A Breath of Hope: Navigating the Landscape of Lung Cancer

Lung cancer is the leading cause of cancer deaths among American men and women, accounting for about 1 in 5 of all cancer deaths. Every year, more people die of lung cancer than prostate, colon and breast cancers combined. But as the American Cancer Society points out, the number of new cases continues to drop, partly because more people are quitting smoking (or avoiding tobacco altogether) and also because of advances in early detection and treatment.This article will uncover the latest treatment options and supportive resources available to lung cancer patients and their loved ones. We'll also give insights into the complexities of lung cancer and the ongoing efforts to improve outcomes and quality of life for the people affected by this disease.

Understanding Lung Cancer

Lung cancer is a type of cancer that starts in the cells of the lungs. When lung cells start growing out of control, they form tumors that can interfere with the lung's ability to function appropriately. Over time, these cancer cells can spread to other parts of the body if undetected.

There are two main lung cancer types: small-cell and non-small cell lung cancer (NSCLC).

• Non-small cell lung cancer is the most common type, accounting for about 85% of all lung cancer cases. It includes different subtypes, like adenocarcinoma, squamous, and large-cell carcinoma. 
• Small cell lung cancer is less common but tends to grow and spread faster than NSCLC.

Risk Factors for Lung Cancer

Lung cancer can affect anyone. According to the American Lung Association, about 238,000 new cases of lung cancer are diagnosed in the US every year, and about 604,000 are living with it. Here are some risk factors:

• Smoking: Smoking tobacco is by far the leading risk factor for lung cancer. Pipes, cigars, cigarettes, vaping and other forms of tobacco contain numerous carcinogens (cancer-causing agents) that damage lung cells and increase the risk of cancer development. The longer and heavier a person smokes, the greater their risk.
• Secondhand smoke: Exposure to secondhand smoke can also elevate the risk of lung cancer. Non-smokers who regularly breathe in the smoke from others' cigarettes or other tobacco products are at increased risk.
• Environmental factors: Occupational exposure to carcinogens like asbestos, radon, arsenic, uranium, and some forms of silica and diesel exhaust can significantly increase the risk of lung cancer. People who work in industries like mining, construction, manufacturing, and transportation may be particularly vulnerable to these exposures.
• Family history: A family history of lung cancer can increase one’s risk, suggesting a potential genetic predisposition to the disease. While genetic factors play a role, shared environmental exposures within families may also contribute to this increased risk.
• Personal history of lung disease: Certain pre-existing lung conditions, like pulmonary fibrosis, COPD and tuberculosis, can raise the risk of developing lung cancer. Chronic inflammation and damage to lung tissue associated with these conditions may promote the development of cancerous cells.
• Radiation exposure: Previous exposure to radiation therapy directed at the chest wall area, particularly during childhood for conditions like Hodgkin's lymphoma, may increase the risk of lung cancer later in life.
• Dietary factors: While the link between diet and lung cancer risk is less clear than other risk factors, some research suggests that diets high in processed meats, certain fats, and low in fruits and vegetables may be associated with a higher risk of lung cancer.

Symptoms of Lung Cancer

Symptoms vary based on the type of lung cancer, its stage, and other factors. For example, stage 1 lung cancer symptoms can be subtle or nonspecific, and in some cases, individuals may not experience any symptoms at all. With that said, here are some common symptoms that do occur:

• Persistent cough
• Chest pain
• Shortness of breath
• Difficult swallowing
• Wheezing or hoarseness
• Coughing up blood
• Unexplained weight loss
• Bone pain
• Headache or neurological symptoms
• Clubbing of fingers
• Fatigue

Please note that many of these symptoms can also be caused by other conditions, and not everyone with lung cancer will experience all of these symptoms. However, if you experience any persistent or concerning symptoms, especially if you're at risk, you should talk to your doctor for checks and tests. Early detection and treatment can significantly improve outcomes for people with lung cancer.

