lung cancer. Lung cancer is the most common and most deadly cancer in the world. It is estimated that 1 in 14 Canadians will be diagnosed with lung cancer in their lifetime. Despite how common it is, 70% of cases are diagnosed at stage 3 or 4, when the cancer has spread to other parts of the body or is too large to remove.(1) In addition, lung cancer is one of the world’s most preventable cancers; it is estimated that 86% of cases are caused by risk factors that people can change – these are otherwise known as “modifiable risk factors”.(2) Read on to learn about some of the things we can do for lung cancer screening and prevention.
Screening
Screening for lung cancer in people who may be at risk is important, as symptoms often go unnoticed until advanced stages. The Ontario Lung Screening Program is Ontario’s organized screening program for people who are at a high risk of getting lung cancer. Screening for lung cancer involves a computed tomography (CT) scan of the lungs once a year. You may qualify for screening if you:
- Are 55 to 74 years old, and
- Have smoked cigarettes every day for at least 20 years (does not need to be 20 years in a row)
Healthcare providers can refer patients to the program, and patients in Ottawa can call (613) 761-4535 to see if they are eligible. If you meet the above criteria for screening, you must also undergo an assessment by a doctor before you are enrolled in the program. Not everyone should be screened for lung cancer, as sometimes the risks can outweigh the benefits.
Smoking and Lung Cancer
Exposure to tobacco is the number one risk factor for lung cancer, accounting for about 72% of all cases.(1) The best way to reduce your risk is to not smoke and to avoid secondhand smoke. That being said, quitting smoking is also extremely important and impactful. Smoking cessation has been associated with a 29% increase in overall survival when done at or around the time of diagnosis.(3) Check out the American Cancer Society for a great visual of the benefits of quitting smoking over time. Immediate benefits include saving money, a better sense of taste and smell, and a better ability to do daily activities, like climbing stairs. Within the first year, your lungs start to repair themselves, which can decrease coughing, shortness of breath, and risk of infection. Ten years after quitting, your risk of lung cancer is half of that of a person who continued to smoke over that time.
Smoking Cessation
Although the benefits of smoking cessation are well-known, quitting is easier said than done! There are pharmaceutical options such as varenicline, bupropion, and nicotine replacement therapy, however long-term abstinence rates are still low.(4) You can enlist the help of friends and family, and other healthcare providers. Psychotherapists and naturopathic doctors (NDs) may be in a unique position to help with smoking cessation; they can offer more time in visits to assess motivators to quit, talk about coping skills, and schedule regular follow-ups for support and accountability. Stress reduction strategies such as breathwork and meditation, and motivational interviewing are used by both psychotherapists and NDs. Some NDs also use an acupuncture protocol that may help with quitting, called the National Acupuncture Detoxification Association protocol.(5)
Radon and asbestos
Two other major risk factors for lung cancer are radon and asbestos exposure. Radon is a radioactive gas which can damage the DNA in lung cells. Some buildings have higher amounts of radon than others. It is recommended that you test the radon levels in your home and, if they are above normal, work with a certified professional to lower them. For more information about radon in your home and to buy a test kit, you can visit https://takeactiononradon.ca/.
Asbestos has been banned in Canada since 1990; however, it remains in certain materials. People at the highest risk of asbestos exposure are those who work with it, such as people in construction, home building and renovation, and certain maintenance industries. In the home, the most common source of asbestos is vermiculite-based insulation and older brake or transmission parts in your car. To reduce your risk of asbestos exposure in your home, you can hire a professional to test for asbestos before renovating or remodeling, avoid your attic if you have vermiculite-based insulation, and check with your mechanic to see if older car parts contain asbestos.
Lifestyle factors
Diet and exercise can greatly influence your risk of getting cancer. Physical activity has been shown to decrease the risk of many types of cancer. The strongest evidence is for breast and colon cancer; however, there is moderate evidence for lung cancer as well.(6) For adults, the Canadian Society for Exercise Physiology recommends at least 150 minutes of moderate to vigorous aerobic physical activity per week with the addition of muscle strengthening activities (i.e., resistance exercise) at least twice per week.
