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What are the symptoms of lung cancer?
Often, early lung cancer does not have any symptoms. This is a real challenge because the best time to treat lung cancer with positive results is in the early stages. Four out of five of early lung cancers are treated successfully. The overall lung cancer survivor rate is closer to 17%. The reason there are no symptoms in the early stages is that the lungs have a phenomenal capacity. A person can live with less than one lung, so it takes a great deal of lung damage before it is noticeable. In later stages of lung cancer, symptoms include coughing, shortness of breath, coughing up blood, weight loss, and pain from a growing tumor. Without symptoms, screening for lung cancer is key. A low dose non-contrast CT scan provides the opportunity to screen patients considered the most at risk for lung cancer. At this time, that includes anyone over the age of 55 who smoked the equivalent of a pack of cigarettes a day for 30 years. Screening can also be offered to younger patients with a lower smoking dose as part of a research trial.


What are the most non-invasive ways to screen for lung cancer?
Imaging is a noninvasive way to check for lung cancer. Since CT scans are so sensitive, many will test with an abnormality, but only 1 in 100 will actually be lung cancer. The usual protocol is to wait for several months, take more images and see if the abnormality has grown in size. If so, more extensive testing will be done. Other minimally invasive screening methods include a needle biopsy, a bronchoscopy, and a navigation bronchoscopy. The navigation bronchoscopy is a device which allows doctors to follow the smaller pathways of the lungs. If you think of the lungs as a tree, we used to only be able to look at the branches. Now we can get to the twigs.


How is a patient treated once lung cancer is diagnosed?
Stage 1 cancers are treated with just surgery alone if the patient is healthy enough. The doctor cuts out the tumor and area around the tumor. Lymph nodes are often removed to make sure the cancer hasn’t spread microscopically. Minimally invasive surgical techniques, including robotic thoracic surgery, are more commonly employed. If it is an early stage, but the patient is not fit for surgery, there are now precise radiation techniques Stereotactic Ablative Radiotherapy, which can treat smaller tumors without much collateral damage by using a highly focused beam in five or less treatments with a good chance for a cure. When the cancer is more advanced, such as metastatic lung cancer, chemotherapy is often used as part of the treatment plan. New treatments are beginning with certain types of tumors with specific gene mutations, which allows for targeted therapies in pill form. It targets the actual machinery that is involved in the mutation and eliminates it. Immunotherapy treatments are now being used effectively in some more advanced tumors. These medicines bring a higher quality of life and time. They are not a cure yet. Some types of tumors are treated with combination of chemo and radiation.


How do you care for a patient after lung cancer is treated?
The most important things to do after surgery is to make sure the pain is controlled so a patient can become mobile. We focus on survivorship, creating a plan for follow up to keep track of any possible recurrence. CT scans are done at least twice a year for the first couple of years and annually after that. We make sure supportive services are available for those that need them from physical therapy to emotional or spiritual services. We work with the primary care physician to take care of other health needs and keep the patient healthy.

Dyson Center for Cancer Care
Division of Thoracic Oncology, Health Quest Medical Practice, P.C. 
45 Reade Place, 3rd floor
Poughkeepsie, NY 12601
TTY /Accessibility: (800) 421-1220

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Hudson Valley Magazine editorial staff.

dr. michelle l. abis
Cliff P. Connery, MD, FACS, FCCP
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