Experts on Lung Cancer: Latest on Symptoms, Screenings and Multidisciplinary Treatments

What is well established regarding lung cancer is this: About 80 percent of cases are linked to smoking — including both current and former smokers. The roughly 20 percent of cases among non- or never-smokers is a bit of a mystery, but growing evidence seems to point to a genetic disposition to lung cancer.

While a majority of lung cancer cases are still caught in later stages, treatment has evolved to a point where more lives are being extended or saved. That’s in large part due to a multidisciplinary approach to each individual lung cancer case, explains Federico Albrecht, M.D., medical oncologist with Miami Cancer Institute.

“We believe that a patient with lung cancer should be approached in a comprehensive perspective, involving different specialties including medical oncology, thoracic surgery, radiation, neuro-oncology and many others,” explains Dr. Albrecht.

In observance of Lung Cancer Awareness Month, host Jonathan Fialkow, M.D., deputy medical director and chief of cardiology at Miami Cardiac & Vascular Institute, gathered a panel of experts for a Baptist HealthTalk podcast on the latest data regarding symptoms, treatments and screenings. Lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women — not counting skin cancer.

Joining Dr. Albrecht was Brenda Gonzalez, M.D., pulmonologist and vice-president of the medical staff at Doctors Hospital, and Lori Adelson, workplace counsel and board member of the American Lung Association.

“Unfortunately, at early stages of lung cancer patients are frequently asymptomatic,” said Dr. Gonzalez. “Symptoms become more frequent as the cancer becomes more advanced. Sixty to 70 percent of lung cancer patients are not diagnosed until the cancer is advanced.”

For Dr. Gonzalez and Ms. Adelson, the topic of lung cancer is also a personal one. Dr. Gonzalez said her uncle died of lung cancer at the age of 40. Ms. Adelson’s mother, a non-smoker, was diagnosed at 70.

Here are some excerpts from the podcast, which can be heard in its entirety here:

Can you elaborate on the multidisciplinary approach to treating lung cancer patients?

Dr. Albrecht:

“The team approach … is the best way to treat a patient and provide the individualized treatment. At the beginning, we analyze the extent of the tumor. And then we define the staging, and then we can ask if the tumor can have a minimally invasive surgery, or could it be resected surgically. We have a team of experts in robotic surgery here that has actually improved the recovery of these lung cancer patients. So, that is an important method and approach.

“If the tumor cannot be removed surgically, then we discuss different options like adding radiation therapy. Here, at Miami Cancer Institute, we have available a full spectrum of techniques in radiation therapy.”

What is the typical presentation of lung cancer cases that you see?

Dr. Gonzalez:

“Symptoms become more frequent as the cancer becomes more advanced. That was the case of my uncle who passed at the age of 40 with lung cancer. He was diagnosed at very advanced stage. About 60 to 70 percent of lung cancer patients are not diagnosed until cancer is advanced. The most common symptoms that patients can present are cough, coughing up blood, shortness of breath and chest pain.

“So, any patient with risk factors, especially former smokers or smokers who present with cough and other symptoms, should trigger an evaluation for lung cancer. And, obviously, as the lung cancer progresses and spreads to other areas of the body, a patient can have other symptoms, especially if it has spread to their brain, liver, bone …”

Tell us about raising awareness about lung cancer and importance of screenings?

Ms. Adelson:

“My mother at the time was diagnosed with stage-two lung cancer. She had been diagnosed through a mammogram. Her OB-GYN had taken her routine exam and saw a spot on her lungs. So, notwithstanding the fact that it wasn’t an actual lung scan, she was saved by the scan. And, fortunately, she caught it at an earlier stage. Unfortunately for us, she still only had a five- to seven-year prognosis.

“So, most importantly, I raise awareness by sharing my story. So, I feel that no person facing lung cancer should go through it alone. And I really hope that this conversation motivates people to listen to their bodies, advocate for themselves and their loved ones, and talk to their physicians about getting lung cancer screening.”