August 2016

One reason lung cancer is so deadly is because it can spread even before it causes symptoms or can be picked up by an imaging scan.

Stopping smoking is the most important step you can take to prevent lung cancer.

Some people at very high risk for lung cancer may benefit from screening with low-dose computed tomography.

Although lung cancer is often deadly, there is hope, particularly when it is caught early.

Although lung cancer is the leading cancer killer of both men and women in the United States, the disease tends to get less public awareness than many other forms of cancer. It doesn’t get breast cancer’s pink ribbons or colon cancer’s well-publicized reminders about scheduling a colonoscopy. But given its toll on humanity, maybe it should.

We spoke to Quynh-Nhu Nguyen, MD, assistant professor of radiation oncology at the University of Texas MD Anderson Cancer Center in Houston to get the facts about lung cancer. Here are 10 essential things that you should know:
1. Lung cancer is the second most common cancer in the United States. It is the most common cancer worldwide, according to the American Lung Association, and it’s the leading cause of cancer-related deaths in the United States. It tends to target adults over the age of 55. Some two out of three people diagnosed with lung cancer are 65 or older, and the average age at diagnosis is about 70, according to the American Cancer Society. Fewer than 2 percent of all cases are found in people younger than 45.

2. Smoking causes lung cancer. Although tobacco smoking is on the decline in the United States, some 37 percent of Americans are current or former smokers. About 85 percent of all U.S. lung cancer cases are linked to smoking.

3. It starts as a symptom-free disease. According to the American Cancer Society, lung cancer most likely begins when precancerous changes occur inside structures of the lungs, including the bronchi, bronchioles, and alveoli. Genetic changes inside lung cells can then cause the cells to grow faster. At this point, the cancerous cells can’t be seen on X-rays or other imaging tests, and they don’t cause symptoms.

4. Lung cancer can spread before it can be detected. Over time, these cells can grow into cancerous tumors. The cancer cells can trigger the growth of new blood vessels, which feed the tumor and help it grow until it eventually causes symptoms and can be seen on X-rays or other imaging tests. Eventually, cancer cells can break away from the original tumor and spread (metastasize) to other parts of the body. One reason lung cancer is such a life-threatening disease is because it can metastasize even before it causes symptoms or can be picked up by an imaging scan.

5. Some lung cancers are treatable. Lung cancer typically has a poor prognosis, says Dr. Nguyen; nearly 90 percent of people diagnosed with it will die. The exception to this grim statistic is early-stage non-small cell lung cancer, which has a better prognosis and can be treated with surgery and stereotactic body radiation therapy.

6. Screening cannot prevent most lung-cancer related deaths. Smoking cessation is essential to prevention, says Nguyen. However, some people who are at very high risk for the disease may benefit from screening, according to the U.S. Preventive Services Task Force (USPSTF).

“The USPSTF concluded with moderate certainty that lung cancer annual screenings with low-dose CT scans (LDCT) can prevent a substantial number of lung-cancer-related deaths among people who are at high risk for lung cancer,” says Nguyen. According to the USPSTF, you could benefit from annual screening if you are:A current or former smoker who quit within the past 15 years
And aged 55 to 80
And you have smoked at least one pack of cigarettes a day for 30 years, or two packs a day for 15 years
7. Screening for lung cancer has risks as well as benefits. According to the Centers for Disease Control and Prevention (CDC), three key risks for lung cancer screening tests are:

False-positive results. This means the test shows something suspicious even when nothing is wrong with you. This can lead to unnecessary tests and potentially to surgery, which has risks of its own, to say nothing of the stress associated with thinking you might have lung cancer.
Overdiagnosis. Sometimes screening tests find cancers that wouldn’t have turned into a dangerous problem. In this case, you’re subjected to unnecessary treatment that may cause complications.
Cancer. Repeated LDCT scans can cause cancer in otherwise healthy people.
8. Ask your doctor if you should be screened. If you are at high risk for lung cancer, talk to your doctor about whether you should be screened. If you decide on screening, have your doctor refer you to a high-quality treatment facility, advises the CDC.

You don’t need screening if you are 81 years or older and you haven’t smoked for 15 years, or if you develop another health problem that would make you unable or unwilling to be treated for lung cancer.

9. Newer therapies may be on the horizon for people with early-stage lung cancer. At MD Anderson Cancer Center, for example, radiation oncologists use proton therapy, which can deliver radiation to a targeted tumor with remarkable precision so that surrounding healthy tissue isn’t affected, says Nguyen.

Only about 15 centers around the United States currently offer proton therapy. Memorial Sloan Kettering Cancer Center in New York City is another that does.

In addition, for patients whose tumors move during breathing, radiation oncologists can use advanced, 4-dimensional CT imaging techniques which allow them to take this movement into account when planning radiation therapy.

10. Get an accurate diagnosis. If you or a loved one has been diagnosed with lung cancer, it’s important to get an accurate diagnosis as early as possible to find out what stage the cancer is in, since this will affect your treatment options, says Nguyen.


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