With screening, new medical advances, lung cancer survivor rates are improving

special to the Herald-LeaderDecember 20, 2013 

LEE P.THOMAS 859-229-1937

Lung cancer forms in the tissues of the lung, usually in the cells lining the air passages. There are two main types of lung cancer — small cell lung cancer and non-small cell lung cancer.

Small cell cancer progresses quickly and is likely to spread beyond the lungs. Non-small cell cancer is more common, grows more slowly and is less likely to spread.

Kentucky leads the nation in both lung cancer incidence and lung cancer death. In many cases this can be attributed to smoking, the main cause of lung cancer, which contributes to roughly 85 percent of all lung cancer deaths. Roughly 29 percent of Kentuckians are smokers, compared to 21 percent nationally.

For years, there has been no way to accurately screen for lung cancer. Because lung cancer rarely shows any symptoms until it is very advanced, the mortality rate is high: More than half of the people diagnosed with lung cancer will die within just one year. Lung cancer kills more Kentuckians every year than the next eight most common cancers combined.

Most everyone knows that an annual mammogram and regular colonoscopies help with early diagnosis of breast and colon cancers, improving survival rates. But most people don't realize that in the last few years, we've learned that you can also screen for lung cancer in an effective way and this early detection can mean the difference of a life saved.

In 2011, the New England Journal of Medicine released a report proving that low-dose CT scanning, a new technology that employs a low-dose of radiation to make a series of very detailed pictures of the lungs, scanning the body in a spiral path, gives doctors an incredible amount of detail, allowing them to see even the smallest cancer growth.

Data shows that using low-dose CT is four times more likely to pick up a mass than a traditional chest x-ray, allowing for earlier detection and a better chance at survival.

For the first time, we now have the needed guidelines for whom we should screen and how we should screen them. For those who have smoked more than 30 pack years (the number of years that someone has smoked one pack a day), are a current smoker or have quit within the last 15 years, and are between the ages of 55 and 79, screening with low-dose CT is recommended.

If screening reveals a nodule on the lung, then your doctor may recommend a visit to a pulmonologist for a biopsy to determine if the nodule is malignant.

An annual chest CT scan can decrease lung cancer mortality by 20 percent, a significant decrease for such a historically deadly cancer.

Major advances have been made, too, in how we treat lung cancer. We're starting to see medications entering the market that are targeted to treat specific cancers, in combination with or without chemotherapy or radiation.

While these medications are currently only shown to treat specific mutations of non-small cell lung cancer, like adenocarcinoma, it's promising to see that cancer research is developing. There is a chance that we will see treatment options like this for many more types of lung cancer soon.

The scientific understanding of the molecular basis of cancer is growing, and thereby changing our understanding of how we should treat it. Thanks to this research, scientists and doctors have a better understanding of what makes cancers grow and metastasize, which means people with the disease are living longer.

Together, we must do a better job of raising awareness about lung cancer screenings to help prevent cancer deaths. This technology has the potential to save lives and improve quality of life.

Dr. Jessica Moss is a hematologist, oncologist at Saint Joseph East Hematology Oncology, part of KentuckyOne Health

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