In the past few weeks we have received many great questions about lung cancer on our Facebook page. Thanks to all Memorial Sloan Kettering fans who engaged!
Here are some of these questions and my answers.
Both of my parents have smoked for more than twenty years. What kind of tests should they have as part of lung cancer screening?
This depends on your parents’ ages and the total amount they have smoked.
Our screening program provides low-dose CT screening for people who are between the ages of 55 and 74 and who have smoked 30 or more pack years. Pack years is the number of years someone has smoked multiplied by the number of packs of cigarettes they smoked per day. For example, one pack per day for 30 years or two packs per day for 15 years is equal to 30 pack years.
If your parents are not in those categories, there is no evidence that screening will benefit them.
What role do the services offered at the Bendheim Integrative Medicine Center play in the treatment plan?
Integrative medicine therapies do not treat the cancer; instead, they reduce the symptoms caused by cancer and its treatment, using massage and mind-body therapies, yoga and t’ai chi, and physical fitness classes for patients at all levels.
Breathing difficulties related to lung cancer can be reduced with these evidence-based therapies, and research shows that fitness activities also can produce survival benefits.
In addition, some of the offerings at Bendheim, including relaxation techniques, can help people quit smoking. At Memorial Sloan Kettering we offer a Tobacco Cessation Program that is open to everyone — people with cancer as well as others who would like to quit.
Which chemotherapy agents are used for lung cancer?
The type of drugs you receive will depend on what kind of lung cancer you have— adenocarcinoma, squamous cell carcinoma, large cell lung cancer, or small cell lung cancer.
What is the benefit of having DNA from a lung tumor sequenced?
At Memorial Sloan Kettering we routinely analyze the DNA of all non-small cell lung cancer patients we treat. The genetic targets that we are able to identify for the most part do not inform the type of standard chemotherapy agents that are administered, but we can target tumors with specific drugs when certain mutations are identified.
Is lung cancer that is not linked to smoking genetic? Or is it a type of cancer that can happen to anyone even if there's no cancer history in the family?
There is an inherited genetic component to lung cancer, independent of smoking. A family history of lung cancer is associated with a higher risk of lung cancer, both in smokers and in nonsmokers.
Our Clinical Genetics Service can help you understand your risk for lung cancer. We offer genetic counseling and testing and can assist you in making informed medical decisions.
Would regular chest x-rays help detect lung cancer in earlier stages? Does the modern x-ray pick up lung cancer earlier than it did 25 years ago?
Having a chest x-ray has been proven in multiple trials to be no better than not having a chest x-ray in terms of being able to detect lung cancers at an early enough stage, where detection can have an impact on survival. Only low-dose chest CT scans should be used for the purpose of lung cancer screening.
Are there early warning signs of lung cancer?
Unfortunately, most lung cancers do not cause symptoms until they are more advanced in stage. Patients who present with symptoms almost always have a more advanced stage. This is why screening rather than waiting for symptoms is so important for those who are at highest risk of developing the disease.
I smoked for about 25 years and I quit about 15 years ago. Am I still at risk of lung cancer?
I’m glad to hear that you quit! Some of the damage done to the lungs from smoking can be permanent, some damage is reversible with time after quitting, and some damage may continue to progress despite quitting. The risk to getting lung cancer is partly due to how much you smoked and how long ago you quit.
If someone is in her eighties and diagnosed with lung cancer, are you still able to operate?
At Memorial Sloan Kettering, we don’t consider age as a reason to not operate on a lung cancer patient. Rather, my fellow surgeons and I use objective tests such as lung function tests and also look at the patient’s overall health to determine if an operation can be done safely.
I’ve been diagnosed with advanced lung cancer. Should I consider participation in a clinical trial?
This is a question to discuss with your physician. There are standard and effective first-line treatments for patients who have been newly diagnosed with advanced-stage lung cancer. Clinical trials are most commonly reserved for patients who did not benefit from standard treatments.