As a leading cause of all cancer-related deaths, the severity of a lung cancer diagnosis has for the longest time, been widely accepted.
According to the World Health Organization, in 2018 alone, lung cancer accounted for around 2.09 million of the 9.6 million cancer-related deaths recorded worldwide — the most common cause of cancer. It is important to note that tobacco is an important player in the pervasiveness of cancer, it is responsible for approximately 22% of cancer-related deaths.
However, while these figures might seem daunting, scientific and technological breakthroughs have ensured that a steady decline has been recorded in the number of lung cancer-related deaths over the years.
Through measures like targeted therapies, immunotherapy etc, lung cancer deaths have steadily fallen from 3% per year between 2008 - 2013. From 2013-2017 alone, that number dropped to 5%.
We’ll be examining these breakthroughs and the impact they’ve had in revolutionizing lung cancer diagnosing and treatment. But first, a quick look at the types of cancers, to better understand the measures that are being taken to manage their effects.
Types of Lung Cancer
There are two types of lung cancers: Small Cell Lung Cancer (SCLC) and Non-Small Cell Lung Cancer (NSCLC)
Small Cell Lung Cancer: also known as oat cell cancer for its distinct shape, SCLC affects about 10% -15% of lung cancer patients. Aggressive in nature, about 70% of people with this cancer will have experienced its spread by the time they are diagnosed. It is typically caused by tobacco smoking and is further divided into two: small cell carcinoma and combined small cell carcinoma.
Non-Small Cell Lung Cancer: NSCLC is a more common form of lung cancer, affecting around 80 - 85% of lung cancer patients.
Its growth is creeping and symptoms usually fail to appear until after the cancer is already advanced. Types of NSCLC include adenocarcinoma of the lung, squamous cell, and large cell undifferentiated carcinoma. Like small cell lung cancer, this cancer is popularly caused by tobacco use.
Advances In Lung Cancer Treatment
As we’ve mentioned, a significant drop has been recorded in lung cancer deaths as advances have been made in diagnosing and treating the disease. 2016-2017 alone recorded a 2.2% drop in death rates, the largest single drop in cancer mortality recorded. This is due in no small part to scientific and technological breakthroughs such as:
Low Dose CT-Scan
A leading cause of increased lung cancer mortality is the slow detection of the disease. This usually results in an advancement of its spread, making treatment all the harder. With innovative screening methods like Low Dose CT scans however, we’re starting to see a noticeable change in the status quo.
LDCT involves the use of an x-ray machine with low doses of radiation to look through the body and lungs to observe any tumor formations. It is the only screening method approved by the US Preventive Services Task Force for lung cancer.
However, while this method has been shown to reduce lung cancer mortality by around 20%, a common worry is its increased risk for radiation-induced cancer.
Dispelling this worry is a 10-year long study which proved that this fear is needless, with only 2 in 10,000 men and 6 out of 10,000 women contracting cancer during its course.
This screening method is breaking new grounds in the detection and subsequent treatment of lung cancer. It is important to note however, that with lung cancer disproportionately affecting the elderly, it is important for those aged 65 and above to observe early screenings to aid the detection and treatment of the disease.
Targeted Therapies
To sustain growth, tumors require the formation of blood vessels to keep nourished. If the term ‘angiogenesis’ sounds familiar, it captures this formation process. To prevent this tumor growth, specialized treatments like targeted therapies are adopted.
Targeted therapy is popularly employed in the treatment of Non Small Cell Lung Cancer. These therapies target the specific genes and proteins that are involved in the growth and survival of cancer cells. They can also affect the tissue environment, making it highly unfavorable for cancer cells to grow.
This treatment is typically used alongside chemotherapy and other cancer treatments.
Types of targeted therapies include monoclonal antibodies and small molecule drugs.
Immunotherapy
Taking one lucky guess, it can be quickly deduced that ‘immunotherapy’ employs the use of individual immune systems to stave off cancer cells. Immunotherapy employs drugs to engage the immune system to identify and destroy lung cancer cells.
The immune system is usually poised to defend the body from dangerous external invaders. However, to prevent it from attacking internal organs and cells,a measure like immune checkpoints are designed to suppress the system to prevent damage.
Unfortunately, cancer cells can take over these checkpoints to avoid getting detected by the body’s immune system. That’s where immunotherapy comes in.
Immunotherapy helps to block these checkpoints, making it easier for the body to recognize and attack cancer cells.
It is applied intravenously, with immunotherapy treatments like KEYTRUDA receiving FDA approval.
Personalized or precision medicine
Cancers sprout from abnormal genes or changes in gene formation. These changes can be brought on by environmental changes, inheritance or can be spontaneous.
Precision medicine looks to identify these mutated genes and understand the driving forces behind them and the cancer in question. This treatment essentially identifies the unique structure of a gene and uses that to deconstruct and treat it.
This method avoids the broad-based treatment given to cancer patients. Instead, it attunes care to the specific features of the cancer genes affecting the individual. This personalized medicine not only targets the cancerous genes, but also the consequences of these mutations.
Precision medicine uses drugs personalized to the individual, as well as immunotherapy in treating cancer. This form of care leaves normal cells largely unharmed.
With measures like Low Dose CT-Scans making the early detection of cancer cells possible, targeted therapy to ensure the specialized treatment of cancers, and other measures like immunotherapy and personalized medicine offering personalized care against lung cancer — this disease is gradually becoming less of a potent threat as the years go by. We can only imagine the changes coming years' promise in the diagnosis and treatment of lung cancer.