Lung Cancer Survival Rates

The overall five-year lung cancer survival rate is relatively low compared to many other types of cancer. According to the American Cancer Society:

The relative five-year survival rates for small-cell lung cancer are as follows:

• Localized – 30%
• Regional –18%
• Distant –3%
• All SEER stages combined – 7%

The relative five-year survival rates for non-small cell lung cancer are as follows:

• Localized – 65%
• Regional –37%
• Distant –9%
• All SEER stages combined – 28%

The lower survival rate is mainly due to many patients being diagnosed in later stages. It's important to remember that survival rates are general estimates and may not accurately predict one's prognosis.

Medical Evaluation and Diagnosis

Diagnosis typically begins with a thorough medical evaluation, including physical examination, a review of the patient's medical history, and imaging tests like chest X-ray, CT scan, and PET scan.

A biopsy is often performed to confirm the presence of lung cancer and determine its type and subtype. This involves the removal of a small tissue sample from the lung or lymph nodes for examination under a microscope.

Treatment and Care

Lung cancer treatment varies based on factors like the type of cancer, its stage and the patient's medical history. Generally, treatment includes:

• Surgery
• Radiation therapy
• Chemotherapy
• Immunotherapy
• Targeted therapy

Surgery

Lung cancer patients with early-stage cancer who are deemed suitable candidates can get surgery. Surgery removes the lung tumor and any affected surrounding tissue or lymph nodes and can be all the treatment needed.

Chemotherapy

Chemotherapy, either alone or in combination with other treatments, may be used to shrink tumors, prevent cancer from spreading, or alleviate symptoms in advanced stages of lung cancer.

Radiotherapy

Radiation therapy uses high-energy rays to target and kill cancer cells. It may be used as the primary treatment or in combination with surgery or chemotherapy, particularly for tumors that cannot be surgically removed.

Immunotherapy

Immunotherapy boosts the body's immune system to fight cancer cells. It's often used for advanced lung cancer or when other treatments haven't worked. The FDA has approved two immunotherapy drugs, pembrolizumab (Keytruda) and atezolizumab (Tecentriq), as adjuvant treatments after surgery and chemotherapy for some people with early-stage non-small cell lung cancer.

Targeted Therapy

Targeted therapy drugs target specific genetic mutations or alterations present in cancer cells. They are particularly effective in non-small cell lung cancer (NSCLC) patients harboring gene mutations such as EGFR, ALK, ROS1, or BRAF. Some examples of targeted therapies include EGFR inhibitors, anaplastic lymphoma kinase (ALK) inhibitors, BRAF Inhibitors, ROS1 Inhibitors, etc.

Supportive Care

Patients with metastatic or advanced lung cancer can get palliative care, which addresses symptoms like chest pain, shortness of breath, fatigue, and emotional distress. Doctors may also recommend symptom management strategies like medications, physical therapy, breathing exercises, and nutritional support to alleviate the side effects of treatment and improve overall well-being. 

And since lung cancer diagnosis and treatment take a toll on patients and their families, counseling, support groups, and other psychosocial interventions are critical. Psychological support could make it easier for people to navigate the challenges of living with lung cancer.

Follow-Up Care

Regular follow-up appointments with healthcare providers are essential for monitoring treatment response, managing side effects, and addressing new symptoms or concerns.

The doctor may perform imaging tests, blood tests, and other diagnostic procedures periodically to assess disease status and detect any recurrence or progression of lung cancer.

Clinical Trials

Clinical trials are always ongoing to explore new treatment approaches for cancer, mainly through immunotherapies. One area of focus in clinical trials involves investigating combinations of immunotherapies with or without chemotherapy to enhance their effectiveness in treating various types of cancer, including lung cancer. Targeted therapies are also becoming increasingly available for advanced lung cancer, and more are in development.

Science 37 also offers a series of clinical trials that provide an opportunity for people with lung and breathing disorders. If you wish to join our decentralized clinical trials and help advance medical research for lung cancer care, you can sign up today.