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S. Vallone

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    MS 18 - Advocacy Snapshots (ID 36)

    • Event: WCLC 2015
    • Type: Mini Symposium
    • Track: Advocacy
    • Presentations: 1
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      MS18.04 - Lung Cancer - a Health Issue for Women (ID 1929)

      14:15 - 15:45  |  Author(s): S. Vallone

      • Abstract
      • Presentation

      For a long period of time, lung cancer has been considered a malignancy affecting only men, but epidemiological data have shown a dramatic increase of the incidence among women and the gender gap has been narrowing steadily since the 1980s,mainly as a consequence of the huge spread of tobacco consumption during the past 60 years. Although more men are diagnosed with lung cancer, incidence is leveling off or decreasing in men, but is increasing among women.Lung cancer is the leading cause of cancer death for women in the United Statesand other countries, with about 105,600 new cases and 71,000 estimated deaths in 2015 for the female gender, whereas in European countries lung cancer is predicted to kill 87,500 women in 2015, but such predictions require caution. In Europe, for the first time in 2015 (unlike in the U.S. where it has been happening for some decades)lung cancer death rates in females are expected to overtake those of breast cancer. This trend is largely driven by women in the UK and Poland, confirming that the continuous increase in lung cancer mortality among women represents a challenge for cancer control. This disease is classified as a significant global women’s health issue. Unfortunately, women still lack awareness and knowledge about lung cancer, it is not considered a priority because most of them still believe that breast cancer is the number one cancer in women. They have misperceptions and in most cases they are not concerned because they are too young or are non-smokers. Gender differences in terms of susceptibility to carcinogens have been reported and several studies suggestthat women are more vulnerable to tobacco carcinogens than men, however this data remains controversial. Although smoking increases the risk of lung cancer dramatically, it's not the only cause. Freedman et Al reported on a cohort of nearly 500,000 individuals aged from 50 to 71 years, in which asignificant increase of cases occurred in women who never smoked, compared with male non-smokers. The rate of lung cancer in those who never smoked is higher for women in every population, counting approximately 20% of women who never smoked. The reason is unclear, but studies suggest that the hormonal status may be one potential explanation and researchers are devoting energies in this area to better understand the implication of gender differences in epidemiology, pathogenesis, prognosis and tumor response, considering that women have better survivalrates than men at any stage regardless of the type of lung cancer and the therapeutic approach. At the moment there are no gender-based approaches on diagnosis and treatment for lung cancer, but an improvement in understanding genetic, metabolic and hormonal factors could stimulate research towards further personalized gender-based investigations. Despite recent advances in treatment, lung cancer still remains a largely incurable disease with a physical impact upon women, as well as social, psychological, practical and emotional consequences. The diagnosis and subsequent treatments are traumatic events for patients and their loved ones. Serious disruptions in social and psychological aspects of their quality of life have been reported and younger women are most at risk. This type of cancer is normally associated with older people, where the disease is often diagnosed accidentally, while in young adults it is relatively rare, the incidence has been found to be around 1.2% to 6.2% (under 40 years), 5.3% (under than 45 years), and 13.4% (under 50 years),but previous reports have shown trends of increasing incidence rates of lung cancer among young patients. Unfortunately in this group this malignancy is more common in women, who are diagnosed at an advanced stage and normally receive aggressive treatments. It can be very difficult to cope with a diagnosis of lung cancer, both practically and emotionally, because the news can generate a wide range of emotions: fear, anxiety, anger, confusion, that could worsen the situation if patients are younger women because they often have to face challenges different than other patients. The worst are mothers of children or teenager, telling them the diagnosis is hard and traumatic, it means dealing with their emotions and reactions and helping them to face a daily routine affected by this event. Many feel unable to manage changes caused by lung cancer and this may create a state of distress that is increasingly recognized as a factor that can reduce the quality of life of patients. Moreover they feel hopeless, worried and sad about the uncertainty of their future and their children’s future. The disease and its treatments often may cause physical changes in the way they look, which is difficult to cope with and may affect the way women feel about themselves. Such body changes can diminish their self-esteem and change the way they relate to other people, especially family and friends. Disease progression, symptoms orside effects may force women to change the daily management of their family and house. The consequence is the inability to keep the pace of motherhood and to keep on doing things like they were used to do (for example working around the house), especially if children are young and energetic.These physical issues may also jeopardize their career and in many situations forcing them to quit job, increasing the frustration of losing their independence. Lung cancer may affect the dynamics of intimate relationships. This is connected to body image changes,in whichwomen may feelless attractive or desirable by their partner. Common symptoms of lung cancer, such as cough, fatigue or shortness of breath may affect their sexual life. Women with lung cancer have a number of unmet needs that require assistance. It is important to identify them efficiently and effectively so that patients can be provided with appropriate resources so they can find help. Physical needs are experienced by the majority of women, but emotional, psychological, social, spiritual, practical and informational needs are also present for some. Interventions must be developed to assist these women to cope with these needs and worldwide several gender focused educational and support programs have already been designed with this purpose. References: Silvia Novello & Tiziana Vavalà Lung cancer and women, Future Oncology Vol. 4, No. 5, Pages 705-716 Cancer 2010, 116(15):3656-3662. PubMed Abstract | Publisher Full Text Subramanian J, Morgensztern D, Goodgame B, Baggstrom MQ, Gao F, Piccirillo J, Govindan R: Distinctive characteristics of non-small cell lung cancer (NSCLC) in the young: a surveillance, epidemiology, and end results (SEER) analysis. J ThoracOncol 2010, 5(1):23-28. Ak G, Metintas M, Metintas S, Yildirim H, Erginel S, Alatas F: Lung cancer in individuals less than 50 years of age. Lung 2007, 185(5):279-286. Skarin AT, Herbst RS, Leong TL, Bailey A, Sugarbaker D: Lung cancer in patients under age 40. Lung Cancer 2001, 32(3):255-264. Bourke W, Milstein D, Giura R, Donghi M, Luisetti M, Rubin AH, Smith LJ: Lung cancer in young adults. Chest 1992, 102(6):1723-1729. Schnoll RA, Patterson F, Lerman C. Treating tobacco dependence in women. J Womens health 2007;16:1211-1218 Freedman ND, Leitzmann MF, Hollenbeck AR et al. Cigarette smoking and subsequent risk of lung cancer in men and women: analysis of a prospective cohort study.Lancet Oncology 2008;9:649-656 Donington JS, Colson YL. Sex and gender differences in non-small cell lung cancer. Seminars Thoracic Surgery2011;23:137-145 American Society of Cancer Oncologists. 2009. Women and Lung Cancer. Margaret I. Fitch, Rose Steele Supportive care needs of women with lung cancer- Canadian Oncology Nurses Vol 18, No 1 (2008)

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