9 Facts You Should Know About Lung Cancer
In 2019, nearly 230,000 new cases of lung cancer and nearly 143,000 lung cancer deaths are expected to occur, according to the American Cancer Society. Up to 20 percent of people who die of lung cancer have never smoked, the ACS notes. Exposure to radon gas, secondhand smoke, work-related toxins like asbestos and air pollution are among top environmental risk factors for nonsmokers. Most people don’t realize they only need lungs to get lung cancer, says Dr. Philip Bonomi, a medical oncologist at Rush University Medical Center in Chicago. Here are nine more things you may not know about lung cancer and lung cancer survival:
1. Certain types of lung cancer are more aggressive.
About 15 percent of all lung cancers are considered small cell lung cancer. The other 85 percent are non-small cell lung cancer, including adenocarcinoma, squamous cell lung cancer and large cell lung cancer. Small cell lung cancers are faster-growing forms of the disease, while non-small cell lung cancer spreads less aggressively and can be treated more successfully with surgery and other therapies. Experts believe lung cancer is caused by genetic mutations that change the way cells divide and affect whether the cancer spreads to other parts of the body and how it reacts to treatments. Cancer such as breast, ovarian or colon cancer can have a genetic component that puts family members at risk. However, it’s unclear if the same type of inherited gene mutation happens in lung cancer, Bonomi says. “But if you do have a family member with lung cancer, there’s a slight increased risk of getting lung cancer.”
2. Lung cancer may not always have early symptoms.
Karen Loss, 59, of McLean, Virginia, put early-stage uterine and ovarian cancers behind her 16 years before she was diagnosed “by accident” with stage 4 lung cancer in 2012. She went in for what she assumed was a regular checkup, only to find her liver and right lung harbored cancerous tumors. She had no symptoms. Those who do develop lung cancer symptoms, however, may experience a cough that gets worse or doesn’t go away; blood with their cough; difficulty breathing; wheezing; chest, upper back or shoulder pain that doesn’t go away; unexplained weight loss and feeling unusually tired.
3. Survival rates for lung cancer have risen slightly.
Lung cancer survival rate has increased somewhat, although overall rates remain daunting. In figures released in 2017 by the Centers for Disease Control and Prevention, five-year survival increased from about 16.5 percent in 2001 to 19 percent by 2009. Although women are more likely to be diagnosed with breast cancer, they are more likely to die of lung cancer – the leading cause of death for men and women alike, according to the American Cancer Society. When Jim Siegfried, then of Germantown, Tennessee, was diagnosed with lung cancer in 2002, he and his wife, Cynthia Zahm Siegfried, didn’t know much about the disease. Together, the couple learned by necessity. Jim “was on every treatment known to man available at the time,” says Cynthia, who became her husband’s constant caregiver. Jim survived 16 years after he was diagnosed, significantly longer than the standard prognosis. On June 12, 2018, he died at 72.
4. Surgery is a standard treatment.
Surgery is a treatment mainstay for patients with early-stage lung cancer. Together, the two lungs consist of five sections called lobes. A lobectomy is an operation to remove a single diseased lobe. An open thoracotomy, in which the chest is opened and ribs are spread, is the most extensive type of lobectomy. Some surgical candidates may do well with a less-invasive surgical procedure called video-assisted thoracic surgery, or VATS. A segmentectomy, as the name suggests, only removes a portion of a lobe, while a wedge resection is even more limited. At the other end of the spectrum, a pneumonectomy is surgery to remove an entire lung.
5. Targeted treatments and immunotherapy exist.
Targeted therapies – or precision medicine – home in on the specific genetic mutations associated with lung cancer. Clinical trials are underway, with some therapies already approved by the Food and Drug Administration. Thanks to these new medications, many lung cancer patients are now experiencing remission – something thought impossible just 10 years ago. Drugs called “immune checkpoint inhibitors” boost the body’s immune response against cancer cells. One study, for example, showed that Opdivo (which Karen Loss took for about two years) decreases the risk for death among lung cancer patients by 41 percent. After his diagnosis, Jim Siegfried took Keytruda, a drug with similar anticancer action. In early 2019, the Lung Cancer Master Protocol, a precision medicine trial for lung cancer supported by the National Cancer Institute, announced an expansion making it available to thousands more new patients with non-small cell lung cancers.
6. Lung cancer patients endure complications.
As of April 2019, Karen Loss is a seven-year lung cancer survivor. “As far as I’m aware, my cancer is still stable,” she says. “As of my last scan it was.” However, she’s been coping with a persistent cough for more than two years and it’s getting worse. In late March, she began a series of treatments called photodynamic therapy in an effort to shrink any partial blockages of her airway. This involves an intravenous injection of light-sensitive chemicals. Within a few days, the next stage uses a bronchoscopic procedure to direct light of a certain wavelength toward cancerous cells. As an aftereffect, Loss must avoid exposure to bright light, like sunlight, for several weeks. “We’re just crossing our fingers that maybe it will have some positive effect on this coughing problem,” she says.
7. Survivors go through emotional upheavals.
Although Loss enjoys advocacy-related public speaking, she says that with her constant cough, “I’m probably not the best candidate right now.” Lately, she’s been feeling discouraged. “I always tell people in my shoes, in the cancer world: We have to allow ourselves to go down in the valley once in a while, because we’re all human and that happens,” Loss says. “We just can’t let ourselves stay there.” However, she’s finding it difficult. “We do our best just to go about our lives and live with cancer rather than do the woe-is-me thing,” she adds. “But it would be nice, sometimes, if we didn’t always have to ask people for support and encouragement – rather, they would recognize that we need it.”
8. Caregivers need support, too.
From a caregiver’s perspective, Cynthia Zahm Siegfried says: “You learn a lot, and fast. You start off knowing very little. I was painfully ignorant about lung cancer.” In her 2010 book, “Cancer Journey: A Caregiver’s View from the Passenger Seat,”she describes the emotional aspect of caring for a loved one and the grief that comes with preparing yourself for potentially losing him or her. At the time of Jim’s diagnosis, there were no local support groups for lung cancer, so she formed her own. “Caregivers can’t really share their feelings with the person they’re taking care of, but you need some sort of an outlet,” she says. In 2012, the nonprofit LUNGevity Foundation honored her as national caregiver of the year. Caregiving can be intense. In Jim’s difficult final months, he developed a deep lung infection that didn’t respond to antibiotics. He underwent a surgical “flap” procedure, done through an incision in his back to reach his lungs. From then on, Cynthia took on the task of packing the resulting large, open woundwith fresh gauze every day.
9. There is hope in survivorship.
Karen Loss strongly believes in reaching out to others. Her book “Trekking Through Cancerland: Letters from the Journey,” was published in 2014. She maintains a monthly e-list for fellow survivors and also uses Twitter and Facebook as information-sharing platforms to share lung cancer updates. “The fact that a lot has been happening in the last (several) years in research, drugs and clinical trials is because more patients are becoming very involved in advocacy,” she says.
Lung cancer facts
If you’re diagnosed with lung cancer, these are some things to consider:
- Nonsmokers can get lung cancer, too.
- Certain lung cancer types are more aggressive.
- Persistent or bloody cough, trouble breathing, lingering chest pain or unexplained weight loss are symptoms.
- You may not have any symptoms.
- Survival rates are gradually rising.
- Surgery is the go-to treatment for early-stage lung cancer.
- Targeted medications may help.
- Complications like infections can occur.
- Survivors have emotional ups and downs.
- Caregivers need support as well.
- Hope is possible for people with lung cancer.