Danger in the Air: How to Protect Yourself from Lung Cancer
Diagnosing and Treating Lung CancerDifficult to Diagnose
In the summer of 2007, Laura McCracken of Dallas was at the gym doing chest presses when she first noticed a dull ache in her chest that felt as if she had pulled a muscle. "I thought I had overdone it," Laura, 35, says. She went to an orthopedic surgeon when the pain wouldn't go away. He took a chest X-ray and sent her home with pain medication for what he suspected was bruised cartilage. With the ache still nagging about two months later, she went to her internist, who refilled the painkiller prescription. But by December, Laura was feeling stabbing pain near her rib cage; her chest hurt when she lay down at night and her left shoulder was sore after working long hours at the computer. Two weeks before Christmas, she was in a hospital emergency room with a diagnosis of lung cancer, which had spread to her lymph nodes and bloodstream. "I had tried to excuse the pain away, saying, 'Oh, it will get better,'" Laura says. "But I should have insisted to my doctors that something was wrong."
Diagnosing lung cancer is tricky, because the lungs don't have sensory nerves. You can't feel a tumor growing in them until it is large enough to press on the airways or another organ and cause the typical signs: chest pain, a sudden cough that won't go away, coughing up blood, wheezing, or hoarseness. Because these symptoms are similar to those of illnesses like bronchitis and pneumonia, doctors may first suspect such infections in a young woman who has never smoked.
Some women, like Kathy and Emily, don't notice symptoms until cancer has spread from their lungs to other parts of the body, which gives it a stage IV classification and a dismal prognosis: More than 95 percent of stage IV lung cancer patients die within five years of diagnosis.A Brighter Future?
Fortunately, a number of young, never-smoking women with lung cancer are starting to live longer, thanks to recent advances in lung cancer medicines. Some women are eligible for targeted-therapy drugs, which block chemicals that signal the cancer cells to grow and divide. Taken daily, these medications have fewer side effects and better results than traditional chemotherapy: In one study, a targeted-therapy drug shrank lung tumors in 74 percent of patients, while chemo had the same effect in only 31 percent. Apart from having skin rashes and nausea, Laura feels somewhat like her old self after being on a targeted-therapy drug for more than four years. She has taken up cycling again, riding 10 miles whenever the weather is nice and going to the gym for Spinning classes. Yet she knows she's beating the odds: Most lung cancers develop a resistance to the drugs within a year. "You never know when it's going to return," she says.
While some scientists are working to develop second- and third-generation drugs to battle resistance, other researchers are pushing for advances in early detection. Because CT scans may lead to unnecessary, invasive procedures in which doctors feel obligated to biopsy any small nodules the scan picks up, the current screening protocol is to give the scans only to high-risk patients, like 30-year pack-a-day smokers. "There are several blood and breath tests being developed for early detection of lung cancer, and I hope in the next five years we'll have one that works," Dr. Baik says.
In Kathy's case, a monthly 45-minute blast of chemotherapy had stopped her lung cancer from growing for two years. But after a setback in June -- when a PET scan revealed that the cancer had spread to her lower spine and right hip -- she started a clinical trial for a new immunotherapy drug, which uses an antibody to boost her immune system so that it will attack the tumors. The medicine leaves her tired, but the eight exercise classes she teaches every week keep her feeling positive, strong, and healthy. Many of her students have no idea she is sick. "I'm not the stereotypical person you think of as having lung cancer," she says. "But it can get anybody."
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