By Sara Bondell - January 30, 2023
EDITOR’S NOTE: In honor of National Women Physician Day on Feb. 3, Moffitt Cancer Center’s Women in Oncology group is highlighting the ways women physicians and researchers are contributing to the prevention and cure of cancer.
In early 2022, President Joe Biden announced the relaunch of the Cancer Moonshot initiative with the goals of reducing the cancer death rate by half within 25 years and improving the lives of patients and survivors. A key component of the initiative is to expand the use of proven cancer prevention and early detection strategies.
Millions of Americans, especially those among medically underserved populations, are at high risk for cancers that have proven prevention and screening strategies in place. Although breast, cervical, colorectal and lung cancers all have nationally recognized screening programs, lung cancer screening participation significantly lags behind.
According to the National Cancer Institute’s Cancer Trends Progress Report, the most recent data available shows 76.4% of women ages 50 to 74 had a mammogram within the past two years, 73.5% of women ages 21 to 65 were up-to-date with cervical cancer screening and 67.1% of adults ages 50 to 75 had received colon cancer screening under current guidelines.
However, only 5.7% of those at high risk for lung cancer are screened, according to the American Lung Association’s State of Lung Cancer 2020 Report.
In 2021, the U.S. Preventive Services Task Force expanded lung screening guidelines to include more people. Annual screening with a low-dose CT scan is now recommended for adults ages 50 to 80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Early detection by low-dose CT scans can decrease lung cancer mortality by up to 20% among high-risk populations.
“If everyone who is eligible to undergo lung cancer screening actually had the screening done, 60,000 lives per year would be saved,” said Jhanelle Gray, MD, chair of the Thoracic Oncology Department at Moffitt Cancer Center. “That’s a significant amount, and when you look at the goals of the Cancer Moonshot project, this to me is low-hanging fruit. This is something we have to do.”
Detecting Cancer Early
Efforts are already in motion at Moffitt to improve lung cancer screening and prevention. Thoracic surgeon Lary Robinson, MD, leads the Lung Early Detection Program, which is dedicated to finding lung cancers earlier. Within that program is the Lung Cancer Screening Program, which facilitates all screenings; the Pulmonary Nodule Program, which is for patients who have had an abnormality identified on a screening; and the Surveillance Clinic, which is for lung cancer survivors who are also at risk for secondary cancers.
"The earlier we can detect lung cancer, the higher your chance of cure is."See Also85 Biotechnology Trivia Questions (Ranked from Easiest to Hardest)153 Psychology Trivia Questions (Ranked from Easiest to Hardest)50 Things You Never Knew About the Making of 'Grey's Anatomy'An Inside View of Chaim Medical
- Jhanelle Gray, MD, Thoracic Oncology Department
“All of these programs use very similar processes and procedures, like the low-dose CT scan, to help follow patients and promote early detection,” Gray said. “This is critically important because the earlier we can detect lung cancer, the higher your chance of cure is.”
The five-year survival rate for lung cancer is 56% for cases detected when the disease is still localized. However, only 16% of lung cancers are diagnosed at an early stage. For cases where the cancer has spread to other organs, the five-year survival rate is only 5%.
To increase the number of eligible individuals who undergo lung screening, thoracic physicians and researchers are trying to identify the barriers and solutions to overcome them. This includes creating shared documentation in the electronic health record to make scheduling screenings easier, increasing access to underserved populations, working to end the need for prior authorization for screening, eliminating stigma, and increasing awareness among communities and primary care providers.
U.S. Rep. Kathy Castor has requested $2.3 million in the fiscal year 2023 budget for Moffitt to purchase a mobile screening unit to reach underserved populations. Meanwhile, the Lung and Thoracic Tumor Education Program is working on developing new partnerships and appropriate educational tools that not only target current and former smokers to come in for first-time scans, but to keep them coming back annually.
“We want to eliminate any negative reassurance,” Gray said. “For example, some may say, ‘I smoked, I received a negative CT scan, so I can continue smoking.’ This is not the correct thinking. Those at risk must continue to have annual low-dose CT scans and quit smoking.”
