Lung Cancer Awareness Month

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By Terry Orr

(Former Smoker)

Sadly, but true, I was a heavy smoker for far more years that I’d like to admit – and quick cold-turkey walking back to work after lunch with my good friend Ron Ziegler who asked me when are you going to quit.  I said right now – and tossed my cigarettes and lighter into the trash can on the sidewalk.  That day was March 31, 1987 and I have not had once since then.  About 12 years later, my doctor and I were discussing my recent chest x-ray which still depicted scar tissues from all that smoking.  Happily – my lungs today are clear. Thanks Z and happy birthday.

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What Is Lung Cancer?

Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs; usually in the cells that line the air passages. The abnormal cells do not develop into healthy lung tissue; they divide rapidly and form tumors. As tumors become larger and more numerous, they undermine the lung’s ability to provide the bloodstream with oxygen.

Although lung cancer is the leading cause of cancer death in the U.S. in both men and women, it is also one of the most preventable kinds of cancer. At least four out of five cases are associated with cigarette smoking, and the cause-and-effect relationship has been extensively documented. (Source: WebMD)

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What are the key statistics about lung cancer?

Lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women (not counting skin cancer). In men, prostate cancer is more common, while in women breast cancer is more common. Lung cancer accounts for about 14% of all new cancers.

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The American Cancer Society's most recent estimates for lung cancer in the United States are for 2012:

• About 226,160 new cases of lung cancer will be diagnosed (116,470 in men and 109,690 in women).
• There will be an estimated 160,340 deaths from lung cancer (87,750 in men and 72,590 among women), accounting for about 28% of all cancer deaths.
• Lung cancer is by far the leading cause of cancer death among both men and women.
• Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.
• Lung cancer mainly occurs in older people. About 2 out of 3 people diagnosed with lung cancer are 65 or older; fewer than 2% of all cases are found in people younger than 45. The average age at the time of diagnosis is about 71.
• Overall, the chance that a man will develop lung cancer in his lifetime is about 1 in 13; for a woman, the risk is about 1 in 16. These numbers include both smokers and non-smokers. For smokers the risk is much higher, while for non-smokers the risk is lower.

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Lung Cancer Causes

Cigarette smoking is the most important cause of lung cancer. Research as far back as the 1950s clearly established this relationship.

About 90% of lung cancers arise due to tobacco use. The risk of developing lung cancer is related to the following factors:

• The number of cigarettes smoked
• The age at which a person started smoking
• How long a person has smoked (or had smoked before quitting)

Other causes of lung cancer, including causes of lung cancer in nonsmokers, include the following:

• Passive smoking, or secondhand smoke, presents another risk for lung cancer.
• Asbestos exposure increases the risk of lung cancer nine times.
• Lung diseases, such as tuberculosis (TB) and chronic obstructive pulmonary disease (COPD), also create a risk for lung cancer.
• Radon exposure poses another risk.
• Certain occupations where exposure to arsenic, chromium, nickel, aromatic hydrocarbons, and ethers occurs may increase the risk of lung cancer.
• A person who has had lung cancer is more likely to develop a second lung cancer than the average person is to develop a first lung cancer.

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Lung Cancer Treatment

There are four basic ways to treat lung cancer: surgery, radiation therapy, chemotherapy, and targeted therapy.

Surgery

A surgical oncologist is a doctor who specializes in treating cancer using surgery. For lung cancer, a thoracic surgeon is specially trained to perform lung cancer surgery. The goal of surgery is the complete removal of the lung tumor and the nearby lymph nodes in the chest. The tumor must be removed with a surrounding border of normal lung tissue (called the margin).

The following types of surgery may be used for lung cancer:

Lobectomy. The lungs have five lobes, three in the right lung and two in the left lung.

A wedge. If the surgeon cannot remove an entire lobe of the lung, the surgeon can remove the tumor, surrounded by a margin of normal lung.

Pneumonectomy. If the tumor is close to the center of the chest, the surgeon may have to remove the entire lung.

Radiofrequency ablation. Radiofrequency ablation (RFA) is the use of a needle inserted into the tumor to destroy the cancer with an electrical current.

Adjuvant therapy

Adjuvant therapy is treatment that is given after surgery to lower the risk of the lung cancer returning. Adjuvant therapy includes radiation therapy, chemotherapy, and possibly targeted therapy.

Radiation therapy is the use of high energy x-rays or other particles to kill cancer cells.

Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells' ability to grow and divide.

Targeted therapy is a treatment that targets the cancer's specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells.

Anti-angiogenesis therapy is focused on stopping angiogenesis, which is the process of making new blood vessels. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor.

Epidermal growth factor receptor (EGFR) inhibitors. Researchers have found that drugs that block EGFR may be effective in stopping or slowing the growth of lung cancer.

Cetuximab (Erbitux) is an EGFR inhibitor given along with chemotherapy to treat lung cancer, especially when treatment with bevacizumab is not recommended. It is given intravenously.

Erlotinib (Tarceva) is another drug that blocks the EGFR. This drug has been shown to work better than chemotherapy if the lung cancer has a mutation (change) in the EGFR gene.

Gefitinib (Iressa) is another drug that blocks the EGFR. In the United States, it is available only to people who were already taking it, had taken it in the past and had a good effect, or as part of a clinical trial.

For additional information regarding treatment of Lung Cancer, please click on the Cancer.net link below. Thank you.

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My advice to those who are smoking today – QUIT. To those who have not started – DON’T.

References and Links:

• http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-key-statistics
• http://www.lungcanceralliance.org/assets/docs/media/LCA%20Funding%20Fact%20Sheet%202012.pdf
• http://www.emedicinehealth.com/lung_cancer/page2_em.htm#
• http://www.webmd.com/lung-cancer/guide/consumer-guide-chapter-outline
• http://en.wikipedia.org/wiki/Treatment_of_lung_cancer
• http://www.cancer.net/cancer-types/lung-cancer/treatment