When Dr. Suresh Ramalingam first became an oncologist in the early 2000s, he delivered a lot of bad news to stage 4 lung cancer patients. On average, they could expect to live less than a year, eight months on average.
But remarkable medical advances in recent years have paved the way for dramatic improvements in life expectancy and quality of life.
Cancer deaths are rapidly declining, and progress in lung cancer treatment is helping lead the way, according to a new report released Wednesday by the American Cancer Society.
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in mortality ever reported, according to the American Cancer Society latest statistics published Wednesday in CA: Cancer Journal for Clinicians.
Experts say more people are surviving lung cancer, the leading cause of cancer deaths, because of a combination of improved therapies, falling smoking rates and earlier detection.
“It’s night and day,” said Ramalingam, a renowned lung cancer physician-investigator and deputy director of Emory University’s Winship Cancer Institute. “I now go into patients’ rooms these days with a lot of optimism that more and more patients will be around for many years. We talk about vacations, about their lives.”
In addition to strides against lung cancer, there has been a dramatic decline in deaths from melanoma, with an average 7% drop in the rate each year from 2013 to 2017. Also decreasing are deaths from colon, breast and prostate cancers.
Still, in Georgia this year, an estimated 17,990 people will die from cancer, and there will be 55,190 new diagnoses.
The U.S. cancer incidence rate was 448.5 per 100,000 people from 2012-2016. In Georgia, the rate is slightly higher at 466.4 per 100,000 for the same time period. The death rate nationally was 158.2 per 100,000 people. In Georgia, it was 162.6.
Across the nation this year, an estimated 135,720 will die of lung cancer. In Georgia, it is estimated 4,210 people will die of the disease in 2020 — about as many as colon, breast and prostate cancers combined. As many as 20% of people who die from lung cancer in the United States every year have never smoked or used any other form of tobacco.
Lung cancer has been difficult to treat and, a decade ago, few options were available besides radiation and chemotherapy, with modest effectiveness.
Promising advances include immunotherapy, in which the patient’s immune system is reactivated to attack the disease, and targeted therapies determined after an analysis of the genetic makeup of a patient’s tumors. There are also improved, more precise and less invasive surgical techniques. Better screening that involves a low-dose CT scan can also help find lung cancer in early stages.
Yet these new treatments have their limitations. Immunotherapy drugs are only effective in about 20% of patients with lung cancer and can have severe side effects. Similarly, targeted therapies are relevant for just a fraction of lung cancers, and tumor cells can become drug resistant.
The National Cancer Institute recently awarded the Winship Cancer Institute a five-year, $9.7 million Lung Cancer Specialized Program of Research Excellence grant aimed at making the new treatments available to a larger number of patients.
And last year, The National Cancer Institute renewed a six-year, $11 million grant to Northside Hospital to enroll more Georgians in clinical trials that include development of targeted therapies for lung cancer. Northside also has expanded access to screenings and early detection of lung, breast, prostate, and skin cancer.
Erica Aronin credits her survival to early detection of a rare form in lung cancer and good medical care. The Sandy Springs woman, who is 58, was diagnosed during a routine physical that included an X-ray followed by a CAT scan. Half of her lung was removed, and she underwent chemotherapy. She’s since had a recurrence and was treated with radiation. But Aronin said she’s doing well, back to playing tennis and hopeful about her future.
When she asked her doctor, Ramalingam, about the five-year-survival rate, he told her the odds are constantly changing and improving.
“He basically told me I can’t go by that anymore because there are new therapies every day,” Aronin said. “Just knowing there’s a plan B, and my doctor has a plan B in his back pocket, puts me at ease.”
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