New cancer weapons: Blount Memorial breaking ground in lung cancer treatment, screening
By Wes Wade | (email@example.com)
While lung cancer continues to be the No. 1 killer in the country among the four most commonly diagnosed cancers, the Blount Memorial Cancer Center is breaking new ground in lung cancer services and screening techniques.
Physicians at Blount Memorial Hospital (BMH) also see more incidence rates of patients diagnosed with lung cancer in Blount County and the surrounding areas compared to the other three most commonly diagnosed cancers — breast, prostate and colon cancer.
The hospital’s cancer center has recently added both a new treatment option and early screening detection for lung cancer. Dr. Albert Petty, radiation oncologist and cancer center medical director, said these latest developments are particularly exciting, especially in an area of the country which sees both a high number of lung cancer patients and those at high risk for developing the disease.
In the Blount County area, more than one person dies each week from lung cancer, he said.
Petty explained that lung cancer is the No. 1 cause of cancer death for both men and women in the U.S., with 160,000 people in the country dying of the disease every year.
“It’s really the major source of mortality in this country,” Petty said.
Yet BMH did see a slight decline in lung cancer diagnoses from 2010 — 114 new patients — to 101 new patients in 2011. It’s a decline partially attributed to the fact that fewer people are smoking, Petty said.
Coupled with new treatment and early screening options, it could make for a promising trend in the cancer treatment field.
“I think there’s been a lot of progress, but it’s slow,” Petty said. “We’ve got a long way to go and I think we’ve made progress in many areas (of cancer treatment). But lung cancer is the biggest (hurdle).”
The problem, Petty said, is that lung cancer is not typically diagnosed until the disease has already progressed to a very late stage. And, unfortunately, the treatments currently available aren’t generally effective for curing patients when the cancer has progressed this far.
That’s where the early screenings, or the CT (computed tomography) scans, come into play. It’s the same thing as a CAT (computer axial tomography) scan, said BMH’s Dr. Paul Miller. Computers are used to x-ray a patient’s lungs, which allow physicians to better see smaller lesions and thus detect lung cancer at an earlier stage, Miller said.
While Miller explained that the technology is not new, the hospital is attempting to encourage those individuals who are at a high risk of developing lung cancer to get scanned. Petty said those most at risk are individuals between the ages of 55 and 74 who have smoked a pack of cigarettes a day for a 30-year period or two packs a day for 15 years. He added that heavy smokers who have quit within the last 15 years are also in the high-risk category.
The National Cancer Institute published a study in 2011 in which members of the medical community performed these CT scans on smokers or former smokers in an effort to detect lung cancer at an early stage. The trial resulted in a 20 percent reduction in the rate of lung cancer deaths among those scanned.
“That’s a huge decrease,” Petty said. “There’s not many chemotherapy treatments that meet that ... if we could do that, if we could screen people and translate that 20 percent drop in mortality, we could potentially save up to 30,000 people a year.”
The cancer center’s medical director said he believes that it’s particularly important to have those high-risk individuals in the Blount County area getting scans as the average number of smokers in the state is higher than the national average.
“It’s especially important here in Blount County that we go ahead and do this because the incidents of lung cancer deaths are higher in Tennessee,” Petty said.
The only downside is that insurance won’t currently cover this procedure. Petty said it’s his hope that will eventually change. But for now, the screening is self-pay and comes at a cost of $375. The upside, Petty added, is that if a patient is scanned and an abnormality is found, then that patient’s follow-up is typically covered by their insurance plan.
New surgery option
The Blount Memorial Cancer Center is also now offering a new radiation therapy for lung cancer patients who don’t qualify for surgery. This relatively new technique, developed within the last decade, is called Stereotactic Body Radiation Therapy (SBRT).
While radiation has long been used to treat lung cancer, Petty said what makes SBRT different is that it offers a very high dose of radiation in a much shorter amount of time.
For those with more advanced stages of lung cancer, standard radiation treatments can take between six to seven weeks, Petty said. SBRT can take as little as three to five treatments.
“We’re giving such a high dose of radiation to a tumor in such a short period of time that it basically destroys the tumor and a portion of tissue around it,” Petty said.
Published studies have shown that SBRT has been an effective treatment for patients with small lung cancers treated in the outer part of the lungs, typically patients that have been treated, unsuccessfully, with surgery or those who don’t qualify for surgery because of a certain condition, such as emphysema.
While those at the cancer center are not at the point of recommending SBRT to patients who do qualify for surgery, Petty said there are studies currently in progress comparing SBRT to surgery when it comes to treating certain cancers typically treated through standard surgical techniques. And current studies show that patients who have undergone SBRT treatment are coming out of the procedure with a large survival rate.
“The local control (group) shows that the success rate is 90 percent or better, which is very impressive,” Petty said. “It’s much better than standard radiation treatments we’ve used in the past. These are much smaller tumors, but the control is really good with this type of radiation.”
Petty said the hospital recently treated its first patient with SBRT and that while it’s hard to say how the patient’s recovery will progress over time, the individual tolerated the treatment very well.
The cancer center also launched its new patient navigator program in January, providing patients with a nurse who can walk them through the treatment and follow-up process. The center’s goal is to provide patients with the information they need about all the services and options available to them during the diagnosis, staging and treatment processes as well as someone to whom they can turn if they have any questions or concerns.
“We’ve always done this type of thing,” Petty said. “But this will be a more formal program. So we’ll start that with lung cancer patients and we’ll probably expand that to other types of cancer in the near future.”
The complementary survivorship plan, developed under the direction of the American College of Surgeons Commission on Cancer, is a written document patients receive at the end of their treatment. This plan details all the information about the patient’s cancer, including the type, stage and required treatment as well as specific recommendations for follow-up and long-term items to look for down the road.
“(It details) what short-term and long-term effects they may need to be on the lookout for,” Petty said. “Their primary care physician will also get a copy so they know what to look for in the future. So we think that will be a very helpful program as well.”