Smoking Leads To Bad Health

The Berlin doctor Jens Kollmeier on the pitfalls of lung cancer, the dangers of fine dust and the question of why there is no screening for this tumor.

Mr. Kollmeier, lung cancer is one of the most common types of cancer. Why is the lungs affected so often?
The lungs communicate directly with the outside world. And if pollutants are inhaled, this can lead to cancer development. Lung cancer comes to a large extent from smoking. Smoking is also an unfavorable influencing factor for other types of cancer, but of course lung cancer is the main focus, since you smoke in the lungs. As long as smoking behavior does not change, the number of new cases will not decrease by 50,000 a year. As smoking behavior has developed adversely in women in recent decades, lung cancer among them is increasing even further.

Research is working on targeted drugs for cancer treatment beyond chemotherapy. Are the chances of a cure better today than they were 20 years ago?
Basically, the chances of a cure haven’t improved that much, even if we can heal more patients today than we did then. But we have also made great strides in incurable cases. Today, we often have better tolerated, yet more effective medication available.

How effective?
On the one hand, there are targeted therapies in the form of tablets that are directed against certain changes in the genetic material of the tumor cell. We believe that these changes are responsible for the development of the tumor. For around 15 percent of those affected, the situation has improved dramatically in some cases, extending life expectancy by years. 

Lung cancer still kills more than 40,000 people in Germany every year. What makes cancer so insidious?
Most patients are diagnosed only at advanced stages because there is still no really good preventive care and because lung cancer starts with symptoms such as cough that a smoker often has anyway. Until the patient notices that something may be wrong, the tumor is often no longer curable by surgery or radiation. In addition, lung cancer is often very heterogeneous in its structure and therefore cannot be permanently treated with a single therapeutic principle


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