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Good News About Lung Cancer

The last thing anyone wants to hear is that they have lung cancer. The patients I see are understandably crestfallen and concerned. Many have painful memories of a relative who died within months from lung cancer.

The good news is the doom-and-gloom past has no bearing on the current state of lung cancer. Tremendous advances have occurred in screening, diagnosis and treatment over the last 20 years. It’s a completely new landscape.

What’s currently happening is a “stage shift,” meaning that we’re diagnosing more patients earlier at stages 1 and 2, when the chances of cure are higher, instead of stages 3 and 4. Significant leaps forward in treatment also make it possible to live longer despite this diagnosis. 

Quick and Painless Lung Cancer Screenings Are Available

The key challenge with lung cancer is that it’s asymptomatic until it advances. You won’t feel anything until it’s invasive and you have symptoms like shortness of breath or coughing up blood. 

Not enough people know that a quick-and-painless screening can detect possible lung cancer – even before you have symptoms. In fact, just 10% of American who are eligible for lung cancer screening are getting screened, compared to 70% for breast or colon cancer. 

The lung cancer screening tool, a low-dose CT scan, provides the clearest images of lung nodules which signal early cancer. This screening is covered by insurance/Medicare if you fit certain criteria. The U.S. Preventive Services Task force recommends yearly low-dose CT scan screening if you: 

  • Have a 20 pack-year or more smoking history, and
  • Smoke now or have quit within the past 15 years, and
  • Are between 50 and 80 years old 

Talk to your provider if you fit these criteria or have any concerns. 

Sooner, Safer and More Comprehensive Lung Cancer Diagnosis is Possible

Newer technologies make it easier to diagnose lung cancer at stages 1 and 2, versus 3 and 4. For example, the robotic navigational bronchoscopy we use offers several advantages: 

  • More precision. The robotic bronchoscope and significantly smaller catheter allows for sharper 180-degree turns and reaches further into the lungs.
  • Fewer complications. We’ve seen complications decrease from 15-20% to 3% or less with this technology. 
  • More capability. Before we had robotic technology, we rarely did biopsies on both lungs at the same time due to the risk of a collapsed lung. Now, we biopsy more than one target in 25-33% of the cases we see. 

The net effect is we are able to biopsy smaller and more peripheral (further away) nodules which might not have been able to reach, or that would require a CT-guided biopsy. That leads to an earlier, more definitive diagnosis. 

Lung Cancer Treatment Has Advanced On Every Front  

Years ago there was a defeatist attitude about lung cancer because the treatment outlook was dismal. That’s no longer the case. Treatment can and does make a difference because all the modalities at our disposal have advanced.

  • Surgery is less invasive. We can do partial resection with fewer complications. 
  • Radiation oncology and medical oncology have taken significant leaps with immunologic agents and other modalities. 
  • Treatment for lung cancer is increasingly individualized, similar to how breast cancer treatment takes into account your personal genetics.  

At CHI Health, our Pulmonary Nodule Clinic gets patients in within seven days so there’s less waiting. Our Tumor Board brings together a variety of different specialists to develop uniquely individualized care plans. The patients I’ve diagnosed at stage 3 or 4 are still here six or seven years later because we have better treatment options. 

My call to action is this: If you smoke or vape, quit as soon as possible. If you qualify, take advantage of lung cancer screening. If you receive a lung cancer diagnosis, follow the treatment advice of specialists who are using the latest tools and treatment modalities. Together, we are improving the outlook for lung cancer patients. 

Zachary DePew, MD
Zachary DePew, MD

Zachary DePew, MD is a pulmonary medicine provider with CHI Health.

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