Lung Cancer
with Robert Donegan, MD
What is the leading risk for lung cancer?
Lung cancer is the most deadly form of cancer. In 2005, it caused nearly 165,000 deaths in the United States—more than the next three most deadly cancers combined (colon, breast and prostate).
Cigarette smoking is by far the most common cause of lung cancer, accounting for more than 90% of all lung cancer cases. Indeed, the current rising incidence in lung cancer in U.S. women in large part reflects the increase in women’s smoking in the last half century. Secondhand smoke is also a significant risk factor for developing lung cancer. Occupational exposure to asbestos also increases the risk and excessive radon exposure may also be a factor. Unlike several other cancers, there is not a clear inherited risk to developing lung cancer.
The diagnosis is often suspected because of symptoms that may include shortness of breath, a persistent cough, blood in the sputum, pain in the chest or bones or unexplained weight-loss. Radiographic studies (such as a chest X-ray, CAT scan, PET scan) and a biopsy confirm the diagnosis.
Unfortunately, by the time a lung cancer has caused a symptom it is usually in a more advanced and incurable stage. However, currently there is no accepted early screening test for lung cancer. Efforts are currently underway to discover if screening people at high risk for lung cancer using chest X-rays or CAT scans will not only lead to earlier detection but, more importantly, to more cures. “Two large screening clinical trials are currently underway in the United States and we should hopefully have an answer to this question within the next five years,” says Dr. Robert Donegan, Medical Oncologist at GBMC.
Treatment depends upon several factors including the type of lung cancer, the extent or stage of the disease as well as the patient’s age, overall health and medical history. When lung cancer is detected early, surgery can be effective. For more advanced cases, radiation and/or chemotherapy may be included in a comprehensive program of care.
Chemotherapy has been historically used to fight more advanced stages of lung cancer. However, in the last three years, multiple studies have shown that when early-stage lung cancer patients receive chemotherapy following surgery, their chances of survival improve significantly. Indeed, offering chemotherapy has now become the standard of care for such patients at GBMC. “Fortunately, recent advances in supportive therapies have made chemotherapy an easier experience for many of these patients,” says Dr. Donegan.
Clinical trials for cancer treatment incorporating exciting new targeted agents are also underway at GBMC. According to Dr. Donegan, “many of our patients qualify for these studies and are eager to participate.”
“While advances in surgery, radiation and chemotherapy have improved the fight against lung cancer, by far the greatest impact in beating this disease is to convince people not to smoke,” says Dr. Donegan.
