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Ways to prescreen LUNG CANCER with inherited genes.

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I am a 27 year old male of mixed European descent and am interested in lung cancer pre-screening. My paternal grandfather and father both died from lung cancers (ages 50 and 58, respectively), and I am concerned I have inherited the gene(s) responsible for increasing my risk. My father cleared the 5 year mark, having his right lung removed in conjunction with radiation and chemotherapy, however a second primary cancer appeared several years later and a stereoscopic radiation technique was unable to stop tumour growth. He did not survive to take chemotherapy treatment. My mother has smoked 15-25 cigarettes/day for 40 years. When my father was diagnosed with lung cancer, she had a chest x-ray which did not reveal anything concerning. It seems my predisposition to lung cancer lies in which parents' genes I have recieved in regulating cell growth in lung tissues, I think?

I have smoked cigarettes for about 6 years, varying from periods of heavier smoking (up to 15/day) to no smoking. Perhaps most consistently I smoked about 5-7/day when I was smoking. Also, I have smoked marijuana for about the same period of time, on average about 0.3 g/day when I used, however this also was not constant over the same period and there were times when I'd smoke more and times where I smoked none. I almost always smoked using a water pipe or "bong," which I feel may have increased the pressure exerted on my bronchiole epithelium and alveoli. I feel this may have a more damaging effect on the lungs than using a cigarette. Lately I am smoking perhaps 1 cigarette/day and no marijuana-- I intend to quit cigarettes forever, and to drastically reduce my consumption of marijuana to perhaps a few times a year.

I am in good health, on no medications, and have a good knowledge of nutritional needs that I usually abide by.  I take vitamin/mineral supplements consistently for periods of times, but try to avoid long-term use of any one item. Anytime I quit or drasticallly reduce smoking, I usually cough up abundant mucous with dark brown flakes, which I can only assume are tar particles that my lung's cilia are finally able to remove. I also feel like I can take deeper breaths without discomfort and can undertake more oxygen demanding activities without feeling "winded." I do not contract respiratory infections (cold, flu) very often (that I am aware of), perhaps only every several years.

I live in Canada and due to our social healthcare system my family doctor must decide if I am eligible for lung cancer pre-screening, despite my having funds to pay for private care. I feel that a regular chest x-ray or MRI would provide a good level of pre-screening, and if any 'spots' appeared then we could move forward, saving me from having my lung(s) removed due to a large tumour being present. I have heard from a GP in the past that a chest x-ray is not a good diagnostic tool for lung cancer? I would also surmise that exposing my chest cavity to a high level of radiation may further increase my risk of lung cancer. Does this sound reasonable? What are your thoughts on my situation? Do you have any advice on improving my lung health using natural methods such as vitamin/mineral supplements, lifestyle techniques or something of that sort?

Thank you very much for your advice!

Category: Pulmonologist

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Category: Allergy and Immunologist
Dr. Jacob George Pulinilkunnathil is online now

Expert:  Dr. Jacob George Pulinilkunnathil replied 4 Days.

Thank you for your query at DoctorSpring.com
We do not have enough evidence to support lung screening to prevent lung cancer.
However there is enough evidence that smoking causes cancer, increase risk in those who are predisposed.
So I will not suggest to do screening. But to quit smoking.
Once you quit smoking, automatically the chances will be minimised and certain cases even reversed. Nicotine is the main contributor, but provided you stop, and also the fact that you're so young, you have no reason to worry. Giving up smoking is the main issue. If you can do that, there is no problem really.
You can take a good multivitamin + antioxidant combination available locally such as Neurobion Forte, once daily at bed time.
Feel free to discuss further,

Dr. Jacob George P

Patient replied :

Thank you Dr. Pulinilkunnathil, You say that nicotine is the main contributor. What do you mean by this? My understanding is that plant matter, when smoked, produces a tar residue that accumulates in the lungs. I thought nicotine was simply the chemical responsible for addiction to using cigarettes. I was wondering if you could send to me any medical research showing the physiologic steps that lead to lung cancers, or a peer reviewed article/summary of potential lung cancers and how they might develop. Thanks again!

Expert:  Dr. Jacob George Pulinilkunnathil replied 3 Days.

Thank you for the follow up.
I am sorry i was not clear about the role of nictotine initially.
Yes it is the tar that keeps accumulating and causes the cancer, i meant to say nicotine, leading to addiction, is the main contributor which makes a person continue smoking.
Some recent studies claim nicotine induces angiogenesis, and also helps in maintaining the tumor, and favors it's growth. But a lot of other research needs to go into this statement.
I am sending you the link of an article by American Cancer Society. I find it really useful.

Dr. Jacob George Pulinilkunnathil
Category: Allergy and Immunologist
Residency, Post Graduation: MD, Respiratory Medicine, J L N Medical College, Ajmer, Rajasthan (2012).
Medical School, Internship: MBBS, Government Medical College, Kottayam, 2001-07 
Indian Diploma in Critical Care Medicine (IDCCM) - Medical Trust Hospital, 2013-2014.
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