Lung cancer is the main cause of cancer related death in the United States and world-wide. The proportion of patients with lung cancer surviving 5 years or greater is a dismal 15 percent. This statistic has not changed substantially in the past 30 years. One of the major causes of the dismal survival seen in lung cancer today is that most patients are diagnosed when the tumor is quite advanced. Lung cancer caught in an early stage is curable with surgery, but unfortunately only a minority of patients present at an early stage. If there was a way in which more patients were detected at an early stage, then outcomes for lung cancer patients would improve dramatically.
While this sounds simple in theory, the fact is that we currently do not have any way to detect lung cancer in the early stages. Most patients who have early stage lung cancer are identified serendipitously on a scan performed for something completely unrelated. The tests that we have today to diagnose lung cancer, chest X-rays, sputum analysis and Computerized Axial Tomography (CT) scans are fraught with problems.
Most patients who have early stage lung cancer are identified serendipitously on a scan performed for something completely unrelated.
Multiple studies both in the United States and abroad performed in the 1960’s and 1970’s have shown that screening for lung cancer with a chest X-ray and sputum studies actually resulted in an increased mortality, rather than increasing survival from lung cancer. There have been a number of advances in CT scan technology in the past few decades and there has been a renewed interest in using CT scans to screen for lung cancer. Current studies from Japan, Italy and United States appear promising, but use of CT scans to screen for lung cancer is not yet ready for primetime. Clearly we need to do more in order to improve the outcomes of patients with lung cancer.
A major reason for the lack of major advances in the lung cancer field is the minimal funding for lung cancer research. One reason for this may be the absence of long-term survivors who can raise lung cancer awareness in the society and also be passionate advocates for increased funding support, much like the breast cancer survivor. Another more worrisome reason is the apathy of professional organizations and funding agencies towards lung cancer. I was at a meeting a couple of years ago, when a speaker mentioned in a very tongue in cheek manner, “Finally the American Lung Association has acknowledged the fact that lung cancer is a disease of the lung!” Increased funding for research has led to dramatic improvements in results from breast cancer and so it stands to reason that the same will be true for lung cancer as well.
As a lung cancer doctor, I live on optimism. Recently there has been increasing activity among patient advocacy groups, such as The National Lung Cancer Partnership and the Bonnie J. Addario Lung Cancer Foundation trying to raise awareness of lung cancer. The daughter of one of my patients, living in Omaha, Neb. recently set up an organization called “Where is The Funding for lung cancer?” She likes to call it “WTF” for effect. If these and other efforts are successful, there is no reason why we should not be able to increase the number of lung cancer survivors in the near future.