The team is also looking into setting up an electronic system that can send out reminders to patients and create an opportunity to easily schedule annual scans.
Smoking Cessation for Patients
Smoking is the main cause of lung cancer and contributes to 80% to 90% of lung cancer deaths in women and men, respectively. Men who smoke are 23 times more likely to develop lung cancer and women are 13 times more likely compared to never-smokers. Exposure to secondhand smoke can also increase risk for lung cancer.
The National Cancer Institute has awarded funding to several projects that align with the Cancer Moonshot’s recommendation to expand screening and prevention strategies, including the Cancer Center Cessation Initiative. The goal is to develop sustainable and effective tobacco cessation programs for patients with cancer while also evaluating approaches and outcomes.
Moffitt is one of the NCI-designated cancer centers to receive funding. Vani Simmons, PhD, co-director of Moffitt’s Tobacco Research and Intervention Program, is leading the two-year, $500,000 project aimed at building infrastructure to provide Moffitt patients access to smoking cessation resources. Studies show up to two-thirds of patients continue to smoke even after their cancer diagnosis.
"Some cancer patients think it’s too late to quit smoking once they’ve been diagnosed with cancer. However, there are a number of adverse outcomes that are related to continued smoking."
- Vani Simmons, PhD, Tobacco Research and Intervention ProgramSee AlsoScant obesity training in medical school leaves docs ill-prepared to help patientsA baby spent 36 days at an in-network hospital. Why did her parents get a huge bill?Opinion: 3 takeaways from doctors about Damar Hamlin's cardiac arrest and resuscitationSeveral fire departments in Butler County report record calls in 2022
“Some cancer patients think it’s too late to quit smoking once they’ve been diagnosed with cancer,” Simmons said. “However, there are a number of adverse outcomes that are related to continued smoking, including cancer treatment being less effective, increased risk of secondary cancers and greater side effects from treatment.”
As part of the initiative, Moffitt developed an automated e-referral system to the Tobacco Free Florida Quitline. The goal is to ask every patient about their smoking history, advise current smokers to quit and refer them to Moffitt’s tobacco treatment specialists or to other resources such as the quitline.
Simmons and the Tobacco Research and Intervention Program faculty are also applying for large grants to advance smoking cessation research with patients. Underreporting is a major challenge because of the stigma surrounding smoking, so they want to investigate better ways to ask patients about their smoking history and to develop more innovative ways to help them quit.
Research shows that while the state tobacco quitline is a no-cost treatment resource, the number of patients referred to the quitline and percentage of smokers who actually get assistance is remarkably low.
“In terms of future directions, our team is interested in leveraging digital technology to increase the proportion of patients who are asked about their smoking,” Simmons said. “We think using a digital method may result in patients feeling more comfortable reporting their smoking, and it can also take some burden off of the providers.”
Researchers at Moffitt are also conducting research on low-nicotine cigarettes, how to best motivate patients with nonsmoking-related cancers to quit, and how to bring smoking cessation resources to racial and ethnic minorities. While Spanish speakers are the largest minority group in the country, there are surprisingly few evidence-based Spanish-language materials available for smokers. A large, randomized Moffitt study with more than 1,400 Spanish-speaking smokers demonstrated the efficacy of a self-help smoking cessation program culturally adapted for Hispanics.
“Our next step for that line of research is to look into how to extend the reach of our work by translating and adapting our written intervention into a mobile health intervention,” Simmons said.
Need to Quit? There’s an App for That
While the national smoking average sits at around 12%, Jennifer Vidrine, PhD, MS, assistant center director for Research Strategic Partnerships, and Damon Vidrine, DrPH, MS, interim chair of the Health Outcomes and Behavior Department, conducted a pilot study in Oklahoma and found that about 50% of food bank clients they surveyed reported current smoking. Many did not have access to transportation and smoking cessation resources. But when offered the opportunity to participate in a pilot study evaluating a prototype of a fully automated, personally tailored, smartphone-delivered intervention for tobacco cessation at food distribution sites, a high proportion of smokers enrolled.
