Lung Cancer: How to Recognize the Signs Early

Spain has reached a historic turning point. According to the latest report from the Spanish Society of Medical Oncology (SEOM), cancer has now surpassed cardiovascular diseases as the leading cause of death in our country. Within this scenario, lung cancer stands as the most complex challenge.

Despite institutional efforts, smoking remains the driver of this disease, responsible for more than 85% of diagnoses. Dr. Luis Manuel Entrenas, head of the Pulmonology service at Hospital Quirónsalud Córdoba, warns of the "shocking figures we continue to find." Currently, 28% of men and 22% of women over the age of 15 smoke daily in Spain, but there is also a concerning trend: 49% of teenagers have used electronic cigarettes under the false assumption that they are harmless.

Regarding this trend, Dr. José María Ignacio, head of the Pulmonology service at the hospitals Quirónsalud Marbella and Campo de Gibraltar, is emphatic about the effects of vaping: "Vaping causes the bronchiole closure. Many patients with respiratory pathology will have an exacerbation of this disease as a direct consequence of the vapor inhalation. Additionally, the toxic relationship still exists as long as it remains a substance dependency".

The “invisible” symptoms to watch for

One of the major problems with lung cancer is its silence. In early stages, it tends to be asymptomatic, leading to eight out of ten patients being diagnosed when the disease is already advanced. Dr. Domingo García Aguilar, coordinator of the Pulmonology Service at Hospital Quirónsalud Infanta Luisa, warns that "the spectrum of symptoms for lung cancer is very broad and often nonspecific," but it is very important to be vigilant because the difference between detecting a tumor in time or not is, literally, life. Dr. Miguel Congregado Loscertales, specialist in Thoracic Surgery at Hospital Quirónsalud Infanta Luisa, provides a revealing fact: the survival rate for tumors smaller than 1 cm is 90%, but if there are affected lymph nodes, it drops to 25%. "Nine out of ten patients can potentially have a good prognosis if diagnosed early," the surgeon emphasizes.

The lack of clear signals often delays the visit to the specialist doctor. That's why it's so important to be aware of red flags such as a persistent cough that doesn't disappear after weeks and doesn't improve with treatments. The chest pain when coughing, breathing deeply, or even laughing, and the presence of blood when coughing or in the sputum.

In slightly more advanced stages, the body starts to show signs of generalized exhaustion manifested in unexplained weight loss, lack of appetite, or extreme fatigue.

Biomarkers, the key to appropriate treatment

There are fundamentally two major types of lung cancer. The most common is non-small cell (microcytic), which accounts for approximately 85% of cases and includes subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. The second type is small cell (microcytic), which tends to be more aggressive and is closely linked to smoking.

However, beyond the type, science has moved beyond this generic classification to focus on the specific mutations of each patient, such as alterations in the EGFR or KRAS genes, two of the most critical biomarkers for determining which treatment a patient should receive, especially in adenocarcinoma (the most common type of non-small cell lung cancer). In this regard, Dr. Andrés Aguilar, a medical oncologist at Hospital Universitari Dexeus, highlights the importance of researching solutions for complex cases where the tumor becomes resistant to standard therapies, noting that the study of new combinations "represents a hopeful advancement in the approach to resistant lung cancer".

The therapeutic revolution: From chemotherapy to precision

In many hospitals, the treatment of lung cancer is no longer a "one-size-fits-all" approach. Although surgery and chemotherapy are still present, the spotlight has been stolen by three fronts: immunotherapy, precision medicine, and TTFields.

With immunotherapy, instead of attacking the tumor, the aim is to boost the body's defenses. Dr. Pablo Ayala de Miguel, an oncologist at Hospital Quirónsalud Clideba in Badajoz, explains this paradigm shift: "In some patients, we have moved from an exclusively palliative approach to talking about long-term controlled metastatic disease, which has also transformed the way patients face the diagnosis, with more realistic and clearly more hopeful expectations".

Another field with significant advances is precision medicine, which seeks to target the specific genetic weakness of each tumor. In essence, to find the tumor’s “ID” to discover the therapeutic combination that best suits it. Dr. Omar Saavedra, a medical oncologist at Hospital Quirónsalud Barcelona, points out that phase 1 clinical trials are no longer the last resort: "Phase 1 clinical trials are no longer the last option, they now represent a real therapeutic opportunity for patients even with a recent diagnosis of metastatic disease".

The latest therapeutic innovation in this field comes from TTFields (Tumor Treating Fields). This therapy completely breaks with traditional methods by using low-intensity electric fields. The treatment is administered through a portable device that the patient carries, connected to a series of patches placed on the torso, which emit waves specifically designed to disrupt the division process of cancer cells without harming the surrounding healthy tissues.

What makes this technology especially relevant is its ability to act in synergy with other treatments. Combined with immunotherapy, the electric fields physically halt the tumor growth, and seem to act as a "wake-up call" for the immune system. According to data handled by specialists from reference centers such as Hospital Universitario Fundación Jiménez Díaz, this combination has shown to significantly prolong average survival. Additionally, it stands out for offering a superior quality of life, since its side effects are minimal.

Future and better quality of life thanks to AI

Innovation is not only in the form of drugs. Artificial Intelligence has become a "precision co-pilot". Algorithms developed by institutions like Hospital Universitario Fundación Jiménez Díaz already allow predicting, through the analysis of blood tests and clinical data, which patients will respond best to immunotherapy, avoiding unnecessary toxicities.

Moreover, oncology today not only looks at survival but at life after cancer. Dr. Javier de Castro, president of SEOM, concludes with an ambitious goal for the next decade: "In metastatic cases, we hope to be able to control the disease chronically and permanently, where the patient can live with it with the best possible quality of life".