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November 11th, 2019

Regular screening, immunotherapy among latest weapons against lung cancer

Courtesy of The Times of Northwest Indiana • November 11, 2019

Bob Moulesong

According to the statistics from the American Cancer Society, 14% of all new cancer diagnoses are lung cancer. In 2018, there were 234,030 new cases in the U.S. — 121,680 in men and 112,350 in women.

Lung cancer, both small cell and non-small cell, is the second most common cancer in men and women. It is by far the leading cause of cancer death among men and women, accounting for more deaths than of colon, breast, and prostate cancers combined each year.

“Smoking is responsible for approximately 90% of all lung cancers,” said Dr. Alan Coon, a specialist in radiation oncology at the Franciscan Physician Network. “The No. 1 way to avoid lung cancer is to avoid or stop smoking.”

According to the Indiana State Department of Health, the average number of annual lung cancer cases in the state rose to 5,425 (2011-15) from 5,167 (2008-12).

“This is likely a result of many factors including increased detection of earlier stage lung cancers as well as the aging population,” Coon said.

Lung cancer symptoms are varied and typically not specific or sensitive, complicating diagnosis. “The classic symptoms are shortness of breath, weight loss, and chronic cough,” said Gail Magsaysay, oncology nurse navigator at Methodist Hospitals. “These symptoms are red flags that should receive attention as soon as possible.”

Very early stage lung cancers may have no symptoms and are frequently detected on a low-dose CT scan. “This is why CT scan screening for patients with increased risk of lung cancer has been shown to reduce lung cancer mortality,” said Magsaysay.

Coon added that information from imaging studies, biopsies and surgical specimens aid in the diagnosis and staging of lung cancers.

Treatment depends highly upon the type of lung cancer, the stage and the patient. “For stage 1 and 2 cancers, surgery is still the No. 1 option,” said Dr. Geeta Kurra, hematologist at Methodist. “In the early stages, the cancer is still local to the affected area, and surgery can increase the chances of remission.”

Radiation and chemotherapy are standard treatments for the later stages, as well as surgery. The chances of remission and recovery decline in later stage cancer, making the low-dose CT scan even more important.

The use of immunotherapy is rapidly expanding in the treatment of lung cancer. Cancer immunotherapy is the artificial stimulation of the immune system to improve its natural ability to fight the disease.

“Basically, immunotherapy uses your natural defenses to battle the cancer,” said Kurra. “We have had great success with immunotherapy, especially in later stage cancers. The results have been very promising.”

Magsaysay said the American Cancer Society is pushing to have a low-dose CT scan added to checkups, much as mammograms and prostate cancer screenings. “A standard X-ray cannot detect stage 1 and 2 cancers,” she said. “It’s a critical detection tool and is really underutilized right now.”

The five-year survival rate for localized lung cancer is 60% for non-small cell lung cancer, and 29% for small cell lung cancer. Those numbers have improved thanks to earlier detection and advancements in treatments.

As part of its efforts to prevent, detect, and treat one of the most lethal cancers, the National Cancer Institute sponsored a National Lung Screening Trial, which promotes an expanded use of the low-dose CT scans as the No. 1 early detection tool. It is sponsoring the use of artificial intelligence in computer algorithms to help make earlier detection.

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