November is Lung Cancer Awareness Month. Why does lung cancer need an awareness month? Because many sufferers aren’t aware of it until it’s too late.
Early lung cancer may have no symptoms at all, or symptoms that are easily confused with a nasty cold.
Read on to discover the warning signs of lung cancer, why it’s important to spot them early, and the new medical advances that are saving patients who are diagnosed.
Early warning signs
The most common early symptoms of lung cancer include:
- an unusual cough (such as one that gets worse over a long period or is accompanied by coughing up blood);
- chest pain that is worse with deep breathing or laughing;
- unexplained hoarseness, weight loss, or lack of appetite;
- shortness of breath or wheezing in patients who haven’t experienced it before;
- and chronic or long-lasting respiratory infections (like bronchitis or pneumonia).
These symptoms are often accompanied by fatigue or weakness. Always check with your doctor if you notice any of the above that you know is not normal for you.
Why is early diagnosis important?
Cancers that are caught before they have time to spread are much more likely to respond to treatment. Once cancer cells have spread over a wide area of the body, a person’s chances of surviving the disease are much lower.
For lung cancer patients, we know that more than 80% of those diagnosed in the earliest stage will survive for at least another year Only 15% of those diagnosed in the most advanced stage survive that long.
New advances in treatment
Artificialt Intelligence (AI)
A study conducted by the Cleveland Clinic, an American research hospital, revealed that new machine learning technology could help tailor radiation treatments to better meet the needs of individual lung cancer patients.
The artificial neural network allows hospitals to upload electronic medical records from former lung radiotherapy patients, forming a dataset that the network can use to predict how future patients will respond to treatment.
It uses probability estimates to select the optimal dose of radiation that reduces treatment failures to a set level, for example a 5% probability of failure.
In the future, this kind of AI could be used to optimise treatment based on age, gender, ethnicity, location, medical setting (e.g. a community hospital or academic centre), or any other demographic category.
Lung cancer is often detected during an unrelated medical exam. It can be hard to tell malign tumours from benign ones without an invasive biopsy. And healthcare practitioners often advise even more invasive solutions, such as surgery, to be on the safe side.
But for delicate organs like the lungs, invasive methods can be risky and can often result in complications, such as lung collapse.
Thankfully, a ground-breaking blood test could now rule out cancer with the prick of a needle.
Researchers at the Medical University of South Carolina have developed a blood test for biomarkers that indicate lung cancer - primarily the proteins LG3BP and C163A.
The study showed that the test was 98% accurate and could reduce invasive procedures on people with harmless nodules by 40% - although patients with negative results would still be monitored as a precaution.
Targeted therapy uses drugs to attack lung cancer cells directly. New advances in understanding of the driver mutations in cells that cause cancer have enabled scientists to develop drugs that directly target some of these mutations.
The drugs target specific parts of cells and block the signals proteins send to cells that make them grow and divide uncontrollably.
Like the blood test above, targeted therapy relies on biomarker testing, using it to discover which driver mutations are present and to determine treatment.
Targeted therapy drugs are different from standard chemotherapy - rather than killing the cancer cells directly, they stop them growing and dividing. Because they’re so precise, they don’t affect healthy cells the way chemotherapy drugs do, so patients tend to suffer fewer side effects.
Immunotherapy is a type of biological therapy that helps the body’s immune system to fight cancer.
Instead of directly targeting cancer cells, immunotherapy trains the immune system to target and kill them, either by enabling the immune system to mount or maintain a response or by suppressing factors that block it.
There are three main types of immunotherapy drugs being developed to fight lung cancer - immune checkpoint inhibitors, adoptive T cell transfer, and therapeutic cancer vaccines.
So far, all of the FDA-approved immunotherapy drugs for lung cancer are immune checkpoint inhibitors, while the other types are still a work in progress.
Patients who only have very small tumours (called nodules) may be told the nodules are too small for a surgeon to find and forced to wait for their cancer to grow before surgery.
But a new technique called microcoil localisation uses CT images to help a radiologist place a small wire coil into the nodule so the surgeon can find it and remove it. This enables patients to get treatment earlier, when survival rates are higher.
There are other ways of finding tiny nodules during surgery, but they’re not much fun for the patient. Patients can go to the radiology suite first to have their lungs implanted with either a wire coil, a metal seed that can be found with an X-ray, or a shot of radioactive protein that can be found with a Geiger counter.
These can’t be done under general anaesthetic in a radiology suite therefore, patients must be implanted with the foreign bodies under local anaesthetic and wait togo to the operating room for surgery - by which time the local has often worn off and left them in considerable pain and discomfort.
Microcoil localisation covers both steps in the operating room under general anaesthetic, leading to a much better patient experience.
Lung Cancer is responsible for 35,300 deaths in the UK each year, however with early detection and further advancements in treatment we can hopefully reduce this number and increase survival rates.