In 1971, President Nixon signed The National Cancer Act, setting into motion a national crusade to cure cancer. At that time, less than 50 percent of patients with a diagnosis of cancer could expect to live five years. Today, the probability of living five years following a cancer diagnosis has improved to 65 percent. And, for those with a diagnosis of prostate or breast cancer, the odds of surviving five years are even more impressive – 99 percent and 89 percent, respectively.
In contrast to those encouraging figures, the survival rate for lung cancer patients remains poor. Today, the likelihood of living five years after a diagnosis of lung cancer is less than 17 percent. Furthermore, deaths from lung cancer outnumber those from prostate, breast, colon and pancreas cancer combined. Fortunately, two groundbreaking developments in the control of lung cancer will be introduced next year – a screening tool for detecting lung cancer before it becomes incurable, and FDA approval of a medication that enables the body’s own immune system to attack lung cancer cells.
Regarding the first development, the National Cancer Institute announced this year that the use of low-dose spiral CT scanning (LDCT) in heavy smokers reduces their risk of dying from lung cancer by 20 percent. A heavy smoker is defined as someone between the ages of 55 and 74 years old, who has smoked at least one pack of cigarettes daily for 30 or more years and either smokes currently or has smoked within the previous 15 years. A guide to the benefits and risks of lung cancer screening using LDCT can be found at www.cancer.gov/newscenter/qa/2002/NLSTstudyGuidePatientsPhysicians.
The other notable development in lung cancer control involves immunotherapy. Lung cancer cells avoid the body’s immune system by masquerading as normal cells. This deception is made possible by a process known as programmed death-1 (PD-1). With immunotherapy, synthetic antibodies block PD-1, which allows the body’s immune system to detect lung cancer cells and inhibit their growth. Anti-PD-1 antibody therapy becomes available commercially next year.
The United States government has spent more than $100 billion on cancer research in the 42 years since President Nixon declared war on cancer. Despite this investment, much of the progress in reducing cancer mortality has come from screening programs such as Pap smears, mammograms and colonoscopies, or from lifestyle changes, not new therapies.
For example, a decrease in lung cancer mortality rates by almost two percent per year over the past ten years is largely due to a decline in the number of men who smoke. It is disappointing, therefore, to note that in 2013, North Carolina legislators allocated less than one percent of tobacco revenue toward control of tobacco use.
Next to heart disease, lung cancer is the leading cause of death in this country. And, smoking causes 85 percent of lung cancers. The time has come for everyone, including policymakers and lawmakers, to address these gruesome statistics.
Dr. Barton Paschal is a graduate of Emory University School of Medicine and completed a fellowship in cancer medicine at Wake Forest University. He is certified by the American Board of Internal Medicine in the specialty of medical oncology. Dr. Paschal is a member of the staff at Radiation Therapy Associates of Western North Carolina, P.A., a 21st Century Oncology affiliate located at the Macon Cancer Center and can be reached at (828)369-4257 #5. For information regarding community efforts to control tobacco use, visit www.ncpreventionpartners.org/dnn/WhatWeDo/Programs/QuitNowNC/tabid/85/Default.aspx.
Dr. Barton Paschal