Cancer of the lung of one of the disease's most virulent forms, but
four new options available to patients today— screening, minimally
invasive surgery, precision medicine and immunotherapy—are good
news for patients:
They say an ounce of prevention is worth a pound of cure; nowhere is that
truer than with lung cancer. Recently enacted guidelines offer screening
options for smokers to catch lung cancer at its earliest stages, when
it is best treated.
Screening for adults age 55 and older with a history of smoking, using
a low-dose computed tomography (CT) scan, has been shown to help identify
cancers much earlier than before. Bridget Saggese, the nurse navigator
at the Saint Barnabas Lung Cancer Institute, oversees the screening process
at the hospital. Last year, the program identified nine patients with
stage 1 cancer. “When an abnormal finding is identified, my role
is to expedite the care of the patient from diagnosis to treatment,”
she says. Those nine patients have all received treatment and are doing
well, she reports.
Minimally Invasive Surgery
Patients with early-stage cancers have new surgical options, says
Subroto Paul, M.D., director of thoracic surgery for RWJBarnabas Health. “We used to do open surgery, in which the ribs are separated so
that instruments can be introduced into the chest to take out cancer,”
he says. “Now we can do video-assisted surgery, which is analogous
to laparoscopic surgery. We use smaller incisions to put a camera in,
find the tumor and remove it. Studies for which I have been the primary
author show that this approach can mean less pain, shorter hospital stays
and a quicker return to normal living.” These techniques also allow
those who cannot tolerate a big, open operation to consider surgical treatment.
The biggest advances, however, have been in treatments for advanced cases.
“We have entered an era of precision medicine, especially in lung
Andrew Brown, M.D., an oncologist who is medical director of the Lung Cancer
Screening Program at Saint Barnabas Medical Center. “It’s a paradigm shift.” Precision medicine describes
today’s ability to look at the cells from a tumor biopsy to identify
an individual’s specific genetic mutations that could be linked
to the cancer itself. “That has made possible medications that target
these specific mutations and, in many cases, can shut them down like a
lock and key. It has been fairly groundbreaking.” There are currently
two FDA-approved medications for these types of cancers, but many more
are being used in research trials, including at Saint Barnabas Medical Center.
In another major advance, the body’s own immune system can now be
primed, with medication, to combat the cancer itself, in the same way
it fights off viruses and bacteria. “This is changing the way we
think about lung cancer and how it behaves,” Dr. Brown says.
Scientists have been studying immunotherapy for decades, he says, “but
just recently have we developed therapies that actually use it.”
Two medications are currently approved for this, Opdiva and Keytruda.
But “plenty more are coming down the road,” he says.
For now, precision medicine and immunotherapy are only approved for advance-stage
cancer patients, and while they extend life and greatly reduce the side
effects of other treatments, they are not curative. But trials are also
under way to determine whether these drugs improve rates of actual cure
for earlierstage patients. Dr. Brown is optimistic. “I feel confident
that this is the future for all lung cancer patients, and it’s pretty
close to happening,” he says. “Nothing is FDA approved now,
but it’s coming fast, within the next 10 years. This is still a
very difficult disease, but we’re getting better at treating it.
It’s a very exciting time.”
Should you be screened for lung cancer?
The U.S. Preventive Services Task Force recommends annual screening for
lung cancer with low-dose computed tomography in adults ages 55 to 80
who have a 30 pack-year smoking history (that is, 30 years of 1-pack-a-day
smoking, or 15 years of 2 packs a day, etc.) and currently smoke or have
quit within the past 15 years.
Screening should be discontinued once a person has not smoked for 15 years
or develops a health problem that substantially limits life expectancy
or the ability or willingness to have curative lung surgery.
Free screenings are available through the Saint Barnabas Medical Center
Lung Cancer Institute. To schedule a screening call 973.322.6644
SOURCE: The U.S. Preventive Services Task Force
Screening can be a lifesaver
In 2016, the Saint Barnabas Medical Center Lung Screening Program screened
296 individuals. Of them,
- 225 were scheduled for oneyear follow-up.
- 326 were scheduled for twoyear follow-up.
- 9 were diagnosed with Stage 1 lung cancer.
- 1 was diagnosed with Stage 3 lung cancer.
- 155 received tobacco cessation treatment.
For information about the Lung Cancer Institute call 973.322.6644 or visit our
Cancer Program's Website.