News about Australia

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The ‘unworthy’ cancer with a terrible survival rate and the program seeking to change it

Sharmila Lakshmanaa never smoked and felt perfectly healthy until doctors found cancerous growths within her lung.

Does that make the 46-year-old more deserving of treatment, than those who do smoke?

Lung cancer is, by a wide margin, Australia’s most lethal cancer – killing more women and men every year than breast and prostate cancer combined. Diagnosis rates are increasing.

Yet, the condition remains deeply stigmatised, advocates say. Many believe sufferers brought it upon themselves.

“If I did smoke, it still wouldn’t be my fault,” says Lakshmanaa. “It does not matter how you got lung cancer. No one deserves lung cancer.”

The disease kills about 9000 Australians a year, predominantly less-well-off and Indigenous Australians. Three-quarters of those diagnosed will be dead in five years; survival rates have barely improved since the 1980s.

Australia is aiming to improve these metrics, with the launch last month of a federally funded national lung cancer screening program.

To get here, lung cancer advocates have fought a long, lonely battle against the presumption that “if you got lung cancer, it was your own fault and you’re not deserving of support,” says Mark Brooke, chief executive of the Lung Foundation Australia.

Lung cancer is particularly lethal because it is silent, with almost no symptoms until the disease has progressed. Forty-two per cent of diagnoses are for final-stage cancer, when it is almost too late for treatment.

The screening program will use low-dose CT scanners to check all heavy smokers aged 50 to 70.

By catching cancer at an earlier stage, when it can be more effectively treated, it is expected the program will save 12,000 lives over the next decade.

Smoking is the major risk factor for lung cancer, responsible for 90 per cent of male and 65 per cent of female cases.

When the tobacco leaf is dried, two nitrosamine molecules are produced. When the tobacco is ignited, the nitrosamines enter the lungs, where they can mutate DNA, turning healthy cells cancerous.

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Lung cancer itself is relatively survivable if caught early, as surgeons can remove the cancerous tissue.

“Our lungs are actually really remarkable. You can more or less remove one whole lung, and for the average person, they wouldn’t notice,” says Professor Brian Oliver, a leading respiratory researcher at the Woolcock Institute of Medical Research in Sydney.

But that cuts both ways. Cancer can take over large parts of the lung without the patient even noticing. It is only once the tumour grows into an airway that a bloody cough can develop.

By this stage, it may be too late. Survival rates halve at each stage the cancer is detected after the first. Hence, the screening program.

A 2021 meta-analysis of nine screening pilots covering thousands of people found a 16 per cent reduction in lung-cancer mortality.

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