“Our ability to recognize and treat lung cancer in its early stages has substantially increased survival rates… [in fact], it is not uncommon to see the five-year survival rate of stage 1 disease greater than 80 percent,” added Dr. Layton. “Twenty years ago, if someone had stage 4 lung cancer, the most appropriate treatment was palliative care, and although survival rates remain low at this advanced stage, it is still much better than 20 years ago when no one survived. ”
This is all very good news, as lung cancer remains the most common form of cancer, according to the American Cancer Society. It is estimated that 236,740 people will be diagnosed with lung cancer in 2022 and around 130,180 people will die from the disease. That’s more than any other cancer and more than breast, prostate, and pancreatic cancers combined.
Despite these bleak numbers, the outlook for lung cancer patients is more promising than ever at all stages of the disease – mainly because more people are diagnosed when their cancer is at an early stage and, as a result, live longer. A decline in smoking also plays a role.
The rate of diagnosis of early-stage localized disease increased by 4.5% per year from 2014 to 2018, while there were sharp declines in diagnoses of advanced disease. The result was an overall increase in three-year survival rates. In 2004, 21 out of every 100 people diagnosed with lung cancer lived three years after diagnosis. By 2018, that number had risen to 31 out of every 100 people – a 50% increase.
“Tobacco abuse causes 90 percent of lung cancer, but it can also be caused by secondhand smoke, exposure to radon and asbestos, radiation, air pollution including diesel fumes, arsenic and other chemicals found in the workplace. ”, Dr. Continuous Layton. “But as smoking becomes socially unacceptable and more people are aware of its dangers, more smokers are quitting, resulting in a significant drop in the number of new cases.”
In fact, the American Society states that from 2009 to 2018, rates of new cancer cases dropped by nearly 3% per year in men and by nearly 1.5% in women. Differences between men and women reflect historical patterns of tobacco use. Women started smoking in greater numbers years later than men and took longer to quit.
Perhaps the best measure of progress against cancer is the trend in cancer death rates. Lung cancer death rates have declined by 56% since 1990 in men and 32% since 2002 in women. These improvements in lung cancer mortality are due to the decline in smoking and advances in early detection and treatment.
But many of these ex-smokers have turned to vaping as an alternative and the question now becomes: will there be an increase in lung cancer due to the new addiction?
“We really don’t know what’s in vape,” cautioned Dr. Layton. “Companies are not required by the FDA to have any specific components. We know there are carcinogens in there, but we don’t know what else is there. There is acute lung injury associated with vaping, likely as a result of the vitamin E which is in some materials, but since lung cancer takes a long time to develop, this association is difficult to make. E-cigarettes haven’t been around long enough to make a conclusive association.
“Marijuana is another substance that is inhaled into the lungs,” added Dr. Layton. “Changes have been identified in airway epithelial cells that are similar to the changes you see when patients smoke cigarettes, but there haven’t been any studies that have made this association.
Many people who smoke marijuana also smoke cigarettes, so trying to isolate the cause and effect of each can be more difficult because there are so many biases built into studies.
Clearly, any time you inhale hot gases into the lungs, it can impair or alter lung function.”
Both the amount and the length of time someone smokes increase the risk of dying from lung cancer.
That’s why the American Cancer Society recommends annual lung cancer screening for anyone between the ages of 50 and 80 who has a 20-pack-year history and is still smoking or has quit within the past 15 years. Pack-years are calculated by multiplying the number of cigarettes smoked per day by the number of years smoked.
“Unfortunately, less than 5% of those who qualify in the United States are screened,” said Dr. Layton. “It’s a simple, low-risk procedure done with a low-dose CT scan rather than a full CT scan. There are no needles involved, it only takes a few minutes to do, and it’s covered by most insurance.
“If done annually, high-risk patients can reduce their risk of dying from lung cancer by 20%. If they stop smoking and have annual low-dose CT scans, they can reduce their risk of death by 40%. These numbers are huge. These exams should be done annually for 15 years after the time they stopped smoking or until they reach the age of 80.”
Doctors would like to see lung cancer screening become as common as mammograms for breast cancer, Pap smears for cervical cancer, and colonoscopies for colon cancer. Simply put, quitting smoking and getting annual checkups can make the difference between living or dying from lung cancer.
The Doctor. Layton completed his medical school, internship and residency at Creighton University. He went to the University of Florida for his scholarship in pulmonary medicine. His office is located at HCA FL St. Lucie Medical Specialists-Hillmoor, 1700 Hillmoor Dr., Suite 505, Port St. Lucie. Call 772-398-7826 to schedule an appointment.