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| SUNDAY, MAY 22, 2022
Lung Cancer Just because you don’t smoke does not mean you can’t get lung cancer.
(PHOTO COURTESY OF ISTOCK)
By CORI URBAN
Special To The Republican
Second-hand smoke, radon, family history and occupational exposures to such things as asbestos can also cause lung cancer. According to the Centers for Disease Control and Prevention, cigarette smoking is the number-one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80 to 90 percent of lung cancer deaths. Using other tobacco products such as cigars or pipes also increases the risk for lung cancer, which is the leading cause of cancer deaths for both men and women worldwide. Nearly 160,000 Americans die of lung cancer each year. “Oftentimes, the first thing someone asks when they find out someone is diagnosed with lung cancer is, ‘Did they smoke?’ While usually asked out of genuine curiosity, it implies that if the answer is ‘yes’ that the patient is at fault for their diagnosis,” said Ashley LeBlanc, RN, Nurse Practice Manager for Thoracic Surgery and Nursing Director of the Lung Cancer Screening Program, at Mercy Medical Center. “The number of lung cancer patients that are non-smokers/never smokers is increasing annually and is currently about 15-20 percent. The amount of guilt and pressure this puts on current/former smokers is significant.” Lung cancers usually are grouped into two main types called small cell and nonsmall cell (including adenocarcinoma and squamous cell carcinoma). These types of lung cancer grow differently and are treated differently. “Typically, non-small cell lung cancer is slightly less aggressive than small-cell lung cancer and is treated with surgery at early stages while SCLC is usually not treated with surgery (chemotherapy and radiation),” explained Laki Rousou, M.D., Chief of Thoracic Surgery, Chief of
Robotic Surgery, and Medical Director of the Lung Cancer Screening Program, at Mercy Medical Center. SCLC also tends to grow near the center of the chest and often affects the lymph nodes. Donna M. Cheria, 62, of Ludlow, was diagnosed with lung cancer in 2018 after suffering with a mild cough and being sent to Mercy Medical Center for a chest X-ray. “The diagnosis changed my life because I started smoking very young, at 16,” she said. “Dr. Rousou was amazing with me and my family. I had great trust in him, and I understood everything that was going on.” She has followed up faithfully with appointments and X-rays every year for four
• Are between 50 and 80 years old
chemotherapy/immunotherapy all in the Sister Caritas Cancer Center,” Rousou said. • Are currently a smoker or About 200 patients are have quit within the past treated there each year. No lung transplants are 15 years done there. “No one deserves lung • Smoked an average of cancer. What I try to explain one pack of cigarettes to patients is that while having a day for 20 years a history of tobacco abuse is indisputably a risk factor, it Studies have shown that is only that — something in such lung screening can lower their history that increases the risk of death from lung the possibility that they may cancer by 20 percent in peodevelop lung cancer,” LeBlanc ple who are at high risk. said. “This does not guarantee a definitive diagnosis. We Trinity Health Of New England and Mercy Medical screen patients who grew up Center offer cutting edge, on a tobacco farm, have been smoking for as long as they comprehensive and multidisciplinary lung cancer care. can remember and have a “We have a robust screening pack year total that exceeds
diagnosed with lung cancer.” Lung cancer usually does not have any symptoms, especially in early stage disease, explained Rousou, who earned a medical degree at Boston University School of Medicine. “Symptoms that one might have are either very nonspecific (fatigue, cough, fever) or an indication of late-stage disease (chest-wall pain, unintentional weight loss, coughing up blood). The absence of specific symptoms especially for early-stage lung cancer is precisely what makes lung cancer screening so essential because early-stage lung cancer has a relatively high cure rate.” Smoking cessation is the best way to reduce risk of
lung cancer incidence and should be the mainstay of public health initiatives,” Rousou said, adding that there is no evidence that any one type of food increases the risk of lung cancer. “There is some evidence that a diet rich in fruits and vegetables can decrease your risk of developing lung cancer, but more research needs to be done. In general, I recommend eating a healthy diet rich in fruits and vegetables and low in processed sugars to reduce overall cancer risk and maintain a healthy lifestyle/weight.” The risk of developing lung cancer increases with age regardless of smoking. “That rate of increase in risk increases much faster in smokers than nonsmokers. Stopping smoking slows that rate of rise in risk. This is just one of the many benefits of smoking cessation,” the doctor said. There are many new tools for the diagnosis, staging, localization, risk stratification and treatment of lung cancer that are being used now at Mercy Medical Center. “New targeted therapies (immunotherapy) are being used now, and new drugs are being developed seemingly by the month,” Rousou explained. “These drugs target specific ‘markers’ that can be identified on the tumors. Until recently, they were used in stage 4 disease, but now these are often used as an adjunct or replacement for our current therapies.” The doctor recalled a patient from about six years Left: Laki Rousou, M.D., Chief of Thoracic Surgery, Chief of Robotic Surgery, and Medical Director of the Lung Cancer Screening ago who was diagnosed with Program, with the da Vinci Surgical System at Mercy Medical Center. Stage 4 lung cancer. “TestRight: Ashley LeBlanc, RN, Nurse Practice Manager for Thoracic Surgery and Nursing Director of the Lung Cancer Screening ing the tumors for ‘markers,’ Program (right), and Johanna Orsolino, Program Coordinator (left), review a patient file at Mercy Medical Center. there was a match to a specific (PHOTOS COURTESY OF MERCY MEDICAL CENTER) treatment for that cancer (immunotherapy). He is still alive today, working and functionyears and appreciates the care program, technology for the 100 whose screenings do developing lung cancer. accurate diagnosis and stagshe has received. not come back suspicious for Radon testing and abatement, ing at a high level with this treatment. On surveillance Persons may qualify for a if necessary, can also reduce ing of lung cancer (Illumisite lung cancer. We also screen – Navigational Bronchoscopy patients who meet the minilow-dose CT lung screening risk of developing lung cancer. imaging tests, there is very and Endobronchial Ultraminimal tumor burden if any. at the Sister Caritas Cancer mum recommendations for “Primary prevention (stopCenter at Mercy Medical Cen- sound), robotic surgical rescreening, having quit smok- ping young people from start- A story like that was unheard ter if they meet the following section, stereotactic radiation ing 14 years ago and only have ing smoking in the first place) of 10 years ago,” Rousou said. criteria: and radiation treatments and a 20-pack year total who are remains crucial to decreasing