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Heavy smokers, typically men, run a high risk of developing lung cancer due to the carcinogenic compounds found in tobacco smoke. 

But while tobacco remains the main risk factor, there has been a rising number of female lung cancer patients who have never smoked — with recognition that treatment for lung cancer in non-smokers can be different. 

There are certain genetic mutations that can lead to lung cancer that is more commonly found in Asian female non-smokers, according to Dr Tan Chee Seng, senior medical oncologist at OncoCare Cancer Centre, Singapore. 

“Lung cancer is unique in Asia. A mutation in the epidermal growth factor receptor (EGFR) may account for up to 50 per cent of female lung cancer cases here. But for Caucasians, it is less than 10 per cent due to genetic differences,” Dr Tan added.  

Chemotherapy — Not The Only Solution, Role Of Oral Targeted Therapy 

Thanks to new forms of treatment options recently developed, those suffering from advanced stage lung cancer now can have access to more personalised treatment options. Increasingly these newer treatment options are getting approval to be used to treat early lung cancers.  

Dr Tan also advised patients to undergo several genetic/molecular tests to determine the cause of their cancer, as certain types of genetic mutations can be treated with targeted therapy drugs or immunotherapy.  

Advancements in technology have made it possible to consider ‘liquid’ biopsy for selected patients where routine biopsies are not viable. These are essentially routine blood tests but with some limitations like lower accuracy (sensitivity/specificity). Also, not all genetic mutations can be tested through this method.  

Lung cancer patients who test positive for the EGFR mutation have the option to take tyrosine kinase inhibitor (TKI), a type of oral drug, as the first line of treatment. Unlike chemotherapy, which affects all body cells, TKI mainly inhibits the growth and spread of cancer cells. Common side effects include diarrhoea and face pimples. 

At the present moment, there are three generations of EGFR TKI drugs developed to fight lung cancer. 

The latest third generation EGFR TKI has the added benefit of treating brain metastases and has also significantly reduced common side effects. Singapore is one of the first few countries in the region to have access to this medication, noted Dr Tan. 

Immunotherapy

However, not all lung cancer patients can be targeted by TKI. Alternative treatment options include chemotherapy with or without the addition of immunotherapy/biologics.  

In selected patients, it is possible to use immunotherapy alone as the frontline treatment. Immunotherapy is a new class of lung cancer treatment that stimulates patient’s own immune system to fight cancer cells and has been shown to have lower side effects compared to conventional chemotherapy.  

For more information, please visit the following link :

Lung Cancer Treatment And Diagnosis

Know More About OncoCare

OncoCare Cancer Centre is one of the largest and fastest-growing private healthcare providers of oncology in Singapore. OncoCare provides patients with quality cancer care services and treatment administered by highly skilled, qualified medical professionals since 2007.

OncoCare website : www.oncocare.sg