Lung cancer is a potentially lethal disease, whose prevalence in Albania is constantly increasing, especially in women. Early diagnosis is extremely important with regard to life expectancy and quality. The authors conducted a survey on the behaviour in a sample group of Albanian women diagnosed with primary and secondary lung cancers. A discussion upon diagnostic methods, smoking habits, histological type, Karnofsky performance status (KPS), and treatment modalities is made. The data collected by the authors suggest that nonsmokers formed the main group of lung cancer female patients. The most frequent histological type was adenocarcinoma. Mesothelioma was the most frequent of the secondary pulmonary lung cancers, followed from metastasizing breast cancer. Despite a generally good performance of the cases, the diagnosis of pulmonary cancer is delayed. The data collected could not find a convincing etiological role of tobacco smoking, but caution is needed, regarding the short time length of the study and the sustained number of participants. 1. Introduction The incidence of lung cancer is constantly increasing, and this is a phenomenology that has raised concerns since decades, mostly important, because the disease has changed its manifesting modalities, and even the histological profile has undergone modifications [1–3]. On the other hand, if previously the age-specific parameter regarded mainly older patients, actually the trend of having more and more younger patients with lung cancer and with females suffering increasingly from the latter, is unrelenting [4]. Tobacco smoking habits have been accused to play a direct role in the fact that females are manifesting increasingly a higher incidence of lung cancer, although conclusions hardly converge [5–7]. Albeit that numerous professional settings have been related to higher incidence of lung cancer, tobacco smoking still remains the mostly discussed factor. It seems nevertheless that several years of exposure to active or passive smoking are necessary before modifications of the bronchial mucosa can be detected. Furthermore, correlating the manifestation of the adenocarcinoma of the lung with tobacco smoking has been continuously an issue of controversy, although recent and more large studies have still found a relation, but rather a smaller one, when compared with other histological types of lung cancer [8, 9]. In the present study, the authors have tried to describe the behaviour of a sample group of 54 Albanian females suffering from lung cancer and recruited for a diagnostic and therapeutic
References
[1]
W. J. Gauderman and J. L. Morrison, “Evidence for age-specific genetic relative risks in lung cancer,” American Journal of Epidemiology, vol. 151, no. 1, pp. 41–49, 2000.
[2]
F. Tas and S. Keskin, “Age-specific incidence ratios of lung cancer (LC) in Turkey: LC in older people is increasing,” Archives of Gerontolology and Geriatrics, vol. 55, no. 2, pp. 276–278, 2012.
[3]
I. Tanaka, O. Matsubara, T. Kasuga, T. Takemura, and M. Inoue, “Increasing incidence and changing histopathology of primary lung cancer in Japan: a review of 282 autopsied cases,” Cancer, vol. 62, no. 5, pp. 1035–1039, 1988.
[4]
J. F. Beamis Jr., A. Stein, and J. L. Andrews Jr., “Changing epidemiology of lung cancer. Increasing incidence in women,” Medical Clinics of North America, vol. 59, no. 2, pp. 315–325, 1975.
[5]
A. Ives and J. Verne, “What's happening to lung cancer in females?” Thorax, vol. 65, supplement 4, P217, pp. A168–A169, 2010.
[6]
P. Boffetta, M. Kreuzer, S. Benhamou et al., “Risk of lung cancer from tobacco smoking among young women from Europe,” International Journal of Cancer, vol. 91, no. 5, pp. 745–746, 2001.
[7]
T. Lienert, M. Serke, N. Sch?nfeld, and R. Loddenkemper, “Lung cancer in young females,” European Respiratory Journal, vol. 16, no. 5, pp. 986–990, 2000.
[8]
W. L. Watson and A. Farpour, “Terminal bronchiolar of “alveolar cell” cancer of the lung. Two hundred sixty-five cases,” Cancer, vol. 19, no. 6, pp. 776–780, 1966.
[9]
P. M. Bracci, J. Sison, H. Hansen et al., “Cigarette smoking associated with lung adenocarcinoma in situ in a large case-control study (SFBALCS),” Journal of Thoracic Oncology, vol. 7, no. 9, pp. 1352–1360, 2012.
[10]
D. J. Wilkie, F. J. Keefe, M. J. Dodd, and L. A. Copp, “Behavior of patients with lung cancer: description and associations with oncologic and pain variables,” Pain, vol. 51, no. 2, pp. 231–240, 1992.
[11]
K. K. Browning, M. E. Wewers, A. K. Ferketich, G. A. Otterson, and N. R. Reynolds, “The self-regulation model of illness applied to smoking behavior in lung cancer,” Cancer Nursing, vol. 32, no. 4, pp. E15–E25, 2009.
[12]
D. A. Karnofsky and J. H. Burchenal, “The clinical evaluation of chemotherapeutic agents in cancer,” in Evaluation of Chemotherapeutic Agents, C. M. McLeod, Ed., Columbia University Press, New York, NY, USA, 1949.
[13]
R. Rami-Porta, J. J. Crowley, and P. Goldstraw, “The revised TNM staging system for lung cancer,” Annals of Thoracic and Cardiovascular Surgery, vol. 15, no. 1, pp. 4–9, 2009.
[14]
K. A. Perkins, N. C. Jao, and J. L. Karelitz, “Consistency of daily cigarette smoking amount in dependent adults,” Psychology of Addictive Behaviors, 2012.
S. Yongxin, D. Wenjun, W. Qiang, S. Yunqing, Z. Liming, and W. Chunsheng, “Heavy smoking before coronary surgical procedures affects the native matrix metalloproteinase-2 and matrix metalloproteinase-9 gene expression in saphenous vein conduits,” The Annals of Thoracic Surgery, vol. 95, no. 1, pp. 55–61, 2013.
[17]
H. Chabrol, M. Niezborala, E. Chastan, and J. de Leon, “Comparison of the heavy smoking index and of the Fagerstrom test for nicotine dependence in a sample of 749 cigarette smokers,” Addictive Behaviors, vol. 30, no. 7, pp. 1474–1477, 2005.
[18]
F. Adlkofer, “Lung cancer due to passive smoking—a review,” International Archives of Occupational and Environmental Health, vol. 74, no. 4, pp. 231–241, 2001.
[19]
A. K. Hackshaw, “Lung cancer and passive smoking,” Statistical Methods in Medical Research, vol. 7, no. 2, pp. 119–136, 1998.
[20]
Law No.9636, 2006, Albanian Parliament, http://www.qpz.gov.al/doc.jsp?doc=docs/Ligj%20Nr%209636%20Dat%C3%AB%2006-11-2006.htm.
[21]
M. Miura, R. A. Daynard, and J. M. Samet, “The role of litigation in tobacco control,” Salud Pública de México, vol. 48, supplement 1, pp. S121–S136, 2006.
[22]
F. X. Lesage, F. Deschamps, and D. Jurca, “Illegal passive smoking at work,” Advances in Preventive Medicine, vol. 2011, Article ID 975678, 5 pages, 2011.
J. Hippisley-Cox and C. Coupland, “Identifying patients with suspected lung cancer in primary care: derivation and validation of an algorithm,” British Journal of General Practice, vol. 61, no. 592, pp. e715–e723, 2011.
[26]
A. Voicu-M?ce?eanu, M. Nitu, M. Olteanu, and D. Bic?, “Epidemiology of lung cancer,” Pneumologia, vol. 56, no. 2, pp. 78–84, 2007 (Romanian).