When Prevention Fails: Advances in Lung Cancer Treatment
Lung cancer is the second most common cancer in the United States, but it remains the number one cause of cancer-related death. This is a major public health threat, but significant progress is being made in the prevention, diagnosis, and treatment of lung cancer.
According to Andrew Parchman, MD, a medical oncologist with the TriHealth Cancer Institute, the best way to prevent lung cancer is to stop using tobacco. We now use smoking cessation classes, phone apps, replacement therapy (patches, lozenges, gums) and as well as pharmaceuticals to help patients quit. Although many patients will try to stop smoking “cold turkey,” only three to six percent will remain abstinent at a year. Dr. Parchman says with the help of a physician, this approaches 30 percent.
The Importance of Early Diagnoses
“If we aren’t able to prevent lung cancer, our goal is to catch it as early as possible,” says Dr. Parchman.
The national lung screening trial demonstrated that low dose CT scans are an effective way to detect lung cancer at its earliest stages in a manner similar to mammography and colonoscopies. This study found that patients who were at high risk for lung cancer and received low dose CT scans had a 20 percent lower risk of dying from lung cancer than those who received standard chest X-rays.
The diagnosis of lung cancer is complex and involves laboratory tests, imaging studies, and biopsies. At the TriHealth Cancer Institute, a multidisciplinary group of subspecialists participates in a patient’s care from the first suspicion of lung cancer. The team includes not only physicians, but also nurse navigators, dieticians, genetic counselors, social workers, and pharmacists to help support the patient and his or her family. This ensures that each patient receives a timely and personalized diagnosis, stage, and treatment plan.
Lung Cancer Treatment Options
Early stage non-small cell lung cancer treatment is treated with either surgery or stereotactic body radiation therapy. New, minimally invasive robotic surgical techniques have been developed that use smaller incisions and help patients recover faster from surgery. Stereotactic body radiation therapy has similar outcomes to surgery but does not require an incision – high doses of pinpoint radiation are used to kill tumors.
“This option is ideal for patients who are not good candidates for traditional surgery due to other medical conditions,” said Dr. Parchman.
For stage 4 lung cancer, the general approach used to be chemotherapy, but therapies are now tailored to a patient’s unique cancer.
“Each patient is unique, each cancer type is unique, and therefore each treatment plan needs to be unique,” Dr. Parchman points out. “By understanding the biology of each cancer in each person, we are able to design treatments that are more likely work for that specific patient, as well as limit side effects.”
This approach is known as targeted therapy. In targeted therapy, biomarkers are used to predict a patient’s response to therapy, and these therapies are more likely to have a greater impact with fewer side effects. This differs from chemotherapy, which is effective against cancer cells, but causes significant side effects on other cells in the body.
Some of these precision therapies include genetic sequencing, where the DNA of a tumor is sequenced to help physicians decide which drug is best for an individual’s cancer, and immunotherapy, which is a type of medicine that activates a patient’s immune system to fight the cancer. Immunotherapy has had tremendous success in treating lymphoma, lung, melanoma, kidney, and gastric cancers, and has drastically changed the treatment expectations in lung cancer over the last three years – for the better.
In summary, said Dr. Parchman, the best way to treat cancer is to prevent it. But if cancer does occur, treatment options are now evolving at a rapid rate and leading to significantly improved outcomes.
Last Updated: October 24, 2018