Published:
November 4, 2021
As a thoracic surgeon who treats patients with lung cancer, I often hear misconceptions about lung cancer risks, diagnosis and treatment in my daily work. These “myths” can cause patients and families undue stress and impact good decision-making. Below you’ll find some common myths vs. truths on lung cancer care. It’s always important to talk with your doctor to learn the most accurate information for you.
Myth #1 Lung cancer surgery is painful and requires a long period of recovery.
Truth: In the past, conventional lung cancer surgery was indeed a painful procedure and required a long period of recovery. Current day treatments utilizing minimally invasive surgical techniques and robotic surgery have had a major impact on improving this long-standing issue.
After robotic minimally invasive surgery and removal of lung tumors, most patients are hospitalized one to two days. Once discharged home they resume most of their regular activities within seven to 10 days. More than 90 percent of our current lung cancer surgery patients do not need opioid pain medications. This decreases complications of confusion and delirium following surgery, as well as issues with constipation.
Myth #2: Radiation from CT lung screening causes lung cancer.
Truth: CT lung screening uses low-dose radiation scans. In one year, an average person naturally gets about 3 millisieverts (mSv) of radiation exposure from environmental factors. In comparison, a low-dose CT lung screening scan contributes approximately 1.5 millisieverts (mSv) of radiation exposure. A conventional CT scan, which is not what is used in the screening setting, contributes approximately 7 millisieverts (mSv) of radiation exposure.
Even though the radiation exposure is extremely small, any radiation can be a risk for developing a malignancy. Low-dose CT lung screening is only used for patients who are at high risk for lung cancer based on age and smoking history. The risk with appropriate use of low-dose CT lung screening is markedly less than not diagnosing a lung cancer which, when discovered in an early stage, can be easily treated and often cured.
Myth #3: There is nothing I can do to decrease my risk of getting lung cancer.
Truth: You can reduce your lung cancer risk by following these guidelines:
- Don’t smoke and if you do smoke, quit.
- Avoid secondhand smoke.
- Test your home for radon, a naturally occurring gas in the soil that can cause lung cancer.
- Avoid exposure to known environmental carcinogens in your workplace.
- Exercise regularly and maintain healthy dietary habits. Both have been shown to decrease cancer risk.
Myth #4: Lymph node removal during cancer surgery causes adverse side effects.
Truth: Unlike other surgical treatment of cancers, lymph node removal during lung cancer surgery does not cause any adverse side effects. The chest cavity has an abundant supply of lymphatic drainage pathways which easily compensate for the removal of any lymph nodes—part of a standard and thorough lung cancer surgery procedure. Patients do not experience any swelling of arms or legs (lymphedema) and are not at increased risk for developing infections after lymph nodes are removed.
Myth #5: Every patient receives the same treatment.
Truth: Lung cancer diagnosis and treatment require a customized plan for every patient. No two patients are alike. For example, lung cancer treatment is often different for women and men (see below). The best treatment plan is one designed by a multidisciplinary team of lung cancer experts. Your team will discuss all options with you and together, you will select the plan that best fits your individual needs.
Myth #6: Sugar causes lung cancer.
Truth: There has been much debate on whether sugar consumption plays a role in causing lung cancer, or cancer in general. People ask this question because like all living tissue, cancer cells require nourishment to continue to develop and grow. The theory was that if sugar intake was reduced cancer cells would have less nutrition or fuel available. This theory is not true. There has been no definitive link between sugar and cancer.
However, obesity is a known factor in cancer growth and development. A good balanced diet of fruits and vegetables with decreased sugar intake is beneficial to weight reduction and a decrease in obesity. This in turn, lowers cancer risk.
Myth #7: Lung cancer screening is experimental.
Truth: Low-dose CT lung screening is not experimental. It is a proven method for finding lung cancer in its earliest stages before people develop symptoms like cough, weight loss, pain, shortness of breath, and other complaints.
Numerous studies have identified low-dose CT lung screening as the gold standard for finding lung cancer early when there is a better chance of cure. The results are so favorable that in 2021 the U. S. Preventive Services Task Force broadened recommendations on who should be considered for the screening. Their new recommendations include people ages of 50 to 80 who have a 20-pack-year tobacco history (1 pack of cigarettes per day for 20 years or two packs per day over 10 years) who are still smoking or quit in the past 15 years.
Medicare has not yet approved payment for this younger group of patients but is expected to do so in the near future. These guidelines were changed to include younger people and those with a low consumption of tobacco because the current guidelines have been so successful in finding early lung cancer and improving survival. Low-dose CT lung screening is essential for at-risk patients, similar to other screening programs like mammograms and colonoscopies.
Myth #8: There are a lot of false positives with CT lung screening.
Truth: Low-dose CT lung screening does find abnormalities inside the chest that are not necessarily lung cancer. Compared to other types of lung nodules, lung cancers tend to have irregular or spiculated nodules or nodules more than 1 cm in size that can be worrisome. Some nodules that are discovered may represent previous lung infections or may be inflammatory in nature. These are usually followed with additional scans to see if they change in size or appearance over time.
Myth #9: Lung cancer is the same in men and women.
Truth: There are some similarities in lung cancer in men and women and there are many differences. Both men and women can develop lung cancer even if they are non-smokers and the death rate is similar. If you have lungs, you can develop lung cancer. Also, the earlier that lung cancer is detected the better the survival for both men and women.
The most common type of lung cancer in women is adenocarcinoma; in men it is squamous cell carcinoma. Women may experience symptoms like a chronic cough, recurrent pneumonia symptoms, or no symptoms at all. Men may experience weight loss, coughing up blood, or new wheezing. Women—especially non-smokers—who have specific lung cancer types may be candidates for specialized targeted chemotherapy treatments more often than men.
Why the differences? Lung cancer in women tends to be located on the edge or periphery of the lung. In men, the lung cancer tends to be more centrally located.
Myth #10: Exposing lung tissue to air or daylight during surgery can cause the tumor to grow rapidly and spread or blossom.
Truth: There is no evidence that exposing the lung to air or daylight during surgery causes lung cancer to grow rapidly and spread or blossom. This outdated tale began before modern imaging techniques like CT scans show what is inside a patient's body before surgery.
Decades ago, surgery was the main way to find out what was wrong with a patient. Most surgeries began as exploratory surgeries. This involved making an incision and opening a patient's body cavity to see what might be causing the patient's symptoms.
In some cases, after exploration the problem could be easily fixed. Other times, the surgeon found the cancer had been present for a long time and spread to other areas. When explaining the findings to patients and families, there was a misinterpretation that exposing the tissues to daylight or air had caused the tumor to grow rapidly. The cancer was actually far advanced before the exploratory surgery. Fortunately, today we have high tech imaging studies like CT scans, PET scans, and MRIs which provide valuable information instead of having to routinely perform an exploratory surgical procedure.
Learn more about how the team at the Ann B. Barshinger Cancer Institute works together to develop a personalized plan of care for every person diagnosed with lung cancer.