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Doctors stress screenings to find lung cancer early

Cancer screenings have dropped during the pandemic.
Published: Feb. 18, 2021 at 11:53 PM CST
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WICHITA, Kan. (KWCH) - Behind breast cancer, lung cancer is the second most common form of cancer.

The CDC reported last year an estimated 228,820 new cases.

The statistics might not sound great.

“Lung cancer is still the number one leading cause of cancer-related death in America,” said Ascension Via Christi Cancer Center Medical Director Dr. David Bryant, M.D.

Doctors who treat lung cancer say it’s not a reason to surrender.

“You should not give up because there are things to be done, even if it has spread,” said Central Care Cancer Center President and Radiation Oncologist Dr. Claudia Perez-Tamayo, M.D., FACR, FACRO.

Lung cancer is commonly associated with smoking but can also be caused by breathing in carcinogens or genetics.

Doctors said the first step for anyone at risk is screening.

Dr. Bryant said, “Current guidelines are if you are over and you’ve smoked about a pack a day for 20 years, that would be a good time or a good patient to screen, and a screen would be a low dose CT scan.”

President of the Central Care Cancer Center, Dr. Claudia Perez-Tamayo, said that early detection is critical.

Dr. Perez-Tamayo said, “They can pick up these cancers at stage one or stage two when they’re highly curable. It can only take a few weeks for them to go from highly curable to very poorly curable or not curable at all.”

Lung cancer is defined by two main types, small-cell and nonsmall-cell.

“Small-cell is exactly what it sounds like. Small-cell is small cells that look like oats. In fact, sometimes we call it oat-cell carcinoma. It behaves very differently than that of the non-small cell. It comes from a different embryologic tissue, so it behaves very, very differently. It is treated very, very differently. Surgery is not part of the role in the small cell.” Dr. Perez-Tamayo said, “Mostly it’s radiation and chemotherapy, and since it is so frequently involving the brain, we even give treatment to the brain before the cancer hits the brain.”

She added, “Nonsmall-cell can be several varieties, but the two most important ones are the adenocarcinoma, andeno meaning of the gland in the bronchial tree. Squamous carcinoma, which is also from your bronchial tree, but the cells are Squamous, which are flat.”

Dr. Perez-Tamayo said nonsmall-cell is usually linked to smoking, carcinogens and genetics.

Cancer is rated into four stages based on how far along the cancer is and the treatment strategy needed to respond.

“Most cancers are staged using the TNM system, and we combine those along with other prognosticator factors to come up with a stage, and we typically stage patients from stage one, which is an early-stage cancer, to stage four, which for the most part is metastatic cancer. Stage one cancer is where we can find it early, treat it aggressively and have a very high chance of curing that patient from their cancer.” Dr. Bryant said, “Whereas stage four is why more difficult to treat. It typically can lead to death in most patients, especially in lung cancer patients.”

Dr. Bryant said at Ascension, another strategy of identifying treatment is through genetic testing of the cancerous cells.

That’s why catching it early is so important, but Dr. Bryant said the number of people coming in for cancer screenings has dropped off during the pandemic.

Medical journals reporting rates of 50 to more than 80 percent declines for some cancers.

“The numbers are going down and also the number of cancer cases are going up, especially later-stage cancers. We really want to stress patients coming in for their annual screening,” said Dr. Bryant.

Dr. Perez-Tamayo said how cancer teams work to find the best treatment for patients is through tumor boards, with people of different specialties discuss a case to determine the best and most effective approach.

“Just like a war, you have to cover all bases.” Dr. Perez-Tamayo said, “You can’t say I’m just going to bring in the land troops and not fight the seas or the navel force or air force. Everybody has to come in.”

Technology and advancements in medicine are also playing a huge role in making treatments easier and less invasive.

At Ascension, Cyberknife is a robot that providers targeted radiation treatments to patients.

“Target the tumor while the patient is awake without anesthesia. They’re typically listening to music, and the robot will even move,” said Dr. Bryant.

He added, “We’re able to target the tumor and minimize the radiation to the surrounding tissues, and because of that, we’re also able to increase the amount of radiation so that our cancer control rates are typically above 90 percent.”

Nicknamed Emma, Cyberknife is a tool they’re continuing to study with other treatments to help get better outcomes for patients.

Dr. Bryant said, “Over 3,000 clinical trials ongoing to figure out the best way to treat lung cancer. We have 10 of those trials here.”

The doctors also said that the effectiveness of these treatments doesn’t decrease with a patient’s age. Still, additional considerations like other health conditions and medications could cause complications that have to be evaluated.

Dr. Perez-Tamayo said, “That’s one of the big debates. People sometimes want to be less aggressive about a cancer that may be curable because of your age, and I am one that doesn’t feel that way. I think you need to decide what are the pros and what are the cons. Definitely, even as an older adult, if you are still very functional, you have taken care of yourself, why not try the best. Now that there all these alternatives of not having to have thoracic surgery, you can get radiation, and it would be a matter of just a few treatments, and you could have a curative situation. Now, again, surgery is a very good way of treating. In fact, now that we do laparoscopic or robotically guided surgeries, the recovery time is in even a few hours or few days.”

Another positive sign doctors see, lung cancer deaths are on the decline as few people are smoking.

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