What Everyone Should Know About Lung Cancer

What Everyone Should Know About Lung Cancer

“Every day a 747 plane full of people dies from lung cancer in the U.S.,” says Malcolm M. DeCamp, MD, chief of thoracic surgery at Northwestern Memorial Hospital.

Lung cancer is the leading cause of death from cancer for men and women in the U.S., killing more people than breast, colorectal, prostate and pancreas cancer combined.

“We lack both awareness and understanding of how common lung cancer is,” DeCamp says. “The magnitude of the problem warrants everyone’s attention.”

Important lung cancer facts:

  • In 2017, approximately 8,600 people in Illinois are expected to be newly diagnosed with lung cancer.
  • The best way to prevent lung cancer is to not smoke.
  • As many as 20 percent of people who die from lung cancer have never smoked.
  • Current and former heavy smokers ages 55 to 80 are at increased risk of lung cancer and should talk to their physician about getting screened.
  • Screening with a low-dose CT scan is readily available for some current and former heavy smokers. Speak to your doctor or take the quiz at SavedByTheScan.org to see if you are eligible for the screening.
  • When detected by a screening CT scan, lung cancer is three times more likely to be found at an early stage and more likely to be cured.


A scary diagnosis

In 2013, Chicago fitness instructor Marla Way visited her doctor for a pain in her groin that would not go away. She assumed it was a pulled muscle, but after a series of tests — including blood work, an MRI and a biopsy — she received shocking news. Way, a non-smoker in her mid-50s, was diagnosed with stage 4 non-small cell lung cancer. The cancer had metastasized and spread to other parts of her body.

Way was told that she had six months to one year to live. Despite this devastating news, she didn’t give up. Instead, Way sought out new doctors who gave her hope and treatment options — two things that lung cancer patients have access to now more than ever.


The promise of new treatments

“It is a very exciting time with much more hope,” DeCamp says. “We have a tremendous portfolio of medications and technology that are effective in treating the disease. We now use precision medicine to probe the genetics of the disease and create a personalized treatment plan tailored to each patient’s individual tumor biology and medical needs.”

New targeted therapies can attack specific “driver” mutations in the cancer’s genes or harness the immune system to help the body battle advanced lung cancer, he says.

The result, DeCamp says, is that patients with lung cancer, even advanced lung cancer, can live longer. “The diagnosis should not equate with hopelessness. We have effective treatments designed to extend life and improve or maintain the quality of life for nearly all patients, regardless of stage at diagnosis.”

Way’s doctors at Northwestern and UChicago Medicine aggressively treated her cancer with surgery, chemotherapy and radiation. When a follow-up scan showed that the lung cancer had spread to her brain, her doctor recommended a genetic test to see if her cancer was ALK-positive, which would make her a candidate for a new targeted drug called Alecensa (alectinib). Thankfully, Way was ALK-positive, and she took her first dose of Alecensa the very day that the drug was approved for use.

Way’s tumors rapidly responded to the targeted treatment and soon began to shrink. That was two years ago, and she continues to take the drug to keep the cancer at bay. “I am not cured,” Way says, “but I can live with lung cancer. I want other people who are diagnosed to know that this does not have to be a death sentence.”


Knowing your risk

“We need to change the face of lung cancer,” says Kristen Young, executive director of the American Lung Association in Greater Chicago. “There has been a stigma that it is a smoker’s disease,” she says. “Anyone can get lung cancer, even non-smokers.”

So how do you know if you’re at risk for lung cancer?

Risk factors include:

  • Smoking
  • Exposure to radon
  • Workplace exposure to asbestos, arsenic, diesel exhaust, silica and/or chromium
  • Personal or family history of lung cancer
  • Pollution

Symptoms include:

  • A cough that gets worse or does not go away
  • Chest pain that is often worse with deep breathing, coughing or laughing
  • Hoarseness
  • Weight loss and loss of appetite
  • Coughing up blood or rust-colored sputum
  • Shortness of breath
  • Feeling tired or weak
  • Infections such as bronchitis and pneumonia that don’t go away or that keep coming back


Saving lives through early detection

Prevention and early detection are the keys to saving lives and increasing the lifespan of people with lung cancer.

The screening for early detection consists of a low-dose CT scan, which may be approved by insurance and Medicare for current and former heavy smokers. Yet fewer than 5 percent of high-risk Americans have been screened for lung cancer, Young says.

“Approximately 8.6 million Americans are at high risk for lung cancer,” she says. “If only half receive early screening, over 13,000 people could be saved.”

The goal of the American Lung Association’s Saved by the Scan initiative is to spread the word about early lung cancer detection. Its site, SavedByTheScan.org, offers a short survey for current and former smokers to see if they qualify for a low-dose CT screening scan.

No one wants to be diagnosed with lung cancer, DeCamp says, “but if detected early, the treatment leads to a cure more often.” Treatment is also much simpler in the early stages.

A lung cancer screening test that’s suitable for everybody — smokers and non-smokers alike — may not be so far off. Research is underway across the globe to find simpler, accurate and less costly tests. Northwestern scientists are working on trials for a mouth swab test to detect lung cancer early, DeCamp says. This could make early detection simpler, safer and more affordable.

“With earlier detection, we can cure more people,” he says. “With precision medicine, we hope to turn advanced disease into a chronic disease that folks can live with, kicking the can down the road and allowing time for research to bring us even more effective therapies.”

Originally published November 30, 2017