Viewing a single comment thread. View all comments

Bax_Cadarn t1_j97cf64 wrote

Reply to comment by tinkh in Can doctors tell when cancer is caused by something specific, such as smoking or chemicals? by [deleted]

I'm studying for a big exam and basically every disease, restrictive or obturative, lowers DLCO lol. (Barring alveolar hemorrhage). Not just COPD or smoking-related diseases like DIP.

By identifying cells from BF or EBUS or biopsies, You mean like looking for macrofages loaded with soot?

3

Snoo16319 t1_j97g3yn wrote

Lung doc here. Not all obstruction reduces DLCO, DLCO is traditionally preserved in non-remodeled asthma.

That said, as a lung cancer researcher, KRAS mutation is much much more common in those who have smoked (not exclusive though). In modern practice, we are doing more assessment of tumor mutational burden and TMB is a lot higher in those who have smoked. Lastly, some subtypes, namely small cell and squamous cell, are almost unheard of in those who have never smoked.

Establishing causation in science is hard, and we observe changes correlated with tobacco use, but as they say, correlation and causation are not the same. We know epidemiologically and through cell and animal models the effects of tobacco smoke on DNA and cell growth, but in an individual, it would be close to impossible to establish exact causation.

5