The numbers are scary.  Lung cancer is the leading cancer killer of both men and women in the United States.  According to the American Lung Association, an estimated 163,510 deaths from lung cancer will occur in the U.S. in 2005.  That represents more deaths than the next three most common cancers combined – colon, breast and prostate.  Moreover, the expected five-year survival rate for patients diagnosed with lung cancer is 15 percent, compared with 63 percent for colon, 88 percent for breast and 99 percent for prostate cancer.

November is Lung Cancer Awareness Month, and Dr. John Hayward, chief of oncology at St. Luke’s Hospital, believes awareness is key to the prevention of this deadly disease.  “We really need to get serious about lung cancer,” he says.  “Smoking is the real issue, since it’s the number one cause of lung cancer.  If we were serious about lung cancer in the United States, we wouldn’t subsidize tobacco companies.  We would wake up to the fact that approximately 40 percent of public health dollars are spent on smokers.”

Hayward notes that while smokers are at greatest risk of developing lung cancer, second-hand smoke presents a serious concern as well.  “Second-hand smoke is dangerous because it’s not filtered,” he explains.  “Lung cancer may be the most tragic cancer because in most cases it might be prevented.  And the most tragic of those cases are the ones where the spouse of a smoker develops cancer as a result of second-hand smoke.”

There are two major types of lung cancer – non-small cell lung cancer and small cell lung cancer.  “Non-small cell lung cancer is by far more common,” Hayward says.  “It generally grows more slowly and can usually be treated surgically if the patient is diagnosed early enough.  Small cell lung cancer, which accounts for about 20 percent of all lung cancers, grows explosively fast and has usually metastasized to other parts of the body by the time it is diagnosed.  News anchorman Peter Jennings had this type of lung cancer and died quickly while receiving treatment. Treatment for small cell cancer generally is limited to chemotherapy.”

The effectiveness of treatments to prolong the life of lung cancer patients depends heavily on early diagnosis.  Unfortunately, lung cancer in its early stages usually does not cause symptoms.  By the time symptoms occur, the cancer often is advanced.  Symptoms of lung cancer can include:

• Chronic cough
• Hoarseness
• Coughing up blood
• Weight loss and loss of appetite
• Shortness of breath or wheezing
• Repeated episodes of bronchitis or pneumonia
• Chest pain

“Lung cancer isn’t easily detected in its early stages,” Hayward says.  “It’s often diagnosed because the patient has come in for a chest X-ray for another reason or because the doctor knows the patient is a smoker.  Unlike the standards established for yearly mammograms to detect breast cancer, there are no accepted standards for the frequency of having a chest X-ray to detect lung cancer.  Even if you have a full physical every year, it would be hard to diagnose lung cancer without a chest X-ray.  I would recommend that people who are at high risk for lung cancer – especially heavy smokers – have a CT scan, which is much more sensitive than a regular X-ray, every six months.”

Treatment options for lung cancer include surgery, radiation therapy and chemotherapy.  The type of treatment used depends on factors such as the type of lung cancer as well as the size, location and extent of the tumor, and whether or not the cancer has spread to other parts of the body.  The treatments may be used either alone or in combination.

“Our success in treating lung cancer has improved with new approaches and new therapies,” Hayward says.  “We now are treating some patients with radiation and chemotherapy even before surgery, which can prolong their lives for perhaps an added two years.  Newer targeted therapies, including ‘small molecule’ therapies such as Tarceva and antibody therapies such as Erbitux, can be used to prolong patients’ lives after they no longer respond to conventional chemotherapy.”

Hayward notes that St. Luke’s Hospital offers a full range of diagnosis and treatment services for lung and other cancers – including diagnostic tools such as X-rays, CT scans, MRIs and bronchoscopy, and treatment modalities such as surgery, radiation oncology and an infusion facility for chemotherapy.  He stresses, though, that preventing lung cancer in the first place is by far the best option.

“If you are a smoker, please get help to quit smoking,” Hayward says.  “Enroll in a quit-smoking class.  Use nicotine products – perhaps even two products in combination, if need be.  Consult your physician about other medications, such as antidepressants, that may help you kick the habit.”

Hayward cautions against using the excuse that classes and medications to help you quit are too expensive -- citing the fact that the out-of-pocket cost to buy one $5 pack of cigarettes a day for only one year is a whopping $1,825. "Plus, some studies show that smokers who have to pay themselves for classes and medications have up to a 30 percent higher success rate,” he says. “Bottom line: the costs of lung cancer are far greater."

And he’s not just “blowing smoke.”

Back to top