Awareness • Early Detection • Treatment • Research • Survivorship

Lung cancer remains a major killer

By Kathryn Roethel of the SF Gate

The No. 1 killing cancer is not the one many people think of first. It’s not the one with the pink ribbon, or the one whose controversial screenings are grabbing headlines. It’s lung cancer. And even though it’s the third-most commonly diagnosed type, behind prostate and breast cancers, it claims more than twice as many lives annually than both of those – combined.

The majority of lung cancer patients are current or former smokers, but even non-smokers are at risk. And while survival rates have increased for many cancers over the last 40 years, the lung cancer five-year survival rate – 15 percent – hasn’t changed much. Symptoms don’t usually surface until the disease is in late stages, and even then they’re ambiguous – coughing, chest pain, weight loss and shortness of breath – so lung cancer is difficult to catch and treat early.

Researchers are trying to change that. Dr. Ann Leung, professor of radiology at Stanford, cites a recent New England Journal of Medicine study showing that a lung CT scan using a low dose of radiation could be a good screening option for some of the heaviest smokers. But the screening comes with risks of its own.

The numbers tell the story.

The percentage of lung cancer patients who have never smoked, according to the Lung Cancer Foundation of America.

The percentage of lung cancer patients who are former smokers. The remaining 40 percent are current smokers.

The number of “pack-years” New England Journal of Medicine researchers used to qualify someone as a heavy smoker with a high risk of lung cancer. If you smoke a pack (20 cigarettes) a day for one year, you’ve smoked one pack-year. To meet the 30 pack-year criteria, you could have smoked one pack a day, every day for 30 years, or two packs a day, every day for 15 years. If you meet this standard, researchers recommend talking to your doctor about having a CT scan to screen for lung cancer.

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The ratio of heavy smokers in the study who had CT scans reveal potentially cancerous lung abnormalities. Upon further examination, about 95 percent of those abnormalities proved not to be cancer. Leung, who was not involved in the research, admitted that the high rate of false positives are a downside to the scan and can be stressful for patients. But she also noted that the screening improved survival rates by 20 percent for the patients who actually did have cancer.