According to a report from the American Cancer Society, lung cancer, the world’s most common cancer, will cause 159,000 deaths in the United States this year – more than the total number of deaths resulting from breast, colon and prostate cancers combined. [1] An estimated additional 219,440 Americans are expected to be diagnosed this year. Still, lung cancer lags far behind other cancers in both awareness and research funding, and, partly due to its connection with smoking, there can be a stigma attached to the disease. [2]But there is hope for lung cancer patients. According to Richard Gaynor, M.D., vice president of oncology product development and medical affairs at Eli Lilly & Company, a leader in thoracic cancer treatment, “Researchers have made important strides in the last decade in lung cancer prevention, detection and treatment. We know that secondary smoke is detrimental. [3] We have better X-rays and spiral CT scans to detect lung cancer earlier on. And we know that where treatment is concerned, lung cancer, like breast cancer, can benefit from a tailored approach.”In the past, oncologists have used similar approaches to treatment based on lung cancer diagnosis, staging and prognosis.[4] But advances in tailored treatment options may help oncologists choose which patients could be more likely to benefit from certain therapies.”While our work is far from finished, we do have a better understanding of lung cancer today, and patients can benefit,” said Dr. Gaynor.Prevalence and PrognosisLung cancer can affect any adult, including nonsmokers. Since 1985, it has risen to be the world’s most common form of cancer. [5] The chance that a man will develop lung cancer is about 1 in 13, and for a woman it is approximately 1 in 16. (1) Nearly 70% of people diagnosed with lung cancer are older than 65; fewer than three percent of all cases are found in people under the age of 45. [6]Survival is improved the earlier a patient is diagnosed with lung cancer. With early detection, there is a 50% chance of surviving for five years. However, only 16% of cases are diagnosed at an early stage. Unfortunately, as the disease is often diagnosed at later stages, approximately 59% of those with lung cancer will die within the first year of diagnosis.[7]The five-year survival rate for lung cancer has increased slightly over the last 30 years. In the mid-1970s the rate was 13%, as compared to the latest statistics which find the rate at 15.6% for the years 1999 – 2006. [8]SymptomsIn the early stages of the disease, many people have vague or no symptoms. Persistent cough along with blood in the phlegm and shortness of breath are common symptoms of lung cancer. Sometimes, symptoms may seem unrelated to the lungs or breathing. As lung cancer is diagnosed mostly in later stages, the primary cancer may have already spread to other parts of the body. Depending upon where the cancer spreads and which organs are affected, symptoms may also include headaches, weakness of a limb, bone pain, weight loss and loss of appetite. [9]Helping patients ask the right questionsNewly diagnosed patients, overwhelmed with the psychological and emotional impact caused by their diagnosis, may have many questions. Properly trained physicians and healthcare support staff may assist them in finding answers to questions like: [10]– What kind of lung cancer do I have?- Has my cancer spread beyond my lungs, or is it limited to my lungs only?- What is the stage of my cancer, and what does that mean in my case?- Are there other tests that need to be done before we can decide on treatment?- What treatment choices do I have?- What risks or side effects are there to the treatments you suggest?- How long will treatment last? What will it involve? Where will it be done?- What are the chances of recurrence of my cancer after treatment? And what treatments are available if it recurs?- Am I eligible for clinical trial?In the patient with advanced disease, anxiety is often not caused by the fear of death but by the issues of uncontrolled pain, isolation, abandonment, and dependency.[11, 12] By helping patients to focusing on the treatment needed, teaching them to manage stress, eating a healthy diet, getting plenty of exercise and finding healthy venues in which to express emotions, many of stress factors can be adequately managed when properly assessed and treated.[1] American Cancer Society, “What Are the Key Statistics About Lung Cancer?,” October 24, 2008, American Cancer Society, http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Are_the_Key_Statistics_About_Lung_Cancer_15.asp?sitearea, (September 1, 2009).[2]Lung Cancer Alliance, “2009 Facts About Lung Cancer,” Lung Cancer Alliance, www.lungcanceralliance.org/pdf_docs/2009_Factsheet.pdf, (October 14, 2009).[3] American Cancer Society, “Secondhand Smoke,” May 22, 2009, American Cancer Society, http://www.cancer.org/docroot/PED/content/PED_10_2X_Secondhand_Smoke-Clean_Indoor_Air.asp, (September 30, 2009).[4] National Cancer Institute, “Non-Small Cell Lung Cancer Treatment (PDQ(R)) Health Professional Version,” July 10, 2009, National Cancer Institute, www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/HealthProfessional/page2, (September 1, 2009).[5] American Cancer Society, “How Many People Get Non-small Cell Lung Cancer?” 2009, American Cancer Society, http://www.cancer.org/docroot/CRI/content/CRI_2_2_1x_How_Many_People_Get_Non-small_Cell_Lung_Cancer.asp?sitearea= , (October 14, 2009).[6] American Cancer Society, “What Are the Key Statistics for Small Cell Lung Cancer?.” October 30, 2008, American Cancer Society, http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Are_the_Key_Statistics_for_Small_Cell_Lung_Cancer.asp?sitearea
, (September 1, 2009).[7] American Cancer Society, “Cancer Facts & Figures 2009,” Atlanta: 2009, www.cancer.org/docroot/STT/STT_0.asp, (October 8, 2009).[8] National Cancer Institute, “Fast Stats: An interactive tool for access to SEER cancer statistics. Surveillance Research Program,” National Cancer Institute, http://seer.cancer.gov/statfacts/html/lungb.html, (September 1, 2009).[9] American Cancer Society, “How Is Non-Small Cell Lung Cancer Diagnosed?.” October 24, 2008, American Cancer Society, http://www.cancer.org/docroot/CRI/content/CRI_2_4_3x_How_Is_Non-Small_Cell_Lung_Cancer_Diagnosed.asp?sitearea=, (October 20, 2009).[10] American Cancer Society, “What Should You Ask Your Doctor About Non-Small Cell Lung Cancer?,” October 24, 2008, American Cancer Society, http://www.cancer.org/docroot/CRI/content/CRI_2_4_5x_What_Should_You_Ask_Your_Doctor_About_Non-Small_Cell_Lung_Cancer.asp?sitearea=, (September 30, 2009).[11] Hackett TP, Cassem NH: Massachusetts General Hospital Handbook of General Hospital Psychiatry. 2nd ed. Littleton, Mass: PSG, 1987.[12] Friedman LC, Lehane D, Webb JA, et al.: Anxiety in medical situations and chemotherapy-related problems among cancer patients. J Cancer Educ 9 (1): 37-41, 1994
