For Dignity Health Hello healthy podcast, Eric Peck, MDcardiothoracic surgeon with Dignity Health Medical Group — Bakersfield discusses recent research that explains the increase in lung cancer in women under 50 and the surgical treatment options available for lung cancer patients. Read the interview transcript below.
Listen to the podcast episode >
Caitlin Whyte (host): In recent years, research has shown that lung cancer rates have increased sharply among women. A recent study from the American Cancer Society found that women ages 35 to 54 are diagnosed with lung cancer at higher rates than men in the same age group. Dignity Health Medical Group cardiothoracic surgeon Dr. Eric Peck joins us today to discuss this new research and surgical treatment options for lung cancer patients.
Well, doctor, let’s talk about this lung cancer research study. Can you briefly tell us what the evidence suggests?
Eric Peck, MD: Well, yes, I would first like to clarify that I think it’s not very well understood that lung cancer is actually the leading cause of cancer deaths in both men and women. Even for women, something like breast cancer isn’t the leading cause of death, it’s actually lung cancer. So I think it’s important to start with that.
In fact, every day, hundreds of women die from lung cancer across the country. This particular study demonstrated that there is a higher rate of lung cancer in women aged 35 to 54, which is a new finding. We’ve never seen this before. And in fact, 15 to 20 percent of women with lung cancer have never smoked, which is another interesting finding. So that’s really the purpose of this study.
So, what are the most common misconceptions about lung cancer?
Eric Peck, MD: Well, I think again, first of all, I don’t think a lot of people understand that it’s the number one cause of cancer death, and so I think that needs to be brought to the forefront of the mind from everyone. Um, I also think because of that, there’s not as much money going into lung cancer research as there is for other types of cancer, and so I think the more public awareness there will be to that, I hope we can get increased funding. so that we learn more about some of these things that we notice in studies.
And finally, I would also like to say that I think a lot of people assume that you have to be a smoker to get lung cancer, and in fact, what this study and many other studies have shown is that people who don’t. Not smoking can also cause lung cancer.
Are there any possible explanations for this, if people get cancer without smoking?
Eric Peck, MD: There are several things that have been proven. This includes exposure to second-hand smoke. There is also a chemical called radon. It is a gas that in some places can accumulate inside someone’s home. And it has also been proven to cause lung cancer. There, and then there are other hypotheses as to why people who don’t smoke get cancer. One of them could be the air pollution that people breathe all the time. And in particular, when it comes to women and lung cancer, people are starting to wonder if women, their bodies metabolize these carcinogens in a different way, making them more likely to develop cancer as a result. of a certain exposure, more than a man of the same exposure. age.
What are the warning signs of lung cancer? Who should be screened and when?
Eric Peck, MD: Well, that’s a great question. I will say first of all that, of course, people who smoke are most at risk, and therefore anyone aged 50 to 80 who has smoked on average a pack a day for more than 20 years, even if they have stopped Over the past 15 years, they have been considered high risk, and there are now many programs for these patients to take a lung cancer screening test, which is a CT scan, to identify nodules when they are small. Unfortunately, lung cancer often does not cause symptoms until it is very advanced, and this is why, historically, lung cancer outcomes have not been very good, as patients do not were only identified when the cancer was advanced or had spread. But certainly, any cough that persists for more than, say, six weeks, if you have upper back pain, shortness of breath, unexplained weight loss, coughing up blood, those are all things that should prompt your doctor to carry out an assessment. .
Additionally, it is important to know that if someone has a family member who has a history of lung cancer unrelated to smoking, this also puts them at higher risk and will also be eligible for screening tests of lung cancer.
When it comes to women in particular, if they are diagnosed with lung cancer, what are their treatment options?
Eric Peck, MD: Hopefully, if diagnosed early, the preferred treatment option will be surgery to remove the cancer and hopefully cure the patient. Usually, at the same time, lymph nodes will be sampled to determine for sure whether the tumor has started to spread or not. Other treatment options available include chemotherapy, new immunotherapies that modulate the patient’s natural immune system to help fight cancer cells, and radiation therapy.
What are the commonly used procedures to treat lung cancer?
Eric Peck, MD: The goal of surgery and lung cancer is therefore to cure the patient. If patients have advanced lung cancer, treatment usually consists of chemotherapy, immunotherapy, or radiation therapy. However, if someone is lucky enough to be a candidate for surgery, the procedure involves making an incision between the ribs and then removing the lung where the tumor is growing. This procedure is called thoracotomy. This involves the incision between the ribs and a lobectomy, which involves removing the lobe of the lung that contains the cancer.
At the same time as we are there, we will perform a lymph node dissection again to identify any early spread of the cancer. There are other procedures that some lung cancer patients may also be candidates for. There is a procedure called mediastinoscopy. This is an incision made in the notch just above the breastbone. This is done under anesthesia, and involves taking lymph nodes from around the trachea if it is suspected that it has already spread there. And the patient undergoes this procedure to really determine if the disease has spread, so we know if they are a candidate for surgery or if the treatment will be chemotherapy or radiation.
The last procedure I would like to mention is for patients whose cancer has unfortunately already spread. And often it spreads to the outer lining of the lungs, causing fluid to build up in the chest cavity, compressing the lungs and making patients very short of breath. There is a procedure, it’s a minimally invasive telescopic procedure called pleurodesis, where we basically merge the lining of the lungs and the lining of the ribs so that there is no more space for fluid to re-accumulate . It is very effective in improving the quality of life of these patients.
For patients undergoing this procedure, what should they expect? How is recovery going?
Eric Peck, MD: In most of these thoracic surgeries, patients will require drainage tubes to be placed during the operation and these drains will usually remain with the patient for three or four days after the procedure. They need to be in the hospital during this time, but we will have them undergo physical therapy to manage their pain. They usually go home the day after the chest tubes are removed, uh, pretty functional. They will feel some pain where the incision is. And it usually takes about six to eight weeks to fully recover from this procedure.
Is there anything else women should know about their lung health?
Eric Peck, MD: Well obviously you talk to a doctor and the first thing I have to say is please don’t smoke. And that includes vaping, too. Vaping prevents, uh, tar from being deposited in the lungs. But the chemicals they use to aerosolize nicotine and the flavors it contains are just as harmful to the lungs and carcinogenic.
So please don’t smoke, don’t vape. This also includes being around other people who smoke, as we know that exposure to second-hand smoke also increases the risk of cancer. Please know the family history of anyone who has had lung cancer, especially if they have not smoked. Be aware of symptoms you may have, such as persistent coughing, coughing up blood, unexplained weight loss.
And if you’re eligible, talk to your doctor about these lung cancer screening tests, because it can really make the difference between catching that lung cancer when it’s curable or, unfortunately, when it’s too late.
