From OHC

November 8, 2013

Years of research have yielded real progress against the assorted group of 200 diseases known as lung cancer, which continue to claim more lives each year than colon, breast and prostate cancer combined. Here is a review of some recent advances in this field.

New screening protocol for those over 55

With the US Preventative Services Task Force’s approval of low-dose CT scans (LDCT exams) for patients facing elevated lung cancer risks, we are in a stronger position than ever to find malignancies early. This is hopeful news, since five-year survival rates are now 40 percent or better for cancers treated at Stage I and around 30 percent for those addressed at Stage II.

New guidelines from the American Cancer Society recommend annual screening for patients aged 55 to 74 who are in relatively good health and have a 30-pack year smoking history. This includes former smokers who have quit within the last 15 years. Many practitioners recommend expanding  the annual screening to those patients aged 75 to 79 who fit this profile, in line with criteria used in the National Lung Screening Trial.

Although LDCT exams are not generally covered by insurance, many clinics offer these exams for approximately $100 to $120, making them affordable to most patients. Many hospitals are beginning to market this modality, and physicians and patients should be considering its use.

Targeted treatments extend life with fewer side effects

A small but growing number of patients diagnosed with lung cancer benefit from targeted therapies that offer real advantages over standard chemotherapies.

Erlotinib, a drug used to treat non-small cell lung cancer, pancreatic cancer and several other types of cancer, is now the drug of choice for epidermal growth factor receptor (EGFR)-mutated forms of the disease, seen in 5 to 10 percent of all lung cancer patients. An additional 4 percent of cancers with mutations involving the anaplastic lymphoma kinase (ALK) mutation are now treated with crizotinib.

These therapies produce fewer side effects than chemotherapy, are more effective than chemotherapy, and can help patients live longer — a welcome advance that will reach thousands more as the next wave of reactive oxygen species (ROS) inhibitors arrives. In fact, within the next decade, we may have more than 100 targeted therapies from which to choose in treating lung malignancies.

Early focus on palliative care for metastatic patients

There is good evidence that a palliative care consult early in the course of treating metastatic lung cancer yields both better quality of life and longer survival. This would involve developing a plan of treatment to address the symptoms, pain and stress of combatting lung cancer while concurrently following the treatment plan to fight the disease itself. For this reason, we recommend a timely discussion with all patients in this group. Thoughtful planning helps patients prepare for the challenges ahead and fosters deeper engagement with the full plan of care.

Our board-certified experts welcome the opportunity to consult with you on all aspects of lung cancer diagnosis, treatment, and palliative care.

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