Ever wonder for how long lung cancer can grow before it’s detected by a doctor or before the patient begins feeling the symptoms?
“There are two approaches to think about this,” says Alex Little, MD, a thoracic surgeon with a special interest in esophageal and lung cancer, and clinical professor at the University of Arizona.
“The first is to ask how long it takes to cause symptoms and for a symptomatic patient to seek medical attention,” continues Dr. Little.
“Reported numbers differ, but one well-done study (Japanese Journal of Clinical Oncology 1994;24:199-204) found the doubling time for all lung cancers to be 166 days, for adenocarcinoma of the lung to be 222 days, and 115 days for squamous cell lung cancer.”
What does that mean?
For instance, it takes 166 days on average for lung cancer cells to grow from four cells to eight.
Or, it takes 222 days for 32 adenocarcinoma cells of the lung to multiply to 64 cells.
This may seem like the cancers grow very slowly. But this growth is exponential, not linear.
The more that something is doubled at fixed intervals, the faster it gets bigger.
“These data suggest it would take a single malignant cell several years before it would become large enough or be in the opportune location to cause symptoms — such as shortness of breath (most common and very non-specific) or chest pain — that would send a patient to a physician,” explains Dr. Little.
Several years may seem like a sweet slow time for cancer to grow, but once it starts causing symptoms, that doubling growth rate skyrockets.
After 222 days, a five centimeter adenocarcinoma will be 10 centimeters! That is a LOT.
“And more stoic patients will delay medical attention longer than others,” continues Dr. Little.
“The second is to speculate how long it would take for the physician seeing such a patient to evaluate for lung cancer with a chest X-ray.
“It can take some time. As you know, most patients are smokers [around 85%] and have some degree of emphysema which can cause shortness of breath without lung cancer being present.
“This can delay the search for a lung tumor. As for patients with pain, again, there are plenty of reasons for chest or shoulder pain other than lung cancer to attribute the pain to before looking for lung cancer.”
Lung cancer, in uncommon cases, can actually cause shoulder pain if the tumor is in the top of a lung lobe, pressing on a nerve that leads to the shoulder.
“So, more time goes by,” continues Dr. Little. “This is why early detection screening in asymptomatic patients at high risk (smokers over age 55) using low dose CT scans to minimize radiation exposure are now recommended.
“Since a lung cancer can be growing without killing the patient, it probably could be present for even a few years before detection — depending on location, amount of spread, patient stoicism and physician response.”
If all of this scares the pants off of you, then STOP SMOKING.
And if you’ve never smoked and are feeling “pressure” to take up this nasty-smelling, very pricey habit – then keep repeating the following mantra in your head:
“No person on this planet has ever regretted NEVER having become a smoker.”
Then make a list of all the harmful things that’ll come your way if you do NOT give in to the “peer pressure” to smoke.
Ask yourself if any of those things will matter six months from now, even three months. Even three weeks.
Though lung cancer may seem like a distant future to you as a young smoker, keep in mind that stinky breath, skin, hair and clothes are always smack in your present.
Dr. Little trained in general and thoracic surgery at the Johns Hopkins University School of Medicine; has been active in national thoracic surgical societies as a speaker and participant, and served as president of the American College of Chest Physicians.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.