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Young, non smokers are increasingly at risk of lung cancer

Dr Brian Bird

Consultant Medical Oncologist, Bon Secours, Cork

With lung cancer becoming increasingly and worryingly prominent in non-smokers, Consultant Medical Oncologist, Brian Bird says, better screening and use of our own immune system are vital areas of innovation for the future.

Risk factors

The common cause of lung cancer is supposedly unambiguous. The big risk factors associated include smoking and asbestos.

However, Dr Brian Bird, Consultant Medical Oncologist at Bon Secours in Cork, says there’s a worrying trend rearing its head among the patients coming through his doors.

“We’re seeing more and more male and female non smokers, young people, coming in with lung cancer. The cause is currently misunderstood.”

Affecting non-smokers

These non-smokers or light smokers are also more likely to have a ‘druggable mutation’. Specific treatments target tumour mutations.

“There’s often a switch that gets jammed on in a cell, commanding it to divide and grow. If you can turn that switch off, it can enable people to live with the disease for years with less of an effect on quality of life,” Bird says.

As with many cancers, finding the disease early can lead to more effective early treatment. Screening for lung cancer in those most at risk could have an enormous impact on the death rate caused by the disease.

“With those who’ve smoked heavily for 20 or 30 years, even if they’ve stopped smoking, providing annual chest CT scans can reduce lung cancer mortality by 20%,” Bird says.

This will in fact enable more oncologists to stop cancers spreading and becoming less manageable.

“Catching it early helps us establish whether we can simply cut it out or – if that’s not an option – use radiotherapy to essentially ‘cook’ the tumour, which is almost as effective as surgery itself.”

Screening and treatments

Better screening and treatments are seeing lung cancer patients’ quality of life improve, despite there being room for further innovation in both areas.

Screening through blood tests would mean less exposure to radition for patients. But this is something that’s still a way off being available.

Currently, much focus is on alerting and enabling patients’ immune systems to fight their lung cancer. It is an area of constant development.

Our body’s immune system constantly receives messages to ‘stand down’ where it’s not needed. Cancer can manipulate these ‘brakes’ put on the immune system, meaning it can divide and spread unchecked throughout the body.

“Having a better understanding of how lung cancer evades the immune system. We’ll be able to ‘take the brakes off’ the immune system and allow it to fight the cancer itself.”

Between 20 – 40% of patients benefit from immunotherapy.

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