Learning about Lung Cancer
- Neal Augenstein, 63, recently discovered he had lung cancer after a series of doctors appointments that began after he developed a persistent, dry cough.
- Lung cancer is the second most common type of cancer and it can develop in both smokers and non-smokers, but people who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who don’t smoke.
- Augenstein isn’t a smoker, but his father did die of lung cancer. One of our experts says “some lung cancers are from unknown exposure to air pollution, radon, or asbestos” and that he sees “more never-smokers with lung cancer who have a family history of it.”
- There has been lots of progress within the world of lung cancer treatment – specifically when it comes to immunotherapy. One of our experts says “it’s really changed the face of lung cancer, just like targeted therapies.”
Augenstein thought he was struggling with allergies when he first went to his doctor. But given that his father, a longtime smoker who quit in his 40s, died of lung cancer at 85, he still wanted to cover his bases.
Read MoreHi, Twitter friends. Over the past 2 months I’ve had a dry cough, suspicious x-rays, CAT scans. Last week, had a bronchoscopy w biopsy. It showed adenocarcinoma — a slow-growing form of lung cancer — that spread to a lymph node in the middle of my chest. A CT scan showed… pic.twitter.com/firSoLjpnw
— Neal Augenstein (@AugensteinWTOP) November 26, 2022
But after a bronchoscopy on Nov. 21, Augenstein found out he had stage three lung cancer. And though he always though his “head would explode” if somebody told him he had cancer, he was relieved to have answers.
“Knowing it was much better than the worry,” Augenstein said. “In the end, you know, I lived through hearing that sentence. And soon after that, I was, and I am, working on a plan — looking to see what I can do to get rid of this cough and to live a long, healthy life.”
Augenstein’s cancer, more specifically, is an adenocarcinoma that’s spread to a lymph node in his chest.
“Somebody can have lung cancer in them for a while before they start coughing,” Augenstein said.
BTW, my hope and expectation is to WFH from a while. In radio studios, they often have a Cough Button, that the announcer can press, to quickly mute their mic for a second. I don’t have one at home, but I can always re-record 🙂
— Neal Augenstein (@AugensteinWTOP) November 26, 2022
But despite the fact that he’ll begin chemotherapy and radiation before the new year, Augenstein is determined to keep doing what he loves: working as a reporter for WTOP.
“WTOP has been wonderful [as far as] ‘Do what you want to do, what you need to do, what you prefer; let us know what we can do to help.’ And I love my job,” he said. “Right now I’m gonna be living with cancer. And I think that I want my life to be happy and healthy and hopeful. And I am very encouraged right now.
“So let’s — you know, let’s keep going. Let’s see where we end up.”
Understanding Lung Cancer
Lung cancer is the second most common type of cancer. Diagnosis and treatment of the disease can be tricky since symptoms often don’t appear until the cancer has spread.
What Happens When You’ve Been Newly Diagnosed With Lung Cancer
An initial symptom, for example, could be as serious as a seizure if the lung cancer has already spread to the brain. But other symptoms can include increased coughing, chest pain, unexplained weight loss, shortness of breath, wheezing, losing your voice or persistent infections like bronchitis or pneumonia.
The two main types of lung cancer are non-small cell, which makes up 85 percent of cases, and small-cell. These types act differently and, accordingly, require different types of treatment.
Dr. Patrick Forde, a thoracic oncologist at Johns Hopkins Medicine, tells SurvivorNet about how distinguishing between the two types – and their subtypes – can be very beneficial.
Immunotherapy and Targeted Therapy for Lung Cancer: What Is It?
“Within that non-small cell category, there’s a subtype called non-squamous adenocarcinoma, and that’s the group of patients for whom genetic testing is very important on the tumor,” he explains. “Genetic testing is looking for mutations in the DNA, in the tumor, which are not present in your normal DNA.”
Despite the fact that lung cancer is the leading cause of cancer deaths for men and women in the United States, there has been lots of progress within the world of lung cancer treatment – specifically when it comes to immunotherapy.
“Immunotherapy is here to stay,” Dr. Brendon Stiles, chief of thoracic surgery and surgical oncology at Montefiore Health System, told SurvivorNet. “And it’s really changed the face of lung cancer, just like targeted therapies.”
Getting even more specific, checkpoint inhibitors and our ability to genetically test for targeted medications have made a huge difference. Checkpoint inhibitors are a class of immunotherapy drugs that specifically target proteins found either on immune or cancer cells to prevent their binding together. In other words, these drugs don’t kill cancer cells directly, but instead stimulate the immune system to attack cancer cells while hopefully not affecting other surrounding healthy cells.
“It’s amazing to me now that you can have Stage IV lung cancer and actually not even need chemotherapy,” Dr. Stiles said. “If you have high expression of a protein that we know is targeted by immunotherapy, you may just get immunotherapy alone.”
There are also many targeted therapies out there for patients to consider. No matter what, it’s important that people with lung cancer advocate for themselves and ask if targeted therapies and immunotherapies may be right for them.
Lung Cancer for Non-Smokers like Neal Augenstein
Declining smoking rates have lead to an improved outlook for lung cancer since cigarette smoking is the number one risk factor for the disease. In fact, the Centers for Disease Control & Prevention states that cigarette smoking is linked to about 80 to 90 percent of lung cancer deaths, and people who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who don’t smoke.
It’s important to remember, however, that even people who’ve never smoked before can still get lung cancer. The CDC reports that, in the United States, about 10 to 20 percent of lung cancers, or 20,000 to 40,000 lung cancers each year, happen in people who’ve never smoked.
“Some lung cancers are from unknown exposure to air pollution, radon, or asbestos,” Dr. Raja Flores, system chair of thoracic surgery at Mount Sinai previously told SurvivorNet in a previous interview. “We also see more never-smokers with lung cancer who have a family history of it.”
Radon is the second-leading cause of lung cancer. It’s responsible for anywhere from 3 to 16 percent of cancer cases depending on the levels present in a given area, according to the World Health Organization, but smokers are still 25 times more at risk from radon than non-smokers.
Another possibility for the cause of lung cancer in a non-smoker can be second-hand smoke. The American Cancer Society estimates that about 7,000 adults die of lung cancer annually from breathing secondhand smoke.
Air pollution, family history, HIV or AIDs can also all impact the chances of a non-smoker getting lung cancer. No matter what, it’s important to not rule out the disease just because you don’t smoke – a fact that Donna Hunting knows all too well.
Just like Neal Augenstein, Hunting was a non-smoker when she was diagnosed with lung cancer. But the active 54-year-old’s cancer had progressed further given that she had stage four non-small cell lung cancer.
If You Have Lungs, You Can Get Lung Cancer — Survivor Donna Hunting Shares Her Story
“That day was shattering to my family and to me,” she previously told SurvivorNet. “It’s not a smokers’ disease. If you have lungs, you can get lung cancer.”
Fortunately for Hunting, testing revealed that her tumors had a mutation in a specific gene called EGFR. This meant that doctors were able to give her a pill to block those mutations and effectively rid her body of the disease.
“After 50 days, miraculously, my PET scan showed no evidence of disease,” she said.
Hunting took the drug for over a year, until it stopped working as well. Now she’s on a different daily medication, but – thanks to advancements in treatment – she’s able to live with the disease.
“Cancer is a part of my life now, but it isn’t my whole life. I’m not letting cancer define me,” Hunting said.
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