Fighting lung cancer: How new therapies are improving outcomes
Lung cancer remains the leading cause of cancer death in the United States. As a medical professional who deals with this widespread disease on a daily basis, I would like to share some of the new treatments and preventative measures we are taking to combat lung cancer and raise awareness of the disease.
Symptoms and screening
Lung cancer is often asymptomatic and found on an X-ray or CT scan performed for other reasons, but can present with symptoms including cough, shortness of breath, or chest pain. In recent years, lung cancer screening has emerged as a proven way to diagnose lung cancer at earlier stages in high-risk individuals, and has become more widely available and utilized. This has been a positive advancement, because we often find that the sooner we catch the cancer, the higher the likelihood of curing it.
Currently, the U.S. Preventative Services Task Force recommends annual screening for lung cancer in individuals 55 to 80 years of age who have a 30 pack-per-year smoking history and currently smoke or have quit within the past 15 years.
What causes lung cancer?
Smoking and a history of exposure to cigarette smoke are risk factors for lung cancer, although there is a significant number of patients who have never smoked who develop the disease. Other environmental risk factors may include exposure to asbestos, radon gas, or pollution.
When is surgery an option?
For early-stage lung cancer, surgery is considered the standard of care. For locally advanced lung cancer (meaning it has spread from the lung to nearby lymph nodes or that it may be invading a nearby organ), surgery is often part of a multimodal treatment plan that may include chemotherapy, immunotherapy, or radiotherapy.
For metastatic lung cancer, patients are generally treated with a systemic therapy like chemotherapy, immunotherapy, or molecular targeted therapy. Because we understand the biology of lung cancer much better than we ever have, there are now more treatment options for advanced lung cancer than in the recent past.
When someone is diagnosed with metastatic disease, for example, we send a sample of the cells, or a biopsy, for genetic testing. If we find there are certain mutations present, we are able to tailor the treatment with drugs that target those mutations. The results of this type of tailored treatment have been remarkable and represent a giant leap forward in lung cancer care.
We also test for markers that would suggest that the individual’s cancer would respond to immunotherapy, which has been successful in recent years. In fact, it has replaced standard chemotherapy as the first treatment for many patients with metastatic lung cancer.
Advancements in surgical treatment
Minimally invasive and robotic surgical techniques have made lung cancer surgery less life-altering than ever before, with decreased recovery time and less pain. For early-stage lung cancer, the surgery that is usually performed is called minimally invasive lobectomy. During this procedure, we remove the affected lobe of the lung using small incisions. Patients who receive a minimally invasive lobectomy usually go home within a few days, and can even be discharged the next day.
For select patients with early-stage lung cancer, we can perform an operation that spares more normal lung tissue. Instead of removing an entire lobe, we can target a smaller section of that lobe. This procedure is called a robotic segmentectomy and results in removal of the cancer while saving more lung tissue. Patients who receive this surgery also usually go home within one to two days.
Moving forward in lung cancer treatment
The field of lung cancer treatment is advancing rapidly. Science and technology are constantly advancing and we understand the biology of lung cancer better than we ever have before.
New treatments, especially in the realm of immunotherapy and molecular targeted therapy are giving us higher cure rates, even in people diagnosed with metastatic lung cancer. It will take some years before the documented statistics catch up with we are currently witnessing. If you have been diagnosed with lung cancer, find a reputable care facility near you, and of course ask questions and discuss your options with a board-certified specialist in lung cancer treatment.
Learn more about the Lung Institute at Baylor College of Medicine or call (713) 798-6376.
See available lung cancer clinical trials at Baylor.
-By Dr. Bryan M. Burt, a thoracic surgical oncologist with the General Thoracic Surgery Clinic and member of the Dan L Duncan Comprehensive Cancer Center at Baylor