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Finding Answers and Hope for Texas’ Deadliest Cancer

Nov 26, 2015 09:58AM ● Published by Kevin

In Tarrant County, home to most Mansfield Magazine readers, 962 residents will be diagnosed with lung cancer this year, according to the Texas Cancer Registry. 

Lung cancer is the deadliest cancer in Texas. Each year it kills more people than colon, breast and prostate cancers combined. In 2015, an estimated 13,619 new lung cancer diagnoses and 10,985 deaths are expected from the disease in Texas.

Lung cancer is the uncontrolled growth of abnormal cells in the lungs. Most lung cancers start in the bronchial tubes, which let air in and out of your lungs so you can breathe. The most common type, non-small cell lung cancer, accounts for approximately 85 to 90 percent of lung cancers. The other main type is small cell lung cancer, sometimes called oat cell cancer.

Risk Factors and Prevention

Smoking is the leading cause of lung cancer. In fact, about 87 percent of lung cancer deaths are caused by smoking, as are at least 32 percent of all cancer deaths, according to the American Cancer Society. Men and women who smoke are 25 times and 25.7 times, respectively, more likely to develop lung cancer. Smoking can shorten life expectancy by 14 years.

Not everyone who smokes develops lung cancer, and sometimes people who do not smoke still get lung cancer. Second-hand smoke, air pollution and workplace exposures to asbestos, arsenic, radioactive gas and diesel exhaust can sometimes cause lung cancer. Although rare, some lung cancers are caused from exposure to a gas called radon — a colorless, odorless, radioactive gas sometimes found in indoor air and in water from underground sources like wells. 

The genes we inherit from our parents also play a factor in lung cancer. Genes essentially contain instructions for controlling when cells grow, divide to make new cells and die. Some people inherit a weak ability to rid certain types of cancer-causing chemicals in the body, such as those found in tobacco smoke. That may put them at a higher risk for lung cancer. People with a parent or sibling with lung cancer also face an increased risk of lung cancer.

Prevention measures help guard against lung cancer. Doctors recommend not smoking; avoiding secondhand smoke; and taking precautions at work against harmful fumes, dust and chemicals. A universal screening test is not yet available, but people ages 55-80 with a history of heavy smoking, who smoke now, or who quit within the past 15 years should consider a yearly low-dose CT to screen for lung cancer, which could reduce risk of dying from lung cancer. Radon detection kits, as well as EPA-suggested companies, can be used to test your home for radon.

Symptoms

There are a few detectable symptoms, which can vary from person to person. They may include coughing up blood or a cough that does not go away or worsens; chest pain that is often worse with deep breathing; hoarseness; loss of appetite; fatigue or weakness; wheezing; unexplained weight loss; shortness of breath; or infections such as bronchitis and pneumonia that don’t go away, or keep coming back.

If lung cancer spreads to distant organs, it may cause bone pain; nervous system changes such as headache, weakness or numbness of an arm or leg; or yellowing of the skin and eyes, from cancer spread to the liver.

Diagnosis and Treatment

To diagnose lung cancer, physicians may use a variety of tests. If cancer is confirmed, doctors conduct additional tests to learn the cancer’s severity and if it has spread to other parts of the body, which may include a computed topography scan (CT scan) or positron emission tomography (PET). The results help physicians determine the best treatment options. 

After a doctor has found the cancer and its stage, patients may be treated by a team of specialists, including pulmonologists, thoracic surgeons, medical oncologists, radiation oncologists and palliative physicians. Treatment options vary depending on the stage and type of the cancer, the patient’s symptoms and overall health and a variety of other factors. Treatment for lung cancer is determined by the stage at presentation and may consist of a combination of surgery, radiation or chemotherapy. Targeted therapies may be beneficial in lung cancers with certain gene mutations, which can be identified by molecular testing. Immunotherapy and proton therapy are other treatment options. Clinical trials evaluating new therapies for lung cancer may be available to patients.

Patients treated with immunotherapy are given drugs that enhance the immune system. The growth of cancer cells is slowed or stopped entirely and the cancer cannot spread as a result. Two new immunotherapy drugs, nivolumab and pembrolizumab, were approved in October 2015 to boost the body’s ability to fight against lung cancer cells.

For some lung cancer patients, proton therapy may be the optimal treatment option. Texas Center for Proton Therapy opens this month in the Dallas/Fort Worth area and has the most advanced proton therapy technology in the state. A machine called a cyclotron accelerates protons extracted from hydrogen atoms. The machine then creates a proton beamline precisely targeted to the tumor, destroying cancer cells while minimizing side effects and damage to healthy tissue. 

Lung cancer is a deadly disease. However, by taking preventive measures and working with your doctor for the best treatment options, hope is within reach.    

Written by Sarju Waghela, D.O., a medical oncologist at Texas Oncology, Mansfield. Dr. Waghela is board certified in medical oncology and internal medicine. She is a longtime Texan, having received her undergraduate degree from Texas A&M University and completing her medical training in Fort Worth and Temple. Her interests include cooking, traveling and spending time with her extended family.

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