Improving the numbers: Advancements in screening, treatment are helping lung cancer patients live longer

Medical oncologist Dr. Ajaz Bulbul explains lung cancer screening and new treatment options if you are diagnosed with this deadly disease

Lung cancer may not be the most diagnosed cancer in women – that’s breast. It may not be the most diagnosed cancer in men – that’s prostate. (Both not including skin.)

But, it is the most common cause of cancer-related death in both men and women, even more so than breast, colon and prostate cancers combined.

Let’s look at the numbers surrounding lung cancer.

This year, the American Cancer Society estimates more than 238,000 men and women will be diagnosed with lung cancer. About 127,000 of those will die. That’s almost half.

Let’s compare that to breast cancer. This year, the ACS estimates more than 353,000 people will develop breast cancer. About 43,700 will die, which is around 12 percent. Still high, and we’d love to see zero percent, but you can see the deadly difference between the two.

Now, we have one more number for you. Twenty percent. That’s the reduction in deaths from lung cancer diagnoses when the patient has a lung cancer screening.

“Why did that decrease happen? It’s simple. We found the cancer earlier when it’s more operable, and it literally saved lives,” says Dr. Ajaz Bulbul, medical oncologist for SJ/C Infusion Center in Hinesville, a partnership with the Lewis Cancer & Research Pavilion and Liberty Regional Medical Center. “Lung cancer is more of a deadly cancer so if we have good screening for lung cancer and it improves mortality, it is even more important to get that screening.”

Related Article: Lung cancer survivor did not delay

What is lung cancer screening?

Lung cancer screening is a yearly, low-dose CT scan of the lungs for people who qualify or who are at high-risk, explains Dr. Bulbul. The U.S Preventative Task Force (a federal agency of experts in primary care and prevention that develops recommendations for clinical prevention services) sets qualifications for lung cancer screening that are accepted by Medicare and CMS. These guidelines were recently updated to be more inclusive and include:

• Adults aged 50-80
• A 20-pack/year smoking history (example: 1 pack per day for 20 years or 2 packs per day for 10 years)
• Current smoker or quit less than 15 years ago

There are other guidelines that your primary care physician or medical oncologist can look at to determine if you need lung screening, especially if you don’t meet the Task Force requirements but may be high risk. Those include:

• Ethnicity – African-Americans and Native American Indians have a higher baseline
• COPD or other lung disease diagnoses
• Family history of lung cancer
• BMI
• Socio-economic factors, such as education

There’s also blood work that can be done to look for specific markers produced by early tumor cells found in the blood, Dr. Bulbul says.

“Sometimes it’s just your genetics,” says Dr. Bulbul. “For example, if you are Hispanic and a smoker, if you are an Asian woman, the risk of lung cancer is much less than a Native American who is smoking that same amount, at the same age. In fact, it’s two times more likely that Native American will get lung cancer, and if you are African American, it’s one and a half times higher.”

St. Joseph’s/Candler offers a comprehensive lung cancer screening program. You can get screened, with a referral, at four locations: Candler Hospital, St. Joseph’s Hospital, SJ/C Imaging Center – Pooler and SJ/C Imaging Center – Bluffton.

Learn more here.

Specifically in Liberty County where Dr. Bulbul sees patients, Liberty Regional Medical Center also offers low dose lung cancer screenings. If you meet the criteria, have your physician fax the CT order to the hospital’s Centralized Scheduling department at 912-369-9502.

Advanced treatments in lung cancer

If a radiologist (the physician who reads your lung CT scan) finds something suspicious, they can determine if it needs to be monitored with yearly scans or if a biopsy needs to be performed. If you are diagnosed with lung cancer, there’s been many advancements in treatment to help save and prolong your life.

One such advancement is in immunotherapy. Immunotherapy is treatment that uses the immune system to find and destroy cancer cells. Traditionally, it was used in advanced lung cancers only, Dr. Bulbul says. Now, it can be used in early stage lung cancers and even before surgery. Past clinical trials have shown a quarter of cancers completely vanished with a combination of chemotherapy and immunotherapy before going into surgery, Dr. Bulbul says. Those same trials showed those patients tended to live longer and have less chance of recurrence.

There are also advancements in targeted therapy for lung cancer treatment. That is the use of certain targeted drugs that attack mutations that are causing cancer cells to grow, divide and spread.

“Over the last five years, I’d say the overall survival rate for lung cancer has significantly improved, even in lung cancers that are stage 4, metastatic,” Dr. Bulbul says. “There are patients that live in years, not months like it used to be when you had stage 4, metastatic.”

Accessing that care

While the updated, more inclusive lung cancer screening guidelines have changed and advancements in treatment have improved, there’s still the issue of access to care, especially in our rural communities like Liberty and surrounding counties.

You have people that are underinsured or not insured who can’t or don’t think they can afford a CT scan. There are folks who don’t have a primary care doctor they see regularly. There are people that don’t even have transportation to get to a doctor if they wanted.

“The goal should be to find cancers early regardless of your circumstances,” Dr. Bulbul says. “If there’s an effort into getting all high-risk patients – again smoked more than 20 years, even if you quit less than 15 years ago and between 50-80 – then you need to get a CT scan of the lungs, and you need to get it repeated every year.”

Dr. Bulbul encourages everyone who thinks they may be at risk of one day developing lung cancer to talk to their primary care doctor. You can also ask for a referral to an oncologist who can help identify those risk factors, because as Dr. Bulbul says, “A cancer doctor’s job is not just treating cancer. We can give expertise into how to detect cancers early.”

Stop smoking now

If you are a current smoker, what you also need to do is stop smoking now. Of the lung cancers Dr. Bulbul treats, which is one of the more common cancers he sees, 90 percent of those patients are current or former smokers.

Related Article: Have lung cancer? Quitting smoking can help improve treatment outcomes.

“The interesting point about quitting is if you are a smoker, it’s always a good time to quit, and it’s never too late to quit,” Dr. Bulbul says. “If you quit, the first year you stop, your risk of lung cancer drops. By five years, your risk is 90 percent less. By 15 years, your risk is like everyone else.”

If you need help quitting, St. Joseph’s/Candler offers a Comprehensive Tobacco Cessation Program that offers one-on-one sessions to help you kick the nicotine habit. Read more about that program here. 

If you are unable to come to Savannah for the program, we recommend the national quit smoking hotline at 1-800-QUIT-NOW. You can speak confidentially to a highly trained specialist and also ask for free samples of some of the over-the-counter products (gums, patches or lozenges).