Lung cancer: new weapons against an old foe
Approximately 1.8 million people develop lung cancer every year.1 Can new diagnostic tools deliver earlier diagnosis and smarter treatment choices?
Despite the best efforts of the medical community and researchers across the world, lung cancer has remained the most common and most deadly of all types of cancer globally, with three people dying of lung cancer every minute.2 This toll represents more deaths than prostate, colorectal and breast cancer combined and underlines that a greater focus on prevention, diagnosis and treatment of this devastating disease is urgently needed to help counter this burden.3
Turning the tide
The situation regarding lung cancer can appear grave. Outcomes have improved radically for many forms of the disease but lung cancer has long been synonymous with poor outcomes – only one in 10 people diagnosed with the disease are alive five years later.4
While early detection improves outcomes, symptoms usually do not appear until the disease is at an advanced stage.5 Tumours can mutate and spread, often causing irreparable damage before its victims are even aware that they are affected.
Is there a smart way to fight back against lung cancer? Thanks to promising advances in diagnostics and treatment, there is! Not only can doctors test for the presence of cancer, but they can figure out what ‘stage’ the disease is at. And, as science deepens our understanding of the disease, experts have found that knowing what type of cancer is present, can inform treatment decisions.6
“When it comes to diagnosis, an x-ray is often the first investigation performed. This can be followed up with a tissue biopsy and CT scan to see how far it has spread,” explains Dr Jesme Fox, Medical Director of The Roy Castle Lung Cancer Foundation, a lung cancer charity. “Using information from the staging, the biopsy and how well the patient is, doctors can decide on the best treatment.”
We have come a long way but more progress is needed in order to improve outcomes. The European Lung Foundation says innovative diagnostic tools are needed to facilitate targeted therapy. “Advances in tailoring chemotherapy to the type of lung cancer must be matched by the availability of diagnostic services for lung cancer phenotyping and genotyping,” the Foundation states in the European Lung White Book.7
By taking this ‘stratified medicine’ approach, doctors can choose surgery, radiotherapy or drug therapy based on the specific type of cancer identified in their patient. The challenge is diagnosing these mutations and diagnosing them early enough to intervene successfully.
The current gold standard for diagnosis is a tissue biopsy. This invasive procedure involves the surgical removal of lung tissue for lab analysis. Many patients find this to be painful or uncomfortable.8 In some cases, patients are too frail to endure surgical biopsy.
It can also be technically challenging. Sometimes insufficient tissue is excised and a subsequent biopsy is required. Tissue biopsies may also miss some mutations because tumours are not homogenous – the mutations present in one part of a tumour may be different to those found in another area of the tumour.
The limitations of surgical biopsies have led scientists to explore alternatives. Read more about “Lung cancer tests: 70 years of progress”.
1. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Last accessed October 2015 at http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.
2. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Last accessed October 2015 at http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Calculation: 1590000/(365*24*60)=3.
3. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Last accessed October 2015 at http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx