Lung cancer: prevention, diagnosis, treatment and survivorship
Lung Cancer Awareness Month 2020
During Lung Cancer Awareness Month, which is observed throughout November, the European Respiratory Society (ERS) is campaigning to raise awareness of four key aspects related to lung cancer: prevention, early diagnosis, treatment and survivorship.
Background: While smoking tobacco is linked to more than 80% of all lung cancer cases, many people that have never smoked or been exposed to passive smoke develop lung cancer. Other causes include exposure to polluted air, including: outdoor air pollution from diesel exhausts and other pollutants; at work from asbestos, wood dust, welding fumes, arsenic, industrial metals e.g. beryllium and chromium: and/or indoor air pollution exposure from radon or coal smoke. Preventing smoking through tobacco control policies, improving access to smoking cessation services and supporting smokers to quit using evidence-based means, and improving air quality may help to prevent lung cancer and reduce burden across Europe.
ERS advocacy recommends: In order to protect lung health and prevent lung disease, ERS calls on the European Commission’s Beating Cancer Plan to:
- Reinforce tobacco control and prevention policies.
- Increase access to smoking cessation services and evidence-based tools for quitting smoking.
- Improve air quality, including by lowering EU limit values for ambient pollution as well as strengthening occupational protection with meaningful pollution exposure limits in workplaces.
Early identification and diagnosis
Background: When lung cancer is detected based on symptoms, the disease is already at an advanced stage, meaning curative treatments are ineffective in up to 90% of cases. Lung cancer screening is recommended for a specific high-risk population in order to diagnose the disease at an earlier and more treatable stage. Ultra-low-dose computed tomography (CT) screening for lung cancer uses up to 90% less radiation than a conventional chest CT scan and is four times more likely to pick up an early tumour than a traditional chest X-ray.
ERS advocacy recommends: To improve earlier diagnosis of lung cancer among high-risk individuals, save lives and reduce medical costs, EU policymakers should:
- Follow the ERS/European Society of Radiology (ESR) action plan for the development of European guidelines for lung cancer screening, which advises on EU, national and local-level actions for effective implementation.
Background: Lung cancer care can be very complex, but it is significantly under-researched and underfunded, receiving only 5.6% of overall cancer research funding worldwide. Optimal treatment should be patient-centred and multidisciplinary with care delivered by thoracic specialist teams, but access to care across Europe is not equal and the patient voice is not always heard.
ERS advocacy recommends: Refining lung cancer treatment will lead to better patient care and improved outcomes. To achieve this ERS emphasises the urgent need for:
- Ensuring treatment is patient-centred and patients’ needs are heard and addressed at all stages of care.
- Increased funding for lung cancer research in EU (Horizon Europe, new IMI) and national research programmes to improve treatment options and access to optimal care.
- Equal weight should be given to multidisciplinary care at all stages of lung cancer treatment.
- Standardised training for thoracic oncology specialists across Europe and increased support for access to training.
Background: Despite the challenges associated with lung cancer treatment, long-term survival is increasing, and mortality is decreasing among men. Following successful treatment, patients may still need physical support through rehabilitation as well as psychological support. We must work to stem the stigma that is sometimes associated with lung cancer and ensure that adequate psychosocial support is offered in order to support patients’ mental wellbeing.
ERS advocacy recommends: Care for lung cancer survivors should:
- Follow the multidisciplinary care approach offered during treatment for lung cancer to ensure integrated supportive care.
- Address physical as well as neuropsychological symptoms such as shortness of breath, fatigue, short-term memory loss and anxiety.
- Avoid stigmatisation.