Strides in Lung Cancer Treatments and Screenings
By Judy O’Gorman Alvarez
November is noted for several important U.S. events – Election Day, Thanksgiving and even the Great American Smokeout, the day smokers are challenged to give up cigarettes for 24 hours.
Lung cancer is the leading cause of cancer death and the second most common cancer among both men and women in the United States, according to the Centers for Disease Control and Prevention. Each year, about 221,000 people in the United States are diagnosed with lung cancer and about 146,000 people die from this disease.
The statistics may seem grim, but a downward trend in smoking, as well as devel- opments in the diagnosis and treatment for lung cancer, has improved the outlook for lung cancer patients and those at risk.
Current smoking rates has declined from 20.9 percent (nearly 21 of ever y 100 adults) in 2005 to 13.7 percent (nearly 14 of every 100 adults) in 2018, and the proportion of smokers who have quit has increased.
“It’s exciting to see the numbers are going down in terms of prevalence of the disease,” said Daniela Molena, M.D., thoracic surgeon at Memorial Sloan Kettering (MSK). “That’s due in part to people are more aware of risk factors and there are more programs for smoking cessation.”
In addition, according to Molena, mor tality rates among lung cancer patients have decreased. “Most importantly, thanks to early screening, we are finding the cancers at a much earlier stage.” In the past by the time a patient had symptoms, the stage was often advanced.
“Finding the cancer at an early stage in the disease gives the opportunity to cure the patient and the survival rate goes up,” she explained.
Molena credits the many changes to a better understanding of the disease and new drugs for treatment, some with a specific genetic component for targeting the cancer and some aimed to treat a patient’s immune system.
“In the past, when we diagnosed, we didn’t have a lot to offer,” she said. But now, “there’s been a lot of innovation and changes for diagnoses and treatment that have been at the basis of improvement in survival,” she said.
“The field is evolving so quickly and fast and we are just at the beginning of what we’ll see in the future.”
That includes surgeries. “Some of the innovations and changes that have been seen over the last several years include introduction of a minimal invasive approach,” Molena said. Surgeons can now find and remove the cancer and part of the lung, if necessary, with a camera and robotic probe. “We have the ability to preserve much of the lung,” she explained.
These advancements mean doctors can give their patients a customized line of treatment rather than a one-size-fits-all approach.
“Every cancer, every patient is just a little bit different and should be treated in the way what is optimal for him or her.”
More and better treatments are why lung screenings, such as the ones MSK offers at its Middletown location, for those at risk are so important.
“We really don’t know what causes lung cancer,” Molena said. “We know there are risk factors associated with it, the strongest is smoking.”
She also noted second-hand smoke and exposure to radon and other substances as other possible risk factors.
“And some just develop lung cancer and have no risk factors,” she said. “There is a significant number of patients who have never smoked.”
What Molena stresses is to eliminate the “blame” often attributed to lung cancer patients, especially smokers. “It’s important to take the stigma away,” she said. “Smoking is an addiction. It is very difficult to quit.”
“When someone is recently diagnosed, they are in a very stressful situation with a high level of anxiety and they may be being blamed by society,” Molena said. “Now we’re asking them to quit smoking at the time of their life they’re so stressed.”
She said now is when they need support the most, “not only from a pharmaceutical standpoint but from an emotional standpoint,” through therapy groups and familial encouragement.
And while lung cancer is never a diagnosis someone wants to hear, the innovations in detection and treatment offer hope, Molena pointed out.
“All these are very good things in terms of positivity and brightness for the future.”
Lung Screening & Smoking Cessation
Memorial Sloan Kettering recommends lung screening for people with a specific tobacco use history. The screening is done using a low-dose CT scan. Specifically, MSK recommends screening for those who:
• are a current smoker, or former smoker who quit within the last 15 years;
• are between the ages of 55 and 80;
• have smoked an average of one pack per day for at least 30 years, or the equivalent (for example, two packs a day for 15 years)
Research shows that screening with low-dose CT scans can reduce the risk of death from lung cancer for people at high risk of getting the disease. Screening takes only a few minutes, and many insurers cover the procedure if a person is deemed high-risk.
MSK’s Tobacco Treatment Program draws on a wide range of approaches to help people quit. Safe and effective medications and the latest behavioral techniques are used to help tobacco users break this physical addiction and be- come skilled in using diverse strategies to resist urges to smoke. The program is open to everyone.
For information on lung screenings and smoking cessa- tion programs:
MSK Monmouth in Middletown: 646-497-9163, mskcc.org/locations/directory/msk-monmouth
Riverview Medical Center’s Lung Cancer Screening Program: 732-530-2222, riverviewmedicalcenter.com/ services/lung-center/
Monmouth Medical Center’s Lung Cancer\
Screening and Lung Nodule Program: 732-923-7966, rwjbh.org/monmouth-medical-center
The article originally appeared in the Nov. 5, 2020 print edition of The Two River Times.
