Lung Cancer

Should I be concerned?

On Aug. 1, 2021, World Lung Cancer Day was observed to recognize lung cancer as the leading cause of cancer deaths in the world, nation and Ark-La- Tex. The American Lung Association’s Lung Force initiative was created to urge everyone to learn about the disease’s risk factors and highlight the importance of early detection through lung cancer screening. The Feist-Weiller Cancer Center in Shreveport supports these efforts through education and providing lung screenings to improve lung cancer survivorship.

Louisiana Lung Cancer Facts

• 3,910 new cases will be diagnosed in 2021, representing 66.2 individuals per 100,000.

• 2,360 patients will die of lung cancer in 2021.

• The parishes of Northern Louisiana have some of the highest rates of lung cancer.

• Lung cancer is the number one cause of cancer death in both men and women.

• Smoking is the number one risk factor for lung cancer.

• La. is ranked 8th in the U.S. for the number of smokers older than 18.

• Screening can significantly reduce the risk of dying from lung cancer.

How do you screen for lung cancer? The screening method for patients at high risk for cancer is a low-dose CT scan (LDCT) of the chest. During an LDCT scan, you lie on a table, and an X-ray machine uses a low dose (amount) of radiation to make detailed images of your lungs. The scan only takes a few minutes and is not painful. The National Lung Cancer Screening Trials revealed that a yearly low-dose CT scan in high-risk individuals could lower the risk of dying from lung cancer by 20%.

Yearly scans in high-risk individuals enhance the likelihood of finding lung cancer early when a tumor is small, which statistically yields the best possible outcome for patients.

Who is considered “high risk” for developing lung cancer?

Anyone between the ages of 55 and 74 who has a 30 pack-year smoking history. A pack-year is calculated by multiplying the number of years you have been smoking times the number of packs per day (PPD). For example, if you smoked one pack of cigarettes per day (PPD) for 30 years (1 x 30 = 30) or 2-PPD for 15 years (2 x 15 = 30), you have a 30 pack-year history of smoking and are considered high risk. Screening should only be done at facilities with the right CT scanner and experience in lung cancer screening. Remember, screening is not an alternative to stopping smoking. Prevention (or quitting) will reduce your risk of getting cancer and is more effective than early detection. To learn more, the American Lung Association offers a lung cancer screening eligibility quiz and encourages those concerned about their risk to speak with their doctor.

Screening Recommendations

• 55 years old or older

• Smoked at least 30 pack-years

• Quit smoking less than 15 years ago OR

• 50 years old or older

• Smoked at least 20 pack-years

• Have one more risk factor other than secondhand smoke

(Data sources: ACS, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, LSUHS Cancer Data.)

Treatment of lung cancer will depend on the stage and type of cancer. Tests used to diagnose lung cancer may include imaging (PET, CT, MRI), sputum cytology and tissue biopsy. Tissue can be obtained by bronchoscopy (a lighted tube passed down into your lungs), mediastinoscopy (a scope inserted behind your breastbone to sample lymph nodes) or by needle biopsy directed by imaging. These tests will determine the type of lung cancer. Lung cancer is divided into two types: small cell (SCLC) and non-small cell lung cancer (NSCLC). Multimodality treatments such as surgery, radiation and chemotherapy are now used to improve outcomes. The goal of treatment is to remove the cancer and make sure it does not return. An exciting advancement in lung cancer treatment is the recent expansion of targeted drug therapies, which focus on specific abnormalities (mutations) and immunotherapies that activate your immune system to identify and kill a tumor. FWCC joins cancer centers throughout the U.S. in prescribing immunotherapy agents like Keytruda (Pembroluzimab®) that have shown the ability to double the survival duration for patients with end-stage lung cancer. Other medications that “target” mutations in lung cancer, like Tagrisso®, not only improve survival but provide ease of administration in pill form. In a landmark FDA approval in 2021, Lumakras®was approved to target a gene thought to be “undruggable” for the past 30 years, further adding to optimism in treatment.

“Lung cancer is a formidable foe. We must use our entire spectrum of care to be able to succeed. At Feist-Weiller Cancer Center we offer a multidisciplinary approach that spans from prevention and screening to precision treatments and supportive care. We offer stateof-the-art genomic profiling of your tumor in order to design the most effective targeted therapies and clinical trials for you. We also know treatment is only part of your cancer journey. We offer additional support through social services, cancer-specific navigation, financial counseling and integrative medicine to take care of both the mind and body. Our team of specialized lung cancer providers will be with you throughout your entire journey,” stated Sarah Thayer, MD. Ph.D., director of Feist-Weiller Cancer Center.

Ira Surolia, MD MPH, is a clinical assistant professor of internal medicine at LSU Health Shreveport and an oncologist at Feist-Weiller Cancer Center, with Ochsner LSU Health Shreveport. Sarah Thayer, MD, Ph.D., is the director of Feist-Weiller Cancer Center, Carol Feist Endowed Chair for the Study of Cancer, professor of surgery & surgical oncology, LSU Health Shreveport. She is also director of Feist-Weiller Cancer Center, LSU Health Shreveport/ Ochsner LSU Health Shreveport. Data sources: ACS, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, LSUHS Cancer Data.