When you hear someone has lung cancer, certain words may come to mind. Smoker. Elderly. Hopeless. But in recent years our scientific understanding of lung cancer has changed. It isn't just one disease with one cause, or even one outcome. Although lung cancer is one of the most commonly diagnosed cancers in the U.S., what you think you know about it may be wrong[i].
Lori Morris learned this first-hand, when she was diagnosed at the age of 54.
Morris was originally diagnosed with asthma after experiencing shortness of breath on a hike. Her condition deteriorated, but since she was an athletic non-smoker with a history of good health, lung cancer never crossed her mind. It wasn't until she ended up in an emergency room four years later, unable to breathe, that doctors discovered masses in her lung that had spread to her brain. The diagnosis was advanced lung cancer.
"Lung cancer wasn't on anyone's radar," said Morris. "I assumed there was only one cause for lung cancer — smoking — and only one kind of person who gets lung cancer, and that wasn't me."
With the support of family and friends, Morris found an oncologist who took a personalized approach to her treatment. The truth is, there are more types of lung cancer than most people realize. Her doctor told her how lung cancer can affect anyone regardless of their age, ethnicity and lifestyle, and that treatment is not one-size-fits-all.
Lori had a type of lung cancer called ALK-positive lung cancer, which typically occurs in younger people who have never smoked or smoked lightly.[ii] Empowered by her genetic testing results, she had the confidence to make an informed decision with her doctor about a treatment tailored specifically for her type of lung cancer. Today, Lori is doing well and looking forward to training for her next major hike in the near future.
If you or someone you love are one of the estimated 230,000 Americans diagnosed with lung cancer this year,[i] here are important tips:
- Know Your Type. Different types of lung cancer are identified by where the cancer cells originate, what they look like and their genetics.[iii] The two main types are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).[iv] NSCLC, which makes up the majority of lung cancer cases, is further divided into three main subtypes — adenocarcinoma, squamous cell and large cell — although some people with NSCLC have a rarer or unspecified subtype of the disease.[ii] More than half of all lung cancers have known genetic mutations, or biomarkers, that may be causing the cancer to grow.[v] Examples of these mutations include ALK, EGFR and ROS-1, which can be identified by asking a physician for biomarker testing. Knowing the specific type of lung cancer is important to determining the right treatment for the each individual person.
- Know Your Treatment Options. Twenty-five years ago, lung cancer treatment was limited to surgery, radiation and chemotherapy. But a better understanding of the different types of lung cancer has led to more medicines that enable doctors to personalize treatment based on the individual characteristics of a tumor. For example, if testing reveals that a person's tumor has a specific genetic mutation, they may be eligible to receive a targeted therapy for their specific type of cancer. Cancer immunotherapy is another recent advance in treatment that works with the body's own immune system to fight against cancer, based on a specific protein found in tumor cells.[vi]
- Know You Are Not Alone. Even though everyone's lung cancer journey is unique, support from others with the same type of cancer can help patients and their families navigate the challenges ahead. Advocacy organizations like LUNGevity, Bonnie J. Addario Lung Cancer Foundation and the Lung Cancer Alliance can connect people with lung cancer with other survivors and provide additional resources for loved ones as well. There are even groups for people with specific mutations, such as the ROS1ders, EGFR Resisters and ALK Positive. Support groups can also help you overcome the burden of stigma that can come with a lung cancer diagnosis.
In the past 25 years, survival rates for advanced lung cancer have improved from a few months to more than a year,[vii] partly due to the new medicines that are available. Because with the information and support available today for people with lung cancer, no one should have to stand alone.
To learn more about different types of lung cancer, visit gene.com/topics/lung-cancer.
[i] American Cancer Society. Key statistics for lung cancer. https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html. Accessed October 10, 2018.
[ii] Lung Cancer Foundation of America. What is ALK Positive Lung Cancer? And what are the options for treatment?. https://lcfamerica.org/research-grants/therapies/alk-positive-lung-cancer/. Accessed October 26, