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Lung cancer is by far the leading cause of cancer death. Request a screening at one of Baptist Health diagnostic screening locations today!

What You Should Know About Lung Cancer
and Whether Screening Is for You

By KiKi Bochi

Lung cancer is by far the leading cause of cancer death in the United States, accounting for about one in five of all cancer deaths. Each year, more people die of lung cancer than of colon, breast and prostate cancers combined.
 
While unsettling, those statistics tell only part of the story. Decades of research have yielded powerful advances, particularly in diagnostics, targeted therapy, immunotherapy, surgical approaches and highly precise radiation technologies. 
 
Further improvements in lung cancer treatment are on the horizon, says Nathaniel McElhaney, M.D, a double board-certified thoracic surgeon with Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health.
 
“I think there are a lot of reasons to be optimistic,” Dr. McElhaney says. “The overall survival from all stages of lung cancer has improved over the last five years. That’s due in part to genetic testing that can guide treatment, targeted therapy, and lung cancer screenings that can help us catch the disease in its earliest stages.” 
 
Roughly 235,000 new cases of lung cancer will be diagnosed in 2024   in the United States, according to the American Cancer Society. Lung cancer is expected to cause some 125,000 deaths this year alone.

GAME-CHANGING DIAGNOSTICS

Lung cancer often isn’t diagnosed until later stages — after it has spread — making it harder to treat. However, expanded use of screening with low-dose CT scans could improve that picture. According to the American Lung Association, such screening among those at high risk could reduce the lung cancer death rate by up to 20 percent by finding tumors earlier, when treatment has the biggest impact.
 
“The low-dose CT scan does a really good job of finding these nodules while they’re still small, and that’s when you have the best chance of curing lung cancer,” Dr. McElhaney says. “The screening is really targeted for people at the highest risk.”
 
Low-dose CT scans use about one-fifth as much radiation as conventional CT scans. Guidelines from the U.S. Preventive Services Task Force (USPSTF) recommend these scans for those 50 years of age or older with a history of heavy smoking (average of one pack per day for 20 years, or two packs per day for 10 years). The USPSTF recommends the screening for current smokers and those who quit within the past 15 years.
 
The American Cancer Society guidelines differ by calling for all former heavy smokers to get yearly scans, removing the 15-year threshold. The organization estimates there are more than 5 million smokers and past smokers who should undergo screenings, with early detection providing their best shot at beating lung cancer. 
 
Unfortunately, not enough people are getting screened, Dr. McElhaney says. A report by the American Lung Association last year found that only a tiny percentage of eligible U.S. adults have been screened for lung cancer. In Florida, according to the report, only 2.4 percent of those at high risk were screened, and nationwide the average was only 4.5 percent.
 
“As a society, we’re doing pretty badly,” Dr. McElhaney says. “I mean, if that was the rate of screening for breast cancer, it would be a big shame.” In comparison, 75 percent of women ages 50-74 years in the United States got screened for breast cancer with a mammogram over the past two years, according to the National Cancer Institute.
 
Lung cancer in early stages often produces no symptoms, which is why screenings are so vitally important, Dr. McElhaney says. If you do have symptoms, they may include chronic cough, chest pain, shortness of breath and recurring lung infections such as pneumonia or bronchitis. 
 

TREATING LUNG CANCER

Treatment for lung cancer depends on the type of cancer and stage. 
 
When lung cancer is caught early, it can be treated by surgical removal of the tumor. At Lynn Cancer Institute, this is most often performed in a minimally invasive fashion, using robotic-assisted surgery or video-assisted thoracoscopic surgery, Dr. McElhaney says. In many cases, the diseased lobe or lung is removed. But when caught early enough, a greater portion of the lung can be preserved.
 
“Typically, when we do lung cancer surgery, we take out an entire lobe, but sometimes if it is really early, we can take out just part of a lobe and it still has the same efficacy. People don’t lose as much of their breathing ability, and they still get the full cancer cure,” Dr. McElhaney says. “Surgery is primarily offered for early-stage cancer, Stages 1 and 2. When surgery options are reduced because the cancer has spread, your chance of cure is less. It’s another reason why getting screened is so important for high-risk individuals.” 
 
When cancer is found, patients benefit from Lynn Cancer Institute’s multimodality clinic approach, which expedites care and brings a wide range of experts together to determine an individualized treatment plan for that patient’s particular cancer. “It’s a big plus to have the Multimodality Clinic and work with all the different specialists at the same time,” Dr. McElhaney says.
 
While surgery may not be an option for every patient, those who receive it as part of their initial treatment have higher survival rates than those who do not, according to the American Lung Association. Other treatments may be recommended instead of or in addition to surgery, such as chemotherapy, radiation, targeted therapy or immunotherapy.
 
Researchers are learning more about the inner workings that control the growth and spread of lung cancer cells. Molecular testing has shown that there are different genetic drivers that fuel cancer growth, helping target specific mutations. It has led to the availability of new options for targeted therapy, with many more medications in development.
 
In some patients, depending on the genetic markers for their cancer, targeted drugs and immunotherapy can help their body fight back, evade or outsmart the cancer for years. These relatively new medications have changed the landscape for the management of many types of cancer.

FACING THE RISKS

Although smoking causes a large proportion of lung cancer, not all people who get lung cancer smoke. As many as 20 percent of people who die from lung cancer in the United States have never smoked or used any form of tobacco. Some recent research data indicates that nonsmoking-related risk factors for lung cancer are fueling cases among younger adults.
 
Risk factors other than tobacco use include concentrations of radon gas in buildings, secondhand smoke, exposure to cancer-causing agents at work, air pollution and even genetics. Any of these can cause changes or mutations in the lung cells that can lead to cancer. And some people who get lung cancer have no known risk factors.
 
“There are some things that just seem to develop out of nowhere,” Dr. McElhaney says. “It’s the same as any other type of cancer, like breast cancer. It’s not like you did something to cause breast cancer. If you have breasts, you can get breast cancer. If you have lungs, which we all do, you can get lung cancer.”
 
Dr. McElhaney strongly advocates staying away from smoking and other inhaled substances to protect the lungs. If you smoke, seek assistance to quit. If you don’t smoke (or vape), don’t start. And ask your healthcare provider whether you are a candidate for a low-dose CT scan. “If your primary care provider doesn’t bring it up, just ask, ‘Hey, what do you think about lung cancer screening? Do I qualify?’ It should be part of preventive healthcare.”
 
Dr. McElhaney is not certain whether people are not aware of this valuable tool, or if they are hesitant to get answers.
 
“Some people have this fear of knowing,” Dr. McElhaney says. “They think they’d rather not know, or they think, ‘If I don’t know about it, it’s not going to hurt me.’ But that’s not the way it really is. When you find out something a lot earlier, you can cure it. But a lot of times, if you find it because you’re having symptoms, it’s usually in a later stage.”

for more information please visit, BaptistHealth.net/LCI





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