In November, Mariah Carey defrosts for another holiday season with her iconic tune, “All I Want For Christmas Is You,” and social media floods platforms with content about Black Friday and the holidays.

November is also Lung Cancer Awareness Month. Lung cancer is the No. 1 cancer killer of both men and women in the U.S. and worldwide. Lung cancer kills more people each year than breast, prostate, and colon cancer combined.

This is an invisible cancer that doesn’t cause symptoms until it has reached an advanced stage when lung cancer is harder to treat.

More than 8 million Americans are considered at high risk for lung cancer. These are men and women ages 50 to 80 who have smoked the equivalent of 20 packs a year, current smokers, or those who have quit in the last 15 years.

And there it is – the elephant in the room: Smoking is the most important risk factor for lung cancer. Over 80 percent of lung cancer diagnoses occur in current or former smokers. It is estimated that 30 million adults are current smokers.

The Midwest represents the region with the highest percentage of current smokers. Smoking accounts for more than $240 billion in health care spending, nearly $185 billion in lost productivity from smoking-related illnesses and health conditions, nearly $180 billion in lost productivity from smoking-related premature death, and $7 billion in lost productivity from premature death from secondhand smoke exposure.

Smoking is a habit that isolates people in public and burns through their wallets just as quickly as they burn through a pack.

In the 1940s, lung cancer was the first health risk definitively linked to smoking by epidemiological studies.  By 1957, the evidence implicating smoking as a causative factor in lung cancer had been established, leading to the first official statement from the U.S. Public Health Service.

Years of successful tobacco cessation campaigns, starting in the 1970s, have resulted in labeling lung cancer as a smoker’s disease and fostered the perception that one “deserves” lung cancer because they smoke.

While smoking is the largest threat, environmental exposures, such as secondhand smoke, radon, and pollutants; occupational exposures, such as chemicals, combustion products, and diesel exhaust; and genetics also play a role.

This stigma impacts lung cancer awareness, funding for research, and the support available to those affected. Feelings of shame, guilt, blame, and fear consume the afflicted, encourage concealment of the condition, and impact the quality of care.

As a thoracic surgeon, I deal with this daily. I encounter patients at all stages of their disease and in varying stages of acceptance, denial, and despair. I provide patients with both good and bad news on any given day. Whatever my role, I aim to be a source of hope, comfort, and most importantly, an educator. I counteract stigma by instilling hope, promoting empathy, and increasing knowledge about lung cancer.

The most efficacious treatment for lung cancer is in its early stages. This is achieved through early detection; the best option is a low-dose CT scan. This quick and easy test takes about 10 minutes to complete and doesn’t involve needles or dye. The scan involves lying on a table and passing through a ring, so there is no risk of feeling claustrophobic.

The radiation dose is equivalent to taking 50 cross-country flights or six months of natural background radiation. The imaging can detect an abnormality the size of a grain of rice. After a scan, patients are contacted with the results, and further testing will be needed if an abnormality is found.

When detected in its early stage, it is possible to reduce the chance of death. When caught before its spreads, the chance of being alive in five years or more improves to 60 percent and may reduce the chance of death by up to 20 percent. Most early-stage lung cancer can be cured with surgery, and this is considered the treatment of choice. Surgery may often be performed minimally invasive with small incisions and a camera.

Lung cancer isn’t a death sentence. The cause of disease doesn’t deny anyone the opportunity or right to treatment. The only way to combat the stigma surrounding lung cancer is to give lung cancer victims, survivors, and educators a voice.

It is essential that this November, along with holiday preparations, everyone can educate themselves on this silent killer and ask their primary care doctor if they qualify for a lung cancer screening scan.

Early detection is the only chance for a cure. The length of Mariah Carey’s iconic holiday song is four minutes, shorter than a low-dose screening scan. But it is long enough to save a life.

 Nicole Geissen is a cardiothoracic surgeon.

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