November is Lung Cancer Awareness Month – approximately 235,000 new cases of lung cancer and 125,000 deaths are expected to occur this year in the US.
Dr. Daniel Sterman, director of the division of pulmonary, critical care and sleep medicine at NYU Langone Health and NYU Grossman School of Medicine, spoke with us about the risk factors and symptoms of lung cancer and the future of lung cancer treatments.
He also warned that it’s not just smokers who can develop the disease – and switching to vaping may not reduce your risk.
Who is most at risk of lung cancer?
Patients at greatest risk for lung cancer are those with a history of substantial smoking—the equivalent of one pack of cigarettes a day for 20 years—and are either active smokers or have quit within the past 15 years.
Are there symptoms to watch out for? When should I talk to my doctor?
Most cases of early lung cancer have no symptoms, but if you have a cough that won’t go away, unexplained chest pain that persists, or a cough that produces mucus with blood in it, you should be evaluated.
How does lung cancer screening work?
Screening for lung cancer can save lives. It’s done through what’s called a low-dose chest CT, which takes about two minutes. It’s a low dose of radiation — about the same as four chest X-rays — and should happen every year. According to research done by the National Cancer Institute, annual lung cancer screening has been found to reduce mortality among smokers by 20%.
It is important to note that CT scans are very sensitive and, in some cases, can pick up “false positives” – abnormalities in the lungs, including small lesions or small lymph nodes, that are not cancer and unlikely to be sometimes cause any problems.
If one of these abnormalities is found, you may need a follow-up CT scan, a biopsy, or another procedure. Any findings from your scan are communicated to your doctor, who will work with you to determine the appropriate next steps. In most cases, the cancer is not found. To avoid unnecessary tests or procedures, it is important to screen only people who have an increased risk of lung cancer.
Our program, which is part of the Perlmutter Cancer Center, provides lung cancer screening for people at risk. The NYU Langone Lung Cancer Screening Program is a collaboration of our experts in pulmonary medicine, thoracic oncology, thoracic radiology, and thoracic surgery.
How common is it for non-smokers to develop lung cancer?
It is not that common for people with no history of smoking to develop lung cancer, but unfortunately, it is much more common for non-smoking women to develop lung cancer than for men.
It is not entirely clear why this is so, but approximately 20% of all new cases of lung cancer in the US are women who have no history of smoking or minimal smoking in the past. We need to find out more about why this is the case.
Does switching from cigarettes to vaping or e-cigarettes reduce a person’s risk of lung cancer?
We do not know whether switching from tobacco cigarettes to e-cigarettes or vaping has any significant impact on lung cancer risk.
There was a study from South Korea that was presented at the American Thoracic Society last May in which switching from tobacco cigarettes to e-cigarettes in South Korea actually appeared to increase the risk of developing lung cancer.
Much more needs to be learned and studied, and frankly, we don’t know the long-term effects of vaping or e-cigarettes.
What is the risk of lung cancer with marijuana use?
We don’t know if marijuana increases the risk of lung cancer, and among the things that need to be studied is a combination of marijuana and smoking, which is quite common, especially among young people.
So what are the chances of beating lung cancer?
The chances of beating lung cancer are better and better with time. We have had tremendous revolutions in the development of lung cancer treatments, including robotic surgery to remove early-stage lung cancer, which is now becoming almost an outpatient procedure.
New immunotherapies, in combination with chemotherapy and occasionally with surgery, can treat locally advanced lung cancer.
New therapies can specifically target, like key and lock, specific mutations that cause lung cancer, dramatically extending the lives of patients even with metastatic lung cancer. We are turning lung cancer from a death sentence to a livable disease.
We look forward to many more interventions that will benefit patients in the future.
Dr. Daniel Sterman is director of the division of Pulmonary, Critical Care & Sleep Medicine at NYU Langone Health. He is also the Thomas and Suzanne Murphy Professor of Pulmonary Medicine and Critical Care at NYU’s Grossman School of Medicine and director of the Pulmonary Oncology Program. He specializes in interventional pulmonology and treats people who have cancer and benign disorders of the lungs and lung membranes.
NYU Langone Health’s pulmonology and lung surgery services were recently ranked no. 1 in the country in US News & World Report’s “Best Hospitals” ranking.
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