Jennifer and Damon Vidrine were awarded a five-year grant from the NCI to evaluate the efficacy of this novel treatment approach in a randomized controlled trial. Upon coming to Moffitt three years ago, the Vidrines worked with the cancer center’s Office of Community Outreach, Engagement and Equity and the University of South Florida’s Center for the Advancement of Food Security & Healthy Communities to develop a partnership with Feeding Tampa Bay to support recruitment for their study.
“We are getting people enrolled in the study at that initial in-person interaction when they are picking up their food,” Jennifer Vidrine said. “They get a 10-week supply of combination nicotine replacement therapy, and we compensate them for their time. We follow them for a full year, and if they complete every single assessment, they can earn up to $510. That is a meaningful amount of money for those who are struggling financially.”
"As smoking has become more and more stigmatized, individuals are sometimes reluctant to admit to smoking, which can make it challenging for them to get help with quitting."(Video) Discovery Series: An Insider’s Look -Innovations in Lung Cancer Treatment
- Jennifer Vidrine, PhD, Research Strategic Partnerships
The mobile app offers 12 weekly smoking cessation treatment videos in English or Spanish that are tailored to each smoker’s unique needs, based on a series of questions they answer. The videos can be watched on demand and then rewatched later, and the app has a proven benefit that a manned quitline doesn’t: It can be accessed 24/7. Studies also show gamification, such as receiving badges or trophies for completing tasks on an app, increases engagement.
The goal is to enroll 500 people into the app study within the next two years.
“As smoking has become more and more stigmatized, individuals are sometimes reluctant to admit to smoking, which can make it challenging for them to get help with quitting,” Jennifer Vidrine said. “Through partnering with Feeding Tampa Bay, we can reach these individuals and offer help with the support of a trusted and well-respected community organization that they have already come to trust and rely on for assistance with food insecurity.”
Saving More Lives
Now that the cancer center has established ways to increase lung cancer screenings, launched research projects and identified digital tools to help smokers quit, it’s time to gain national support. In September 2022, Gray and other lung cancer screening advocates, patients and researchers traveled to Washington, D.C., to meet with congressional members and ask for support to increase access to and improve education about lung cancer screening.
“We got some really important questions on how to make this move forward in partnership,” Gray said. “We have drafted a policy letter with multiple items such as potential barriers and how to address them. Each one of the items we have on there can be its own policy that a representative can sponsor and help support as a bill.”
Targeting lung cancer screenings for current or former smokers is just the beginning, and lung cancer advocates are also hoping to lay the groundwork for federal support for screening for nonsmokers in the future. About 15% of patients who develop lung cancer have never smoked, so it’s also important to study other exposure risk factors like radon and air pollution and develop tests to identify genetic mutations that can cause cancer.
“The best-case scenario is that we are all working in partnership across every field to understand these patient populations and focus on increasing screening rates with the ultimate goal of saving lives,” Gray said.
From left: Jhanelle Gray, MD; research coordinator Monica Reyes; and community relations specialist Haley Tolbert traveled to Washington, D.C., in September 2022 with other lung cancer screening advocates to meet with congressional members. The group was advocating for support for increased lung cancer screening efforts.
What is the emotional toll of lung cancer? ›
You can have emotional and social effects after a cancer diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones.What is the best treatment of lung cancer? ›
People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. People with small cell lung cancer are usually treated with radiation therapy and chemotherapy. Surgery.How do you cope with lung cancer treatment? ›
- Share with friends and family about how you're feeling.
- Seek peer support through groups like the Lung Cancer Survivors Community on Inspire.
- Find a therapist who has experience working with clients who are experiencing life-limiting illness.
