By Jubrail Dahabreh, Chiropractor, Director of Thoracic Surgery, Athens Medical Center
The link between smoking and lung cancer, as with other fatal diseases, is a serious social and economic problem.
It is estimated that 80% of all lung cancer deaths in women are owed to smoking, compared to 90% in men, and this relationship is linear with the number of cigarettes smoked and the duration of smoking in years.
In addition to smoking, other factors such as radon, exposure to asbestos, uranium and carbon, as well as atmospheric pollution, are also implicated in the development of lung cancer.
Lung cancer accounts for 28% of all cancer deaths, and causes more deaths than cancers of the colon, breast or pancreas.
The effects of lung cancer are on the patient himself, on his family, on society, on the individual and on the national economy. With regards to the patient, this is related to hospital stay, high cost diagnostic tests, and treatments, which are often performed at regular intervals.
Equally important is the social cost, which is unbearable, as patient often suffer dramatic consequences in their personal as well as family and professional lives. Often, patients are treated with compassion, others are rejected, lose opportunities to progress in their work, and overall they have an extra burden on them.
It is important to implement prevention and early diagnosis and treatment programs for people with a family history, those who are at high risk due to smoking or occupation, and for those suffering from pulmonary emphysema and chronic obstructive pulmonary disease.
At Athens Medical Center in Maroussi, the Thoracic Surgery Clinic has been operating since 2001 and has treated a large number of patients with lung cancer, many of whom have undergone successful surgical treatment with long-term survival. Patients undergo the necessary surgery after extensive clinical laboratory testing. The decision to take any treatment must be personalized and considered to be acceptable, and in accordance with the guidelines of the European Society for Medical Oncology (ESMO, as well as the American Association for Thoracic Surgery (AATS) and the American National Comprehensive Cancer Network (NCCN).
It is worth mentioning that the decision to undergo surgical treatment is made after an evaluation of the patient's entire situation by the chief thoracic surgeon (Dahabreh Jubrail), in collaboration with a Pulmonologist, Oncologist, Radiotherapist, CT Specialist and Cardiologist. Finally, the patient's situation is evaluated by an Anesthesiologist, with extensive experience in administering anesthesia but also in the treatment of postoperative pain. It should be noted that old age (80 years or more), diabetes mellitus, kidney failure, possible coronary artery disease, and advanced coronary artery bypass (Bypass) are not in themselves a contra-indication for surgical treatment. All of these risk factors are evaluated and the final decision for surgery or not is made accordingly.
Patients with lung cancer are a special group of thoracic surgery patients who need proper evaluation by an experienced team of experts, since surgical treatment is the therapy of choice that offers long-term survival. It should be emphasized that major and specialized thoracic surgeries should only be performed by a qualified, experienced thoracic surgeon and take place in specialized hospitals. There are many patients who have undergone successful surgical treatment after a proper evaluation by the Athens Medical Center's expert team in Maroussi, that were initially excluded from surgical treatment when evaluated in non-specialized centers. Patients with limited respiratory reserve may undergo surgical treatment thanks to special surgical techniques such as bronchoplasty, with or without angioplasty, aimed at maintaining as much functional lung tissue as possible. Patients with locally advanced cancer can also undergo surgical treatment, after successful preoperative chemotherapy or radio-chemotherapy. In addition, patients with advanced lung cancer that has spread to the adjacent anatomical structures, such as the ribs, the diaphragm, the pericardium, or the superior vena cava, as well as those with a single brain metastasis, can be treated with very low-risk surgery . Performing this type of surgery is extremely demanding and requires skill and long experience.
Surgical treatment in the above groups of patients not only increases survival but also offers a better quality of life. Thanks to the great advancement of the surgical technique, the use of the most up-to-date technical support tools, the advancement of anesthesia and the support of the Intensive Care Units, perioperative risk has been significantly reduced even for the most severe surgical procedures.
Until we get the perfect treatment with the desired results, young people need to be properly informed about the dangers of smoking, and this information is most effective when passed in schools. Finally, an important role in the early diagnosis of lung cancer is low-dose computed tomography of the chest, which must be performed annually in heavy smokers over 55 years of age and in those with first-degree relatives who have had cancer, but also to those exposed to various risk factors, such as asbestos and environmental pollution.