The State of the Fight: Lung Cancerby Eric Alejandro Sweet-Cordero, M.D.
Lung cancer is the most frequent cause of cancer-associated death in the world. In the United States, about 160,000 people die from this disease every year. It may comes as a surprise to some that lung cancer is actually more common in women than breast cancer.
There are two forms of lung cancer: small cell lung cancer and non-small cell lung cancer (NSCLC). The most common form is NSCLC, which is often seen in people with a history of smoking, even if they have not smoked for many years. It can also be seen in people who have never smoked at all. This type of cancer can be cured if it is detected early, but unfortunately, in most patients, it is caught too late. The three main types of NSCLC include squamous cell carcinoma, large cell carcinoma and adenocarcinoma, which is the most common.
Small cell lung cancer, on the other hand, is the most aggressive type of lung cancer, because it often spreads very quickly. It affects approximately 15% of lung cancer patients and is mainly found in smokers. It is also classified into two different types, small cell carcinoma and combined small cell carcinoma. This type of cancer occurs when malignant cancer cells form within the tissues of the lung.
Most people think that if they do not smoke, they cannot get lung cancer. This is definitely not the case. Anyone with symptoms of a chronic cough, difficulty breathing, chest discomfort, wheezing, hoarseness, blood in sputum, loss of appetite or weight loss should be evaluated by a doctor to make sure they do not have lung cancer.
Secondhand smoke exposure also puts you at risk for lung cancer and is the third leading cause of preventable death in the United States. Other risk factors for lung cancer are asbestos (which causes a specific form of lung cancer called mesothelioma), radon exposure, and exposure to soot, tar or air pollution.
During the last 20 years, there have been some major advances in lung cancer treatment, including the discovery of certain forms of lung cancer that carry mutations for which we have drugs. For example, some NSCLC patients carry mutations in a gene called the epidermal growth factor receptor, for which there are specific inhibitors.
Lung cancer is certainly a very promising area of research and one I began studying after working as a pediatric resident. While taking care of children with cancer, I became amazed that in the clinic, most of the advances in our molecular understanding of cancer were not being applied. We were (and are) still treating cancer with 20- or 30-year-old drugs. There is a disconnect, which stems from how hard it is to transfer what we learn in a lab to the clinical care of patients. I decided I wanted to be involved in trying to change this.
My SU2C Innovative Research Grant enables me to find ways to make chemotherapy more effective against NSCLC. Other investigators have tried to do this using established “cell lines,” which are cells that were isolated from patients many years ago and have been grown in tissue cultures. Our approach is to develop a way to isolate tumor cells directly from live tumors to develop screens that will help us find ways to make chemotherapy work better.
Already, we have found a connection between molecular mechanisms that allow normal stem cells to grow and mechanisms that allow tumor cells to grow. This is very exciting, and further experiments are being done to test whether this could lead to a new therapy for lung cancer.
The hope is that the new treatments we find for lung cancer may actually work for other cancers as well.
Our research is still in the early stages, but we are hopeful that we will be able to find new targets for therapy that will make a difference for this disease. In the meantime, my words of wisdom are: If you smoke — stop. If you do not smoke, do not start. And please do all you can to keep smoke away from children and to educate others about the risks.