- Welcome to this edition of Housecall.
Did you know that lung cancer is the leading cancer killer
of men and women in the United States?
And while most of us associate lung cancer with smoking,
there's a significant increase of lung cancer
in non-smokers.
While some of the contributing reasons are unknown.
Radon is a known risk factor contributed to
a lot of our new smoking cases.
I'm Sammy Mansfield with the Sarah Cannon Cancer Institute,
and I'm here today with Dr. Nisreen Haideri
who's a board certified,
practicing oncologist and hematologist in Kansas City.
She's been with us here for more than 10 years, practicing
in our backyards and she has significant experience
in lung cancer.
Dr. Haideri, welcome to our house call today.
How are you?
- I'm good, thank you, Sammy.
- Absolutely.
Thanks for talking about this really interesting
and in my mind, not very understood topic.
First of all, tell us what is radon
and why should we be concerned?
- Yeah, so when it comes to radon,
it's basically the element,
and it's a gaseous, decay product of uranium and radium,
and we started learning about radon
as a cause of lung cancer when we learned about
uranium miners and we started noticing
increased risk of lung cancer
and they were being diagnosed with lung cancer.
So basically what this gas does is that
it is capable of damaging the lung tissue
by emitting alpha particles,
and that increases the risk of lung cancer.
- So how is it that somebody who's, you know, not a miner,
like how is it that a homeowner is at risk of radon?
You know, they're in their home, like, do they smell it?
Do they know it's there?
What should homeowners know?
- So basically radon is also present in soil, rock, and
groundwater, and it can accumulate in homes.
So therefore we are learning about some more implications
of radon in addition to smoking as a risk factor
for lung cancer.
- Interesting, are you seeing more
potentially radon, you know, cases that would be
impacted by radon, like non-smokers or younger smokers
in your practice?
I mean, obviously you've got 10 plus years of experience.
What are you seeing day to day?
- So basically when it comes to the causes of lung cancer,
radon is a number second cause of lung cancer after smoking,
but when it comes to environmental factors,
it actually is the second leading cause also of lung cancer.
So what we see is like this year,
we saw like 21,000 lung cancer deaths
and approximately 29,000 of them were in non-smokers.
- Wow, and do you think that, you know, from your research,
I've heard that radon is more prevalent here in the Midwest
due to like the soil and rocks that we're sitting on?
Is that in fact true
or is that something that's kind of speculation?
Some people think, oh, that's a hoax.
What do you see?
What does the science tell us about being located
in the Midwest and our risks of radon?
- Well, when it comes to our
state and our neighboring states, we are seeing increased
connection to radon and as a cause of lung cancer,
especially also in non-smokers.
- Do you ever talk to patients and hear them say,
especially you've got younger patients,
that they didn't know that radon was a risk factor,
they didn't know anything about testing.
I mean, what are the patients kind of talking about,
or are they even aware that this is a risk factor
that they're living in?
- So a lot of patients are not aware of the radon
as a risk factor when it comes to lung cancer,
it's typically just the smoking.
But I'm talking to patients more about
getting their homes tested for radon
and also looking at other causes of lung cancer,
which includes vaping in the younger population.
Besides radon as an environmental factor, asbestos,
arsenic, chromium are other environmental factors
that we have to keep in mind
if anybody has had exposure to that.
Indoor pollutants like smoke, burning coal,
cooking oil smoke can also contribute
so there are other risk factors like
even exposure to secondhand smoke.
Now we are learning that maybe prior history of lung disease
or radiation to the lung could also be linked
to developing lung cancer.
We are not clear about the role of HPV virus,
the human papilloma virus and its linkage to
as a causal factor for lung cancer.
Now in women, we have learned about estrogen receptors,
especially the beta type being exposed in the lung tissue
and maybe that may also have some connection to lung cancer,
especially in women who are non-smokers.
- Interesting.
Well with lung cancer being the number one cancer killer
in the United States, I think people always are like,
how can I prevent this disease that could take my life?
And we're obviously seeing these links in radon
as something that we can all do.
What are your thoughts around?
Is it too late to test a home?
Should everybody get their home tested?
As a professional, what would you recommend
to your neighbors or your friends that they should do?
- [Dr. Haideri] I mean, ideally,
when you're moving into a new home,
we should all get our homes tested for radon,
but especially if there is
somebody who's smoking in the house,
I would definitely promote radon testing at home
because we have seen an interactive effect
of radon exposure and smoking together
as a cumulative effect in causing lung cancer.
- So you're telling me that if you're already a smoker,
I mean, certainly you're at risk,
but if you're a smoker and your house has radon,
your risk is increased, is that what we're learning today?
- Correct.
- Okay.
So I think it's really important for people to know
there are things that they can do to reduce their risk
or to not increase their risk.
Talk to us a little bit.
Are we seeing anything about children?
Are we concerned that children that are
being raised in homes with radon
could be developing cancer themselves?
You know, what should we know?
- So basically in the pediatric population,
there may be radon exposure linked
to some other types of cancer, like childhood leukemia,
but the evidence for such a connection is mixed,
and I think future studies will kind of
throw more light on this connection.
So basically we also have learned as
the relationship between the time of exposure.
So if somebody has been exposed to radon
like close to 15 to 25 years of their life,
then they have a more chance of developing
a harmful effect from radon.
- Wow. Good to know.
Thank you Dr. Haideri for your information today,
this has been really helpful.
Is there anything else you would want to add
for the viewers today?
- Well, my only
advice to everybody who is smoking,
we do have low dose CT screening now for the lung
as an accepted recommendation for lung cancer screening
so that is something that we can always
discuss with a primary care doctor in addition to
mammograms and colonoscopy and pap smears.
- Excellent information.
And can you reiterate that for one moment?
So since we have these low-dose screenings
who qualifies for these screenings, if they're a smoker?
What's the amount of smoking history
that qualifies for this?
- So patients who
have smoked for more than 30 years,
and if you are above 65 years of age, you qualify for
low dose CT screening of the lung on an annual basis.
- Okay, and that would help us identify a lung cancer
much earlier, is that correct?
- Exactly, so we can pick up the small lung cancers,
which could be still cured by surgery or by radiation,
and it has a benefit effect on survival.
- And remind us, they should reach out to a primary care
for that referral or find more information?
(Dr. Haideri hums approval)
Excellent, great to know.
We definitely want to prevent these cancers
or reduce our risk wherever we can,
because obviously we know that
it's definitely important for all of us
to live better longer.
Thanks so much for joining our Housecall today.
I hope you have a great day.
- Thank you, Sammy, I wish you the same.