The New Lung Cancer Treatments Available for Patients
- TV presenter John Stossel was diagnosed with lung cancer back in 2016 and underwent surgery remove it. Stossel thankfully didn’t further treatment for the disease, which he credits his “overanxious wife” for leading to him to detecting it early on, and he returned to work soon.
- Lung cancer doesn’t cause symptoms until it has already spread outside the lungs, making it harder to catch in its early stages. It predominantly impacts people with a history of smoking, although this cancer can also impact non-smokers.
- Lung cancer screening is painless and lasts only a few minutes. It involves using a low-dose computed tomography (LDCT). While lying on a table, an X-ray will scan your lungs for anything unusual, such as a shadow over the lungs.
- Treating lung cancer depends on the cancer’s location and how advanced it is. Treatment options include surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of any of these treatments. In recent years new Food and Drug Administration-approved drugs have improved the prognosis for lung cancer patients.
- Many of the new lung cancer drugs come with manageable side effects that range from diarrhea to fatigue or fever. Your doctor will help you with resources to mitigate many of these potential side effects.
Consumer journalist and TV presenter John Stossel, 77, recovered well and quickly returned to the spotlight after being diagnosed with lung cancer, a disease he credits his "overanxious wife" for leading to him detecting it early on. Stossel, known for his work hosting on popular networks like ABC News, Fox Business Network, and Reason TV, revealed in an opinion piece for Fox News that he was diagnosed with lung cancer in April 2016, a disease he ultimately beat by having surgery to remove part of his lung.
Lung Cancer: Treatment He
wrote , "I write this from the hospital. Seems I have lung cancer. My doctors tell me my growth was caught early and I'll be fine. Soon I will barely notice that a fifth of my lung is gone. "I believe them. After all, I'm at New York-Presbyterian Hospital. U.S. News & World Report ranked it No. 1 in New York. I get excellent medical care here." He recounted getting "X-rays, EKG tests, echocardiograms, [and] blood tests," prior to undergoing surgery to remove the cancer. Stossel credits his wife for urging him to seek medical advice when he suffered from a cough. Speaking to
TVNewser in an interview from the year he was diagnosed, Stossel admitted his wife was "overanxious that I get a CAT scan for a cough" despite the cough having "had nothing to do with what they found." As per the news outlet, doctors found a cancerous growth in his lung, removed it via surgery, and left him feeling "90 percent" recovered without needing chemotherapy or radiation. Shortly after his hospital stay he returned to work. https://twitter.com/JohnStossel/status/730828176692142080?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E730828176692142080%7Ctwgr%5E560ec3df0466ef5926dcc5fd8ffdff8e13f9058e%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.adweek.com%2Ftvnewser%2Fjohn-stossel-credits-his-overanxious-wife-for-early-discovery-of-cancer%2F It's important to note that Stossel has never smoked in his life. Although non-smokers can still be diagnosed with lung cancer, the American Cancer Society advises yearly lung cancer screenings with a low-dose CT (LDCT) scan for anyone between the age of 50 to 80 who have either smoked, or used to smoke, or have a 20 pack-year history of smoking.
RELATED: If You Smoke a Pack a Day, Lung Cancer Screening Should Start at Age 50 & Be Free, Say New Federal Recommendations Additionally, nonsmokers may get lung cancer through the following environmental factors: Radon gas exposure, secondhand smoke, air pollution, and by cancer-causing agents in a workplace, for example diesel exhaust, asbestos, or heavy metals.
Lung cancer in smokers vs. nonsmokers Treating Lung Cancer with Surgery
John Stossel underwent surgery to remove one-fifth of his lung, something which successfully removed the cancer as doctor's discovered the disease ealy on. SurvivorNet previously spoke with some leading surgeons in the country to help explain the options for lung cancer surgery.
RELATED: Do You Need Some Motivation To Quit Smoking? Smokers Who Quit By 45 Reduce Their Excess Lung Cancer Risk by 87%, Research Shows There are several types of surgery for lung cancer, and the decision about which is best is based largely on the
location of your cancer, its size and whether it has started to spread. A wedge resection is an option if the tumor is small and located on the outside of the lung. In this procedure, your surgeon removes a piece of the lung (in the shape of a wedge) and lung function is not affected. By contrast, a lobectomy or a segmentectomy involves the removal of a certain segment of the lung (a lobe). During a pneumonectomy, however, the entire lung is removed.
Surgical Options for Lung Cancer There are several different ways to do lung cancer surgery. The standard operation used to be open surgery with a big incision in the chest and then spreading apart the ribs. However, due to pain after the operation and the lengthy recovery time, doctors are increasingly using less invasive operations including minimally invasive video-assisted thoracoscopic surgery (VATS) and robotic techniques. Your surgeon will go over all of these options with you when planning your treatment.
How to Choose a Surgeon — Does Volume Matter? Healing from Lung Cancer
For those who are fortunate enough to be able to have surgery, like Stossel, managing pain after the operation can be difficult once you get home. SurvivorNet previously spoke with
Melissa Culligan , Director of Clinical Research – Division of Thoracic Surgery at University of Maryland Medical Center, who has been taking care of lung cancer patients for 30 years. Culligan expressed how crucial it is to stay in touch with your medical team. “It’s important that you stay connected and as things change that maybe don’t feel right, that you connect with your care team and make sure that either they do something to make you feel better or that they reassure you that this is to be expected,” she said, “because your pain will change in location and nature,” Culligan added.
