Imagine seeing a city similar in size to Athens, Georgia, being wiped off the map year after year after year, the comparable loss of life from the deadliest cancer in the United States. According to the National Cancer Institute (NCI), more than 154,000 people will die from lung cancer in 2018.
“While the number of new cases of lung cancer has been on the decline, it is still the number one cancer killer in this country,” said Dr. Nagla Abdel Karim, a lung cancer medical oncologist working at the Georgia Cancer Center and Medical College of Georgia at Augusta University. “November is an important time for the lung cancer team to remind people about the dangers of smoking.”
The NCI estimates there will be more than 234,000 people diagnosed with lung cancer in 2018, with the number of people dying from the disease totaling more than 154,000. There is good news to report, however. NCI research also shows the number of new cases of lung cancer and the number of deaths is declining.
“One reason lung cancer is so deadly is because there are no identifiable symptoms in the earlier stages,” Karim said. “By the time a person shows symptoms that could be caused by lung cancer, it’s at a more advanced stage that can be much harder to treat.”
Screening with a CT scan can detect lung cancer at an early stage before patients become symptomatic, thus reducing mortality. However, a tissue diagnosis is mandatory for treatment planning. Lung cancer usually presents as nodules or a mass in the lung that requires advanced techniques to identify.
“We have launched a new Interventional Pulmonology program where least invasive methods are used to diagnose lung cancer without surgery and minimal risk of complications to the patients,” said Dr. Shaheen Islam, director of Interventional Pulmonology and Pulmonary Oncology at the Georgia Cancer Center and Medical College of Georgia at Augusta University.
One of those methods, bronchoscopy, is a technique where biopsy forceps are inserted into the lungs under ultrasound and direct camera guidance through the mouth.
“Even with these least invasive methods, we can obtain additional tissue for diagnosis of genetic mutation and molecular markers,” Islam said.
There are two forms of lung cancer: small cell and non-small cell. In both forms, tumor cells grow in the tissues of the lung. Smoking is the leading cause of both non-small cell and small cell lung cancers. The difference is in the types of cells, such as squamous cells or glands found in the lungs, where the tumor develops. According to the American Cancer Society, about 10-15 percent of lung cancers are small cell, which are the most aggressive.
“There’s new research being presented showing a new treatment having a significant response rate in patients with small cell lung cancer,” Karim said. “We are also moving into the field of molecular profiling to identify which treatment would have the best chance of success.”
Depending on the extent of the cancer, the treatment may include chemotherapy, immunotherapy, radiation or surgical resection. In patients with advanced cancer when tumor blocks the airways causing extreme shortness of breath, stents can be placed to keep the airways open to improve the quality of life so additional treatment can be provided.