Lung cancer is third most common cancer in men and women in Singapore. 

It is also the leading cause of cancer death for men and second cause of cancer death for women. Lung cancer is more commonly diagnosed in individuals above 40 years old, however the disease can occur in younger individuals.

Dr Amit Jain, Senior consultant from the Division of Medical Oncology at National Cancer Centre Singapore (NCCS), a member of the SingHealth group, shares what you need to know about lung cancer and debunks common myths.

Top 3 lung cancer myths debunked!

Myth 1: “Never-smokers” can’t get lung cancer. 

Unfortunately, they can. An NCCS study found that 32 per cent of non-small cell lung cancer (NSCLC) patients were never-smokers and another study done by NCCS in 2018 showed this number increased to 48 per cent. 

While it is challenging to identify who is at high risk among people who have never smoked, this is currently an area of active research to find the best way to do so. However, it is worth noting that smoking is carcinogenic.

Myth 2: Patients with lung cancer shouldn’t exercise. 

Some patients think they’ll get breathless if they exercise, and that they should rest more. But we recommend that patients exercise daily to stay fit. This can help them feel better when their condition improves, so that they can enjoy a better quality of life. 

Exercises should mimic daily activities. For example, a patient who struggles to stand after sitting could try repetitions of it. Fitter patients may want to try climbing stairs and build up capacity over time. 

Lung cancer patients are also welcome to join the NCCS exercise interest group (#lungcancerwillnotkeepmedown) or e-mail for details.

Myth 3:  You have to become vegetarian or avoid certain foods to starve the cancer. 

It is likely that patients will need to eat more to avoid loss of nutrients. Dr Jain recommends that patients are free to eat anything and be happy, although it is important to have nutritious, balanced meals, and get enough protein to maintain and grow muscles. Consult a dietician if in doubt. 

FAQs about lung cancer

Q1: What are the risk factors for lung cancer? 

Smoking remains the most important modifiable risk factor in getting lung cancer. But in societies like Singapore where smoking rates are lower than in some European countries, it is clear that a substantial proportion of lung cancers occurs in people who have never smoked. 

There is emerging evidence that small pollutant particles may be driving some cancer mutations that eventually lead to lung cancer. This was shown to be the case in experiments involving mice and is now an area of active research to unravel causality in humans too.

While there are occasionally some cases that seem to run in the family, lung cancer is not generally attributable to a single genetic cause but may be related to environmental factors.

Q2: How is the treatment of lung cancer dependent on the type and stage of the disease?

There are two main types of lung cancer: 

  • Small cell lung cancer (SCLC) and 

  • Non-small cell lung cancer (NSCLC).

It is important to note that treatments are recommended based on the needs of individual patients. 

For SCLC, a limited stage of the disease is usually treated with chemotherapy and radiotherapy, while more advanced stages may be treated with chemotherapy and immunotherapy. Some patients may also be treated with radiotherapy, depending on the site of their cancer, its spread and the response to treatment. 

Treatment varies for NSCLC, depending on the cancer stage. In early stages, surgery will be proposed to remove part of the affected lung. This may be followed by chemotherapy, immunotherapy and targeted therapy, depending on the extent of the spread and the subtype of the cancer. 

For cancers at a more advanced stage, a combination of treatments may be proposed, comprising surgery, radiation, chemotherapy, targeted small molecule inhibitors and immunotherapy. The plan for patients is discussed at multidisciplinary tumour boards before treatment is started.

Q3: What can lung cancer patients do to manage their condition better and improve their quality of life? 

Having a frank, open discussion with loved ones and your attending doctor may help set a realistic tone for what the cancer journey may entail. These discussions are best carried out early on, and should be as candid and kind as possible to help you cope and plan better. Eat well, exercise and understand what’s coming next, so you can live life to the fullest.

Q4: What can I do to lower my risk of lung cancer? 

Majority of lung cancer cases are diagnosed at stage 4, which is incurable. Early detection offers a chance of better outcomes, although rates of cure may still be modest and relapse is possible. To lower your risk, there are several ways to do this:

  • Primary prevention: If you have never smoked, don’t start.

  • Secondary prevention: If you are a smoker, stop smoking. Stopping smoking at any age can help to reduce the risk of developing lung cancer. Avoid exposure to second hand smoke (from others around you who may smoke).

  • Screening: If you are aged between 55-74, and have smoked 30 or more pack years* and are continuing to smoke or quit less than 15 years ago, you can consider undergoing a low dose CT scan to screen for lung cancer.

It is also recommended that you eat a balanced diet rich in fruits and vegetables and to exercise regularly.

* Pack years are calculated by multiplying the number of cigarette packs smoked daily by the number of years smoking.

Ref: I23

Other cancer articles you may be interested in:

Top 10 Cancers in Singapore

8 Top Cancer-Fighting Foods

Must-Eat Foods for Cancer Patients

New Study Links Genetic Diversity in Asian Lung Cancer and Resistance to Treatment

Why Non-Smoking Asian Females Can Still Be at Risk of Lung Cancer

Why Asian Lung Cancer Tumours May Be Tougher to Treat