This is the fifth in a series of instalments devoted to breakthroughs for the more common solid and blood cancers; this week is dedicated to lung cancer (LC).

The lungs are two spongy inverted pink conical structures located in the chest. The right lung has three lobes while the left has two. Within each lung there are a series of branching tubes which facilitate the movement of air. At the tips of the smallest tubes are clusters of air sacs, the alveoli. The lungs contain over 600 million alveoli and when laid out edge to edge have the surface area equivalent to a tennis court. Within the alveoli, oxygen diffuses out of the inhaled air into the bloodstream while carbon dioxide moves in the opposite direction.

Worldwide, LC is the leading cause of cancer deaths. On average 1 in 16 people will develop,LC in their lifetime with the incidence in men being slightly higher than in women. LC kills three times more men and women than prostate and breast cancer, respectively. The 5-year survival, rate for all types of LC is 22%. Women have a 7% edge in their survival rates over men.

Over the last 20 years the incidence of LC has fallen worldwide. Cigarette smoking accounts for up to 80% of LC deaths. Other known causes include second hand smoke, diesel exhaust, family history, asbestos exposure, and previous radiation exposure. Other possible causes include the protracted use of beta carotene, especially in smokers, air pollution, e-cigarettes, and talcum powder. Systematic screening using low dose CT scans in high risk individuals results in the early detection which in turn reduces deaths from LC. There are different types of primary LC.

Two of the main types are small cell and non small cell LC, respectively.

Some recent discoveries and advancements regarding LC:

• Pre-surgery IV priming with a combination of a specific cocktail of two forms of chemotherapy plus one form of immunotherapy is found to be quite effective in lowering the chances of the return of LC post surgery.
• Low dose CT scan screening for the very early detection of LC is increasingly being used in active smokers and in those who have previously smoked 20 cigarettes or more daily, within the last 15 years.
• There are a number of immunotherapy medicines which have shown enormous promise in treating LC. Such medicines stimulate the immune system to attack the cancer. For metastatic non-small cell LC durvalumab and tremelimumab have recently been approved.
• Targeted therapy has come into its own in recent times. This form of therapy attacks the LC cells while sparing non-cancerous tissue.
• Australian scientists have discovered a protein called Menin that’s closely linked to LC. They are currently working on a therapy that would target Menin and in turn destroy LC.
• Japanese scientists have recently discovered that the juice from the sarunashi fruit can limit LC growth. The sarunashi fruit belongs to the same family as kiwi.
• Scientific studies are showing promise in the use of berberine, a yellow plant derived compound, in the treatment of LC. Berberine is an alkaloid found in turmeric, wild sugar apple, and blueberries among other plants.

Recently diagnosed lung cancer (LC) patients should attend their doctor with a close family member or friend, and below are some questions that need to be asked:

•  What type of LC do I have?
• Where in the lung is the LC located?
• What is the stage? What’s the prognosis?
• What are all the treatment options? Are all available locally? What’s not?
• Should molecular profiling be done before specific treatment is carried out?
• Could any coexisting lung conditions influence the treatment options?
• What is the goal and likely success of my treatment?
• Can copies of all the reports be provided?
• Is there any additional treatment that can be beneficial even if it means having to travel or pay to bring it into the country?
• Are other doctors going to be involved in my treatment?
• What are the possible side effects of the proposed treatments?
• Is a second opinion locally or overseas recommended or worth pursuing?
• (In advanced cases) What are the plans for palliative care?

 Endometrial cancer will be covered next Friday.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)

Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.