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Opinion: We need to remove the stigma around lung cancer - no one should be blamed for getting it

Smoking is one of the primary causes of lung cancer and some patients feel they are being blamed for having cancer, writes Dr Anne-Marie Baird.

Anne-Marie Baird

Today, 4 February 2019 is World Cancer Day. 

LUNG CANCER KILLS more people in Ireland than any other form of cancer and we urgently need a screening programme to detect the disease earlier to save lives. 

We need to talk about lung cancer to remove the stigma too – no one should ever be blamed for having cancer. There is a lack of awareness among healthcare professionals as well as the general public in relation to the prevalence of lung cancer in Ireland.

Most people struggle to identify the symptoms of the disease and are not as aware of the need for early medical intervention as they are with other types of cancer.

Smoking is one of the primary causes of lung cancer and some patients feel they are being blamed for having cancer.

This feeling is not without substance, according to the Marie Keating Foundation research,  27% of people surveyed believe that patients with lung cancer who never smoked, should be given treatment priority over patients with lung cancer who do, or did, smoke.

This is a startling finding.

No matter what anyone’s lifestyle choices are, nobody deserves a cancer diagnosis – whether it’s breast, cervical or lung cancer.

Lung cancer kills

Figures from the National Cancer Registry of Ireland (NCRI) last year showed that approximately 2,600 people are diagnosed with lung cancer in Ireland each year. The fatality rates are high and more than 1,800 people died from the disease in 2018.

That means lung cancer is the single biggest cancer killer in Ireland, accounting for more deaths than breast cancer and colorectal cancer combined.

Lung cancer is the single biggest cancer killer among Irish women too but recent research conducted by the Marie Keating Foundation showed that only 9% of respondents correctly identified that fact. 

47% of people surveyed thought that breast cancer was the number-one cause of female cancer mortality, while 37%  believed it was cervical cancer. 

The percentage of these young people (aged 18-24) who correctly identified lung cancer as the biggest cancer killer among women was a startlingly low, at just 1%.

Dark diagnosis

On a personal level, lung cancer, in particular, can be a dark diagnosis for patients to receive — the survival rates are very poor at just 15% to 18% over five years. That makes very difficult reading for patients and their families before they have started their treatment journey. 

There is also the stigma that patients have to deal with. This stigma can come in many forms; it can impact when and how often patients engage with the healthcare system not only when they become worried about their symptoms but also throughout the cancer care pathway. 

Surveys show that the public expects lung cancer rates to drop in the coming two decades, while actually they are set to increase. Lung cancer is increasing in female non-smokers and the number of women contracting the disease is predicted to rise by 136% by 2040.

On a clinical level, there is a difference in how men’s and women’s biology deals with toxins in the environment. 

Women who do have a smoking history are also more at risk of developing lung cancer compared to their male counterparts. Women don’t have to smoke as much, or for as long as men, to be at increased risk of lung cancer. This is a fact that needs to be highlighted as a matter of urgency.

The reasons for the predicted rise in lung cancer cases in Ireland are multifactorial. The National Cancer Registry of Ireland report states that ‘lung cancer rates track smoking prevalence from decades past’, however it is most likely more complex than this.

No matter what the reasons are behind the numbers – it is critical that people are aware that anyone can get lung cancer, as the disease is not confined to smokers. 

Screening

At the moment in Ireland, the majority of patients present when they are at the late stage of the disease and so surgery is often not an option. However, we are witnessing a change in survival rates, in select cohorts of patients, due to new targeted treatment options and immunotherapy.

There is still much work left to do and we need vital funding to be invested in research, as well as improving access to new innovative therapies.

Ireland lags behind other Western European countries in terms of timely access to medications and this is extremely frustrating for patients, their families and physicians alike.

While improved education, awareness and treatment options are critical, there is also an urgent need to establish a screening programme. From a number of studies, it is now clear that low dose CT lung cancer screening programmes save lives.

At the moment lung cancer screening is not part of Ireland’s 10-year national cancer strategy 2017-2026. We cannot wait 10 years to have the same conversation about the need for a screening programme this is doing a disservice to all of those at risk of lung cancer.

There now needs to be a coordinated, focused call for action from all the stakeholders in the lung cancer community in Ireland, to come together and work as a team to advocate for the establishment of a screening programme and to make lung cancer a priority.

All cancer types should be treated equally and as lung cancer is the number one killer cancer in Ireland we need a screening programme now. 


Dr Anne-Marie Baird is a molecular biologist, Cancer Researcher; Patient Advocate; Board Member at Lung Cancer Europe and member of the European Cancer Organisation Patient Advisory Committee. This opinion piece is based on a speech she gave at a conference on lung cancer which was run by MSD Ireland. 

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Anne-Marie Baird

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