Your diet may also influence your risk of getting cancer. The World Cancer Research Fund reports that consuming red meat, processed meat, and alcohol may increase risk of lung cancer. They also report that consuming a high fruit and vegetable intake may be associated with a decreased risk of lung cancer for those who smoke. This has been supported by more recent research on the Mediterranean Diet, which is characterized by high amounts of fruits, vegetables, nuts, legumes, fish, whole grains, and extra virgin olive oil, as well as low amounts of red meat, processed meat, and alcohol. In smokers, adherence to the Mediterranean Diet was associated with a decreased risk of respiratory cancers, such as lung cancer.(7) Part of the reason for this may be the fact that the Mediterranean Diet is high in fibre. Consuming fibre has been inversely associated with risk of certain cancers, including lung cancer.(8)
If you or someone you know is looking for help with smoking cessation, nutrition and exercise, or support during lung cancer treatments, consider reaching out to a naturopathic doctor working in cancer care, or another healthcare provider, to start making changes today.
Other resources:
- Quitting tobacco tool kit
- Indigenous tobacco program
- Smokers’ Helpline by the Canadian Cancer Society
- Radon test kit
Mark is a full-time clinical trial coordinator with the Patterson Institute for Integrative Oncology Research. He is involved in the development, implementation, day-to-day activities, and publication of all clinical research conducted at the CHI. Mark joined Dr. Dugald Seely, ND’s research team in 2018 after volunteering with his brother, Dr. Andrew Seely, at The Ottawa Hospital. Mark is also an employee of The Ottawa Hospital Research Institute, a Certified Clinical Research Professional (CCRP), and an active member of the Ottawa Health Sciences Network Research Ethics Board.
Erica is a licensed naturopathic doctor at The Centre for Health Innovation, where she works with people affected by cancer, as well as other conditions such as anxiety, eating disorders, and digestive health concerns. Erica joined the team at The Patterson Institute for Integrative Oncology Research as a research assistant in 2022, and continues to support research initiatives. She is also a member of the research committee for the Oncology Association of Naturopathic Physicians.
References
- Canadian Cancer Society. Canadian Cancer Statistics. 2023;
- Brenner DR, Poirier AE, Walter SD, et al. Estimating the current and future cancer burden in Canada: methodological framework of the Canadian population attributable risk of cancer (ComPARe) study. BMJ Open. 2018;8(7):e022378. doi:10.1136/bmjopen-2018-022378
- Caini S, Del Riccio M, Vettori V, et al. Quitting Smoking At or Around Diagnosis Improves the Overall Survival of Lung Cancer Patients: A Systematic Review and Meta-Analysis. Journal of Thoracic Oncology. 2022;17(5):623-636. doi:10.1016/j.jtho.2021.12.005
- Hawk LW, Jr, Tiffany ST, Colder CR, et al. Effect of Extending the Duration of Prequit Treatment With Varenicline on Smoking Abstinence: A Randomized Clinical Trial. JAMA Network Open. 2022;5(11):e2241731-e2241731. doi:10.1001/jamanetworkopen.2022.41731
- Stuyt EB, Voyles CA. The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. Subst Abuse Rehabil. 2016;7:169-180. doi:10.2147/sar.S99161
- Rezende LFM, Sá TH, Markozannes G, et al. Physical activity and cancer: an umbrella review of the literature including 22 major anatomical sites and 770 000 cancer cases. Br J Sports Med. Jul 2018;52(13):826-833. doi:10.1136/bjsports-2017-098391
- Morze J, Danielewicz A, Przybyłowicz K, Zeng H, Hoffmann G, Schwingshackl L. An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. Eur J Nutr. Apr 2021;60(3):1561-1586. doi:10.1007/s00394-020-02346-6
- Wei X, Zhu C, Ji M, et al. Diet and Risk of Incident Lung Cancer: A Large Prospective Cohort Study in UK Biobank. Am J Clin Nutr. Dec 1 2021;114(6):2043-2051. doi:10.1093/ajcn/nqab298
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