Huge changes, most for the better, are taking place in the world of lung cancer — the leading cause of cancer deaths, and one of the most common cancers nationwide. While there is still much to be done to further increase survival rates, over the past 20 years, changes in prevention, treatment and attitudes have led to people with lung cancer living longer and healthier lives.
Here are the major shifts:
1. More People Are Surviving Lung CancerRead More
2. Fewer People Are Being Diagnosed with Lung Cancer
Over the last two decades, rates of lung cancer diagnoses have steadily declined, according to SEER data. In 1999, there were roughly 66 new cases of lung cancer diagnoses per every 100,000 people. That number is down to about 50.
3. Prevention Has Improved
One of the clearest, most direct reasons for the drop in lung cancer diagnoses has been a national shift away from cigarettes. In 1999, 23.5% of all U.S. adults smoked cigarettes; today, that number is below 14%.
4. New Screening Technologies Have Entered the Game
In addition to the standard chest X-rays long been used to detect lung cancer, imaging tests such as low-dose CT scans have given doctors more detailed images of their patients’ lungs, adding another tool to the lifesaving early detection toolbox. Among adults between 55 and 80 with a history of smoking, recent research found that annual screenings with these low-dose CT scans could reduce the lung cancer death rate by up to 20%. That’s a major improvement, but it’s worth noting that access to these screening tests (and insurance coverage) varies a lot from state to state, and groups like the American Lung Association are pushing for better access.
5. National Screening Guidelines Have Become Clearer
It’s long been acknowledged that routine screening tests save lives. But who should get screened for lung cancer, and with what test? As of February 2019, the CDC recommends annual screening tests with low-dose CT scans for people between 55 and 80 who have a history of heavy smoking, who currently smoke or who quit within the last 15 years.
Despite the guidelines becoming clearer, though, the number of people actually following them remains quite low. According to the CDC, only about 4.4% of people who meet these guidelines are getting the annual low-dose CT scans.
6. Immunotherapy Has Changed the Game for (Some) Patients with Lung Cancer
Immunotherapy drugs, which empower the body’s own immune system to fight off cancer cells, have been lifesaving for specific patients with lung cancer. “It’s amazing to me now that you can have stage 4 lung cancer and actually not even need chemotherapy,” Dr. Brendon Stiles, a thoracic surgeon at Weill Cornell Medical Center who treats patients with lung cancer, previously told SurvivorNet. “That’s really changed the paradigm in lung cancer.” These specific patients are those who have a high expression of a protein called PD-L1, which immunotherapy drugs called checkpoint inhibitors can target directly.
7. Treatment Methods Have Become Tailored to the Individual Cancer
As far as lung cancer treatment goes, there’s been a really important shift in recent years, as oncologists begin to look at lung cancers as many different unique cancers that need similarly unique treatments. With the rise of what’s called “targeted therapy,” oncologists have zeroed in on ways to target specific genetic mutations with new treatments.
Dr. Geoffrey Oxnard, a thoracic oncologist at the Dana Farber Cancer Institute, told SurvivorNet, for example, that “with mutations like EGFR and ALK, you can have a dramatic and durable response with targeted therapies with an overall survival advantage.” Better diagnostic methods and genetic tests have given doctors the tools to find out which lung cancer tumors have which mutations — better informing the best methods of treatment.
8. More Survivors Are Speaking Out about the Stigma Surrounding Lung Cancer
For years, lung cancer has been viewed as a “smoker’s disease,” but the reality is that anyone with lungs can get lung cancer. People who have never touched cigarettes still receive lung cancer diagnoses, and nearly 20% of people who die from the disease have never smoked. More and more survivors, such as Amanda Kouri, who was diagnosed with lung cancer in her early 20s having never touched a cigarette, are sharing their stories to remove the stigma.
“No one thought to give me a CT scan or take a look further because they assumed I either had pneumonia or I had asthma,” Kouri told SurvivorNet. “It’s not a smoker’s disease, but the stigma is incredibly difficult. It’s why we are the number one killer cancer with the lowest amount of funded research.”
9. The Disease Has Disproportionately Affected Women
While a lot of changes in lung cancer have been positive ones, some have been troubling, including the difference in mortality rates between men and women with lung cancer. While overall lung cancer rates have been declining, a 2018 study in the New England Journal of Medicine found that, among women born between 1950 and 1960, the rates actually went up. And among women born after that, the rates did decline, but not as dramatically as they did for men.
10. New Potential Risk Factors Have Entered the Scene
Additionally, as positive as it’s been to see the rates of tobacco smoking decline steadily, there’s been an exponential rise in the number of people — especially young people — who have taken up vaping. There’s not enough research yet to say whether vaping causes lung cancer, but some early research has raised red flags. It will be years before we have the answer, because smoking-related lung cancers develop over time, but the consensus among oncologists and health professionals seems to be, “why risk it?”
There is evidence that while e-cigarettes can help people shake the habit of smoking traditional cigarettes, they can also have the opposite effect for people that weren’t smokers to begin with; recent data shows that taking up vaping increases the likelihood that former nonsmokers will go on to take up smoking traditional cigarettes.