We are approaching the third year of living with COVID-19 in Singapore. Symptoms such as cough, shortness of breath, and weakness or fatigue are no longer uncommon, many will simply self-medicate or opt for a video consultation to get medication delivered whilst putting themselves under quarantine until these symptoms “go away”.
But what if these symptoms persist? You could have stage 1 lung cancer without realising it.
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Lung cancer is the uncontrollable growth of abnormal lung cells that interferes with how normal lungs should function. These cancer cells can spread from the lung to lymph glands, bones, brain and liver, and other parts of the body.
There are two major types of lung cancer:
Small-cell lung cancer (SCLC)
SCLC accounts for up to 10 - 15% of all lung cancer cases and can aggressively spread to other parts of the body in its earlier stages through the bloodstream. Unfortunately, SCLC is typically detected and diagnosed in its advanced stages, to which oncologists will prescribe treatments in the form of surgery to remove tumours, chemotherapy, radiotherapy or immunotherapy.
Non-small-cell lung cancer (NSCLC)
NSCLC, while still aggressive, is considered to be milder and more common. It grows and spreads at a slower rate compared to SCLC. Detecting NSCLC in its early stages has a high chance of successful recovery through surgery, radiotherapy and chemotherapy, or a combination of treatments.
In this article, we’ll discuss the telltale signs of early-stage lung cancer, the importance of lung cancer screening, and how often to get screened.
It may be difficult to determine if a person has lung cancer; symptoms may not show at all or can be passed off as the regular flu.
However, once obvious characteristic symptoms start to develop, cancer could already be in its advanced stages . This diagnosis is usually discovered after scans are done for other medical reasons.
Symptoms can include:
Shortness of breath
Feeling fatigued or weak
Rusty-coloured spit or phlegm
Loss of appetite and unexplained weight loss
Lung cancer in Singapore is more common than you think. From 2014 to 2018, it was reported that:
14% and 7.5% of all cancer cases in men and women respectively were lung cancer
Lung cancer accounted for 26.4% and 15.7% of deaths in men and women respectively
This is backed up by statistics from the Ministry of Health (MOH): lung cancer is the leading cause  of cancer death in Singapore — particularly in men and smokers (both current and former).
Non-smokers aren’t entirely protected from this deadly disease as well; in recent years, there has been an increase in lung cancer cases in female non-smokers.
This is partly attributed to the increase in air pollution  in Singapore, giving way to more non-smokers being at risk of NSCLC.
There are several methods to detect stage 1 lung cancer in Singapore. This includes:
If you show no or minimal symptoms of lung cancer, a chest x-ray can be done as the first stage to determine if your lungs are in good shape. Your doctor may request for more tests to be done if nothing is found or anything suspicious arises.
A CT scan can show a slice of the lung or other parts of your body to determine if any tumours or cancer cells are present.
Current and past smokers can undergo a low-dose CT (LDCT) scan to screen for lung cancer. It is the most common method used to detect abnormalities in the lungs.
However, as with most tests, a CT or LDCT scan may produce false-positive results. A false-positive result is a test result that indicates an individual is affected by a condition when in actuality he/she is unaffected.
In this case, a CT scan for lung cancer may imply abnormalities in the lungs only to be proven false once further testing has been carried out.
A number of factors are taken into account when determining the life expectancy of a lung cancer patient. Some patients manage to beat it, but others may not be so lucky.
On average, around 60%  of patients diagnosed in the early stages of lung cancer survive for at least 5 years or more. However, this percentage drops to 6% in the late stages of lung cancer, especially when cancer cells have spread to other areas of the body.
Although early-stage lung cancer is curable, many of these cases stay in remission with the possibility of cancer returning within 2 years. You are considered cured if your remission lasts over a 5-year  time period.
The earlier cancer is diagnosed, the higher the chances of survival – frequent lung cancer screening is key.
The recommended age for lung cancer screening is between 55 to 80 years old. This applies to:
Individuals who have smoked more than 30 pack years and are current smokers or,
Quit smoking within the past 15 years
Lung cancer usually creeps up from age 65 to 70. However, though uncommon, the diagnosis of lung cancer has also been reported in people aged 45 and below. As such, we recommend starting screening as early as 40, especially if you smoke.
Patients have a higher chance of survival when lung cancer is detected early and treatments are started as soon as possible.
Depending on your age, gender, and overall health condition, the frequency of your cancer screening can vary.
Generally, women are advised to get breast cancer screening annually between the ages of 40 to 49. For men, cancer screening for prostate cancer should start at the age of 50 and above.
If you may be at risk of lung cancer, getting an annual LDCT scan helps to detect any cancer cells before symptoms start and get treatment before it reaches the late stages.
At Speedoc, we provide a variety of health screening packages including cancer screening which can help highlight indicators of varying cancers. You will receive a comprehensive and personalised report that outlines your health risks, with recommendations by our doctor.
If you have a family history of cancer or simply wish to get peace of mind, you can reach us at +65 6909 7799 or email us at email@example.com, or use our app to book a video consultation with our doctors.