Lung cancer remains the most common fatal cancer in both men and women. When lung cancer is finally diagnosed, only about 15% of people survive for 5 years, no matter what treatment is used. This is because when lung cancer is diagnosed on the basis of symptoms, such as coughing up blood or from pain associated with spread of deadly cancer, known as metastasis, the disease is too far advanced to be successfully treated. Sometimes lung cancer is diagnosed by accident when chest x-rays are taken for other reasons. Chest x-rays most commonly reveal disease that is too far advanced to be successfully treated.
Ninety percent of lung cancer is caused by smoking. Yet, about 45 million Americans, (25% of U.S. adults), continue this destructive, addictive habit. Teenagers are starting to smoke at the rate of 3,000 per day. Even though smoking cessation treatments are more successful than ever before, many people have smoked so many packs for so long, they remain at risk for lung cancer for the rest of their life. In fact, today, there is more lung cancer diagnosed in former smokers than in current smokers!
No medical society or governmental agency recommends screening for lung cancer, even in high risk populations, including heavy smokers and those with an occupational risk. This nihilistic attitude is simply wrong, and must be changed.
Today, we have the knowledge and the technology to be able to change the outcome of lung cancer. The first step in early identification is for heavy smokers (smoking a pack a day or more for thirty years, or 2 packs a day for 15 years, i.e., 30 pack-years) to have a simple spirometric test done. Approximately 25% of heavy smokers will have airflow disorders. If their airflow is abnormal, these smokers have a four- to six-times greater chance of having lung cancer than if airflow tests are normal. They also have a higher risk of heart attack and stroke, and are generally well on the pathway to developing symptomatic stages of COPD. If the spirometry test is below normal, a sputum Apap@ test, like a pelvic pap test in women, can be done to look for cancer or pre-cancerous cells. A CT scan of the chest will find tiny lesions in the far reaches of the lungs. When lung cancer is diagnosed by a sputum Apap@ test or by CT scan, surgery, radiation, or chemotherapy treatment can result in a cure in about 80% of these early lung cancers.
So, what are we waiting for? Lung cancer can be diagnosed early, treated, and cured. It is time to find and to treat early lung cancer now!
I will be in touch next month
Thomas Petty, MD