Managing discomfort after lung cancer surgery As you become more active, Culligan says your pain “may increase a little bit."
Advancements in Treatment for Lung Cancer
However, surgery is not the only way to treat this disease. When it comes to lung cancer, it can be particularly tricky to treat because symptoms tend to show once the cancer has reached later stages and metastasized or spread to other organs. There are two main types of lung cancer, which doctors group together based on how they act and how they're treated:
- Non-small cell lung cancer (NSCLC) is the most common type and makes up about 85% of cases.
- Small cell lung cancer (SCLC) is less common, but it tends to grow faster than NSCLC and is treated very differently.
Smoking is the main risk factor for lung cancer although non-smokers, like Stossel, can still get the disease. Medical oncologist at Cedars-Sinai Medical Center
Dr. Ronald Natale explains to
SurvivorNet that oral medicines are available to help lung cancer patients who don't smoke. "Among patients who are nonsmokers, or former very light smokers, we identify a mutation that we can target with pills in about 60% to 70% of them," Dr. Natale said.
WATCH: Lung Cancer in Smokers vs. Non-Smokers Treatment options for lung cancer depend on the type of lung cancer you're diagnosed with. Surgery has been the go-to treatment for early-stage lung cancer. Surgery is sometimes combined with chemotherapy before or after surgery. However, immunotherapy and targeted therapy are becoming more important players when it comes to lung cancer treatment. Immunotherapy uses your own immune system to recognize and target cancer cells. Doctors can use internal mechanisms like the body's proteins, white blood cells, tissues, and organs, or external mechanisms by synthesizing molecules in the lab. "Using a patient's own immune cells is a very complex way to treat a cancer," says Dr. Steven Rosenberg, Chief of Surgery at the National Cancer Institute and a pioneer in immunotherapy research and treatment.
Helping Patients Cope with Lung Cancer Diagnosis
Generally, targeted and immunotherapies can include one of the following forms:
- Small molecules: These can enter cells effortlessly, so they are utilized for intracellular targeting.
- Monoclonal antibodies: These are proteins synthesized in the lab. Some of these monoclonal antibodies are made to mark cancer cells to be recognized by the immune system and destroyed, others can stop cancer cells from growing or cause them to self-destruct. These antibodies can also be loaded with toxic drugs to directly project them into cancer cells. This last form is called an antibody-drug conjugate and there have been many new advancements with this type of therapy.
When using immunotherapy for early-stage lung cancer checkpoint inhibitors are usually part of the treatment. The treatment works like this:
- Checkpoints are proteins on the surface of T-cells, a type of immune cell. T-cells attack harmful substances such as bacteria, viruses, and cancer cells. PD-1 is an example of a checkpoint.
- Lung cancer cells have their own protein, PD-L1, that activates PD-1 and tells the T cell to ignore them. You can think of PD-L1 as a cloak that hides the cancer cell from the immune system.
- The interaction between PD-1 and PD-L1 is like a switch that shuts off the immune response.
- Immunotherapy drugs called PD-1 and PD-L1 inhibitors flip the switch. They block these proteins to switch the immune response back on so that your immune system can kill the cancer cells.
Several immunotherapy drugs have been approved by the Food and Drug Administration (FDA) over the last few years to improve the prognosis for patients.
- Nivolumab (brand name Opdivo) can be combined with chemotherapy to shrink the cancer before surgery.
- Atezolizumab (brand name Tecentriq) may be used after surgery and with chemotherapy to destroy any cancer cells left behind.
- Pembrolizumab (Keytruda) or cemiplimab (brand name Libtayo) might be the first treatment you get if you aren't a good candidate for surgery, radiation, or chemotherapy, or if the cancer has spread.
- Durvalumab (brand name Imfinzi) can control the cancer's growth after you've had chemotherapy plus radiation.
When using targeted therapy drugs, they work by identifying specific markers on tumor cells. These markers allow doctors to target specific cancers with drugs or other treatments designed to attack them. Targeted therapy can also minimize side effects, increase efficacy, and improve survival rates. Currently, researchers have successfully produced many non-small cell lung cancer-targeted drugs that are specific for changes in genes and proteins found within cancer cells. They include drugs that target:
- Blood vessel growth (also known as the angiogenesis process)
- KRAS gene mutations
- EGFR mutations
- ALK gene mutations
- ROS1 gene mutations
- BRAF gene mutations
One example of a targeted therapy drug designed to target the EGFR mutation is osimertinib (brand name
Tagrisso ). This drug has been approved for early-stage NSCLC with EGFR mutations, and a new study revealed how well it can help patients. The study from lead author Roy Herbst, deputy director and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, showed that the risk of death was cut in half for patients with non-small cell lung cancer that can be removed with surgery and have the EGFR mutation. This new data shows that Tagrisso can help extend and improve the lives of patients living with the disease. Although lung cancer tends to return after being treated, these new treatment options give hope to patients fighting to keep the cancer at bay.
Contributing: SurvivorNet Staff 
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