Although treatments for lung cancer have advanced significantly in recent years, prevention—and screening—remains the preferred method to fight the disease, says the director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Bayview.
“You don’t often feel lung cancer until it’s too late,” said Dr. Phillip Dennis, who decided to become a thoracic oncologist—or lung cancer specialist—about 20 years ago when, as a fellow, he cared for two patients who eventually succumbed to the disease.
“I remember how helpless I felt,” said Dennis. “The therapies weren’t so good back then; they weren’t based on the best science.”
Things are better today, but with a less than 10-percent survival rate for stage 4 lung cancer, “we have to do better,” Dennis says.
The problem, according to Dennis, is that cancer, which constantly evolves and mutates to stymie treatments, will “do better” too.
“It’s a frustrating and endless game of whack-a-mole,” he said.
Which is why screening and prevention hold the most promise, he says.
Recently, the U.S. Preventive Services Task Force issued a statement approving screening for high-risk individuals, or those aged 55 to 80 who have smoked a pack of cigarettes a day for 30 years and still smoke or have quit within the past 15 years. The task force’s approval has insurance implications, Dennis said, noting that Medicare will have to pay for screening in the form of CT scans for those high-risk individuals.
The oncologist says that, obviously, smoking is a huge risk factor for lung cancer.
“Eighty-five percent of the time, we can trace [lung cancer] back to some kind of smoking,” he said.
But there’s also a less-understood family risk component. If your father smoked and eventually got lung cancer, your risk increases, even if you have never smoked and were never exposed to his second-hand smoke.
“There’s a family predisposition that’s less understood; we’re studying it at Johns Hopkins,” said Dennis.
Other risks include working with asbestos, cooking indoors with an open flame, or being exposed to radon. Exposure to cooking smoke, while common in rural China, is not a major problem in Maryland, Dennis says, but radon exposure is.
“Radon is endemic in Maryland,” he said. “About 60 percent of households have radon, whether or not they are aware of it.”
Risk factors are important to consider, says Dennis, because the early stages of lung cancer do not present with symptoms. By the time something feels amiss, it’s often too late.
“Lung cancer is insidious,” he said. “Most people never feel it in the early stages. There are no pain receptors in the lungs. A chronic cough may be a sign, but it’s very hard to distinguish a cancer from an infection.”
As November is Lung Cancer Awareness Month, Johns Hopkins Bayview is holding two lung cancer events in the near future. On Thursday, Nov. 7, the hospital will host a discussion aimed at people living with lung cancer, their families, and people at high risk for lung cancer. The event, “Living with Lung Cancer,” begins with a dinner at 6 p.m.; discussion—led by Dr. Dennis and including doctors from the cancer center, cancer patients and survivors—begins at 6:30 p.m.
The second event—also led by Dennis and a panel—is on Monday, Nov. 18, and is aimed at people at-risk for lung cancer, and those who have family members living with the disease. That event, which also includes a 6 p.m. dinner and 6:30 p.m. discussion, will focus on screening, early detection and individualized risk.
Both events are at the Asthma and Allergy Center Auditorium, 5501 Hopkins Bayview Circle, Johns Hopkins Bayview Medical Center. For more information on lung cancer or to register for the events, call 410-955-LUNG (5864).
by Erik Zygmont