What You Need To Know About Lung Cancer
Did you know that November is Lung Cancer Awareness Month? Since losing my dad 14 years ago this month to lung cancer, I’ve been passionate about sharing information surrounding this topic. It was a very difficult time for my family that still has ramifications today. If someone you know has lung cancer, encourage them to be their own advocate when it comes to their health.
In recent years, researchers have learned significantly more about lung cancer. This includes the stages of lung cancer and new scientific advancements that have led to new treatment options.
What researchers have learned about lung cancer in recent years may surprise you.
In the United States, lung cancer is the leading cause of cancer death among both men and women, accounting for approximately 154,000 deaths each year and about one-quarter of all cancer deaths – more than breast, prostate and colorectal cancers combined.
In 2018, an estimated 234,000 people will be diagnosed with lung cancer – that is three and a half times the number of seats in a typical professional football stadium.
But there is more to lung cancer than just one diagnosis.
The name “lung cancer” covers more than you may have thought or previously heard. Treatment options will vary based on the stage and type a person has. Lung cancer is not just one disease; about 80 to 85 percent have non-small cell lung cancer (NSCLC) and about 10 to 15 percent of patients have small cell lung cancer, and each category has many different subtypes within it.
Because there are different types of lung cancer, when someone is diagnosed, it’s important to understand the specific characteristics of the disease, so they can find out which types of treatment are most appropriate for them. This is the crux of “personalized medicine” – ensuring each patient is treated according to the specific characteristics of their unique diagnosis.
There are medicines that have been proven to benefit patients with specific types of lung cancer, so if diagnosed, it is critical to understand the details of your diagnosis and talk to your medical team about what treatments are approved to treat your specific type of disease.
As you can see, knowing the specific type of lung cancer a person has can greatly impact the treatment options available for them.
What To Know About The Stages of Lung Cancer
The different stages are determined with different and varying criteria. Specifically, a lung cancer stage is determined by tumor size and whether it has spread to nearby areas, lymph nodes, or other organs. Some of these stages have unique names, which can sometimes make understanding the types of lung cancer confusing.
Stages of lung cancer:
There are four main “stages” of NSCLC, defined primarily by the size of the tumor and how far the cancer has spread within or outside of the lungs.
There are a lot of misperceptions about lung cancer, particularly in grouping Stage 3 cancer with Stage 4 cancer.
Stage 4 NSCLC is called “metastatic” and occurs when the disease has spread to distant parts of the chest or to other organs, such as the brain, bones or liver.
Stage 3 is different—it is an earlier stage of disease with better long-term survival rates. Typically, the earlier we treat disease, the better outcomes we have.
About 1 out of every 4 people diagnosed with NSCLC – more than 43,000 cases each year in the US – are diagnosed with Stage 3. And most people who are diagnosed with Stage 3 NSCLC have tumors that are determined to be “unresectable,” meaning they cannot be removed surgically.
Historically, the standard treatment path for unresectable Stage 3 NSCLC was concurrent chemoradiation therapy. After approximately 6 weeks, the treatment would typically stop, and the cancer would be monitored to see if it would spread to other organs. Although most patients initially benefit from chemoradiation therapy, up to 9 out of 10 patients would ultimately progress to Stage 4 – meaning the cancer would spread.
With the advancement of treatment options, it is critical for patients not to give up – to be aware of their options and talk to their doctor about what treatments may be appropriate for them.
In recent years, researchers have come to understand important details of how lung cancer grows and spreads. This has led to important new treatment options that treat cancer differently from conventional therapies, like chemotherapy and radiation.
Two important types of therapy are targeted medicines and immunotherapies. In later stages of lung cancer, particularly stages 3 and 4 NSCLC, these types of medicines are changing the way cancer is treated.
Targeted medicines: Lung cancers have certain “biomarkers,” which are unique traits of each individual lung cancer, diagnosed through testing, that can help patients and their doctors understand its specific characteristics and can play a role in determining what types of medicines the cancer is most likely to respond to.
This is often considered a form of “personalized medicine,” which includes treatments specially designed for certain tumor characteristics. Personalized medicines include targeted treatments for lung cancer with certain biomarkers, such as the epidermal growth factor (EGFR) mutation. EGFR is a protein found on the surface of some cells to which epidermal growth factor binds, causing the cells to divide. It is a common mutation of NSCLC, for which targeted medicines are available.
Immunotherapy: In the fight against disease, the immune system is the body’s greatest ally. However, cancer is smart and can take on a disguise. Proteins such as “PD-L1” can cloak cancer cells, preventing the immune system from recognizing them and making it nearly impossible for the body to attack the harmful cells.
Unlike traditional types of therapy, such as chemotherapy, which seek to attack the cancer directly, immunotherapies – also called Immuno-Oncology (IO) medicines – empower the body’s own immune system to find and attack cancer. By blocking or inhibiting proteins such as PD-L1, we are able to make the cancer cells more recognizable to the immune system, thereby activating it to find and attack cancer cells.
For some lung cancer patients, immunotherapy may be an option following conventional therapies, to keep the cancer at bay for longer and, in some cases, showing positive signs for improved overall survival.
How You Can Help
Given the more targeted treatment options and the new research and information available, there is a reason for hope for those diagnosed with lung cancer.
Spread the word about Lung Cancer Awareness month. Those with lung cancer need to be their own advocates. It’s crucial they understand their diagnosis and get tested for the right treatment options. With test results and open conversations with their medical teams, they can better advocate for themselves when it comes to their treatment.
I was selected for this opportunity as a member of CLEVER and the content and opinions expressed here are all my own.