The lung cancer five-year survival rate (18.6 percent) is lower than many other leading cancer sites, such as colorectal (64.5 percent), breast (89.6 percent) and prostate (98.2 percent). The five-year survival rate for lung cancer is 56 percent for cases detected when the disease is still localized (within the lungs).What are signs your body is fighting lung cancer? ›
Cough that produces blood. Pain in the chest, back or shoulders that worsens during coughing, laughing or deep breathing. Shortness of breath that comes on suddenly and occurs during everyday activities. Unexplained weight loss.What are the signs that lung cancer is getting worse? ›
a change in a cough you have had for a long time. breathlessness. unexplained weight loss. ongoing chest infections.
Large-cell (undifferentiated) carcinoma.
It tends to grow and spread quickly, so it can be harder to treat than the other types.
Atezolizumab is approved to treat some people with non-small cell lung cancer after surgery. The HER2 mutations seen in lung cancer make the HER2 protein activated all the time, Dr. Neal explained.What is the easiest lung cancer to cure? ›
Because stage 0 NSCLC is limited to the lining layer of the airways and has not invaded deeper into the lung tissue or other areas, it is usually curable by surgery alone. No chemotherapy or radiation therapy is needed.How long does it take for lung cancer to get worse? ›
Studies have shown that lung cancer doubling time can vary, from 229 days to 647 days in one study, depending upon the type. 7 It's possible that some types of lung cancer progress within weeks to months, while others may take years to grow.
How quickly does lung cancer spread? ›
A 2018 study found that the median doubling time varies by type of NSCLC: Adenocarcinomas had a median doubling time of 261 days. Squamous cell carcinomas had a median doubling time of 70 days. Other lung cancers, which included large cell carcinomas and SCLC, also had a median doubling time of 70 days.How can you prevent lung cancer from getting worse? ›
- Don't smoke. If you've never smoked, don't start. ...
- Stop smoking. Stop smoking now. ...
- Avoid secondhand smoke. If you live or work with a smoker, urge him or her to quit. ...
- Test your home for radon. ...
- Avoid carcinogens at work. ...
- Eat a diet full of fruits and vegetables. ...
- Exercise most days of the week.
Survival for all stages of lung cancer
around 15 out of every 100 people (around 15%) will survive their cancer for 5 years or more. 10 out of every 100 people (10%) will survive their cancer for 10 years or more.
The results show that patients diagnosed with lung cancer at an early stage via CT screening have a 20-year survival rate of 80 percent. The average five-year survival rate for all lung cancer patients is 18.6 percent because only 16 percent of lung cancers are diagnosed at an early stage.Where is the first place lung cancer spreads? ›
While it's possible for lung cancer to spread virtually anywhere, it most commonly metastasizes in the liver, brain, bones or adrenal glands.What foods should I avoid with lung cancer? ›
Though your nutritional needs can vary over time, the basic rules -- like avoiding added sugar, sodium, and saturated fats -- still apply. Things in your diet that often trigger side effects during lung cancer treatment include: Greasy, fried, or super-spicy foods, which can lead to nausea and diarrhea.Where does lung cancer pain usually start? ›
Chest pain: When a lung tumor causes tightness in the chest or presses on nerves, you may feel pain in your chest, especially when breathing deeply, coughing or laughing.Which lung cancer spreads the fastest? ›
Small Cell Lung Cancer
It is a fast-growing cancer that spreads much more quickly than other types of lung cancer. There are two different types of small cell lung cancer: Small cell carcinoma (oat cell cancer; most small cell lung cancers are of the oat cell type)
Most lung tumours appear on X-rays as a white-grey mass. However, chest X-rays cannot give a definitive diagnosis because they often cannot distinguish between cancer and other conditions, such as a lung abscess (a collection of pus that forms in the lungs).
Staging is based on:
- The size and location of the original tumor (also called the primary tumor)
- Whether the cancer has metastasized (spread) to nearby lymph nodes.
- Whether the cancer has metastasized (spread) to other organs.
What is the new lung cancer treatment for 2022? ›
On August 11, 2022, the FDA also approved T-DXd for non-small cell lung cancers caused by mutations in the HER2 gene. The trial that resulted in the approval was led by MSK medical oncologist Bob Li, MD, PhD, MPH.How long can you live with lung cancer if not treated? ›
Without treatment, the outlook for lung cancer is poor. A 2013 review of studies found that the average survival time for people with NSCLC who do not receive treatment is just over 7 months . A 2012 review found that the survival time for untreated SCLC is in the range of 2–4 months.Can you live with incurable lung cancer? ›
Your lung cancer may be incurable, but, with good treatment and ongoing care, you can lead a relatively normal life. With improvements in treatment and care, people are not only living longer with lung cancer, they are enjoying a better quality of life.What is the miracle drug for lung cancer? ›
The way berberine works to fight cancer was determined by measuring the mRNA levels of tumour-associated genes and protein expression levels. The study discovered that the natural compound boosts tumour suppressor genes and lowers proteins involved in cancer cell migration and proliferation.What are the best fruits for lung cancer? ›
In fact, a study in over 478,000 people showed that a higher intake of apples and pears was associated with a lower risk of developing lung cancer ( 47 ). Anthocyanins, a type of plant pigment found in pears, have also been linked to decreased cancer growth and tumor formation in test-tube studies ( 48 , 49 ).Is there a pill that lung cancer survivors take? ›
These drugs can often shrink tumors in people whose advanced lung cancers have an ALK gene change. Although they can help after chemo has stopped working, they are often used instead of chemo in people whose cancers have an ALK gene rearrangement. These drugs are taken as pills.
The 5-year survival rate for men is 18%. The 5-year survival rate for women is 25%. The 5-year survival rate for NSCLC is 26%, compared to 7% for small cell lung cancer. However, it is important to note that survival rates depend on several factors, including the subtype of lung cancer and the stage of disease.What is the slowest growing lung cancer? ›
Lung carcinoid tumors are uncommon and tend to grow slower than other types of lung cancers. They are made up of special kinds of cells called neuroendocrine cells. They are usually classified as typical or atypical carcinoids. Carcinoids are very rare, slow-growing and most commonly treated with surgery.Which type of lung cancer has the best prognosis? ›
People with a type of adenocarcinoma called adenocarcinoma in situ (previously called bronchioloalveolar carcinoma) tend to have a better outlook than those with other types of lung cancer.Is lung cancer difficult to cure at any stage? ›
For patients who have small, early-stage lung cancer, the cure rate can be as high as 80% to 90%. Cure rates drop dramatically as the tumor becomes more advanced and involves lymph nodes or other parts of the body.
Does 5-year survival rate mean you have 5 years to live? ›
The percentage of people in a study or treatment group who are alive five years after they were diagnosed with or started treatment for a disease, such as cancer. The disease may or may not have come back.How long can you live with lung cancer that has spread? ›
Life expectancy for people with metastatic lung cancer is low. The overall 5-year survival rate for small cell lung cancer is 3%, and 8% for non-small cell lung cancer (NSCLC). 25-30% of people with metastatic NSCLC have a life expectancy of under 3 months.How long can you live with lung cancer that has spread to the bones? ›
The median survival time of lung cancer after bone metastasis 148 days. Male gender and ECOG 3–4 were significant poor prognostic factors for lung cancer after bone metastasis, with hazard ratios of 1.42 (95% CI 1.17–1.73), and 1.30 (95% CI 1.06–1.60), respectively.Where does Stage 4 lung cancer usually spread to? ›
The cancer cells often travel from the lung to the brain, bones, liver and adrenal glands where they may form new metastatic tumors.What vitamins are good for lung cancer? ›
In addition, an adequate vitamin D status may be important for lung cancer prevention. Furthermore, vitamin D or its analogs, alone or in combination with cytotoxics, have potential in the treatment of lung cancer.Can lung cancer go into remission on its own? ›
It often spreads to other tissues and comes back in most people. Relapse usually occurs within the first couple of years after treatment. Some people with small-cell lung cancer do go into remission without relapsing. Cancer that's limited to the lung is sometimes considered curable.Can lung cancer go away naturally? ›
It's rare for cancer to go away on its own without treatment; in almost every case, treatment is required to destroy the cancer cells. That's because cancer cells do not function the way normal cells do.What is the number one cancer killer? ›
Lung and bronchus cancer is responsible for the most deaths with 130,180 people expected to die from this disease. That is nearly three times the 52,580 deaths due to colorectal cancer, which is the second most common cause of cancer death. Pancreatic cancer is the third deadliest cancer, causing 49,830 deaths.What are the signs that lung cancer has spread? ›
- Bone pain (like pain in the back or hips)
- Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain.
Just 19% of those diagnosed at stage 4 survive more than 12 months. But now more than ever, those living with lung cancer are living better, longer lives thanks to the power of research and advancements in treatment.
What is Stage 4 lung cancer life expectancy? ›
Stage 4 lung cancer usually has a poor prognosis. One study found that depending on the stage of the metastases (spread) the average survival time following diagnosis of stage 4 lung cancer ranged from 6.3 months to 11.4 months.What is the psychological impact of lung cancer? ›
Patients with lung cancer are more likely to develop various degrees of anxiety and depression due to physical discomfort and psychological factors the disease incurs (3).How does lung cancer affect a person's daily life? ›
It is affected by the severity and the number of symptoms such as fatigue, loss of appetite, dyspnea, cough, pain, and blood in sputum, which are specific for lung tumors. Fatigue and respiratory problems reduce psychological dimension of QoL, while sleep problems reduce cognitive functioning.How does cancer affect you emotionally? ›
Sadness and Depression. Many people with cancer feel sad. They feel a sense of loss of their health, and the life they had before they learned they had the disease. Even when you're done with treatment, you may still feel sad.What are the emotional stages of cancer? ›
- State 1: Denial. ...
- Stage 2: Anger. ...
- Stage 3: Bargaining. ...
- Stage 4: Sadness and depression. ...
- Stage 5: Acceptance.
This study demonstrates that lung cancer patients exhibit cognitive impairment before and after chemotherapy. Before the treatment, C− showed verbal memory deficits as well as a widespread WM damage.Can stress bring on lung cancer? ›
No, being stressed doesn't directly increase the risk of cancer. The best quality studies have followed up many people for several years. They have found no evidence that those who are more stressed are more likely to get cancer. Some people wonder whether stress causes breast cancer.What is the most common cause of death in lung cancer patients? ›
Infections were responsible for death in 20% of the patients in the study. 2 About 60% died from pneumonia and 40% from an overwhelming infection that begins in the bloodstream and spreads through the entire body (sepsis).What organ does lung cancer affect the most? ›
Lung cancer can start anywhere in the lungs and may affect any part of the respiratory system. This can cause breathing or heart problems, such as: Pleural effusion, which is the buildup of fluid between the outer lining of the lungs and the chest wall. This is a common condition with lung cancer.Can stress make cancer worse? ›
Evidence from laboratory studies in animal models and human cancer cells grown in the laboratory suggests that chronic stress may cause cancer to get worse (progress) and spread (metastasize) (9–11).
What happens if you refuse cancer treatment? ›
You don't have to have treatment.
People with very advanced cancers sometimes find they'd rather treat the pain and other side effects of their cancer so that they can make the best of the time they have remaining. If you choose not to be treated, you can always change your mind.
Many people living with cancer experience anger. Often, the feeling arises when receiving a cancer diagnosis. But it can develop any time throughout treatment and survivorship.How do you keep a cancer patient happy? ›
- Listen without always feeling that you have to respond. ...
- Gear the conversation to your friend's attention span so they don't feel overwhelmed or guilty about not being able to talk.
- Help your friend focus on whatever brings out good feelings, such as sports, religion, travel, or pets.
- “Really you have cancer? ...
- "Just live in the moment."
- “I read about this new diet that cures cancer!”
- “I know you will get better!”
- “I know what you're going through. ...
- “I can't stop worrying about you.” Please don't add another burden to my already heavy heart!
without) a past cancer diagnosis would experience an increase in neuroticism, and decreases in conscientiousness, agreeableness, openness, and extraversion, and that changes in these traits would mediate the relationship between receiving a cancer diagnosis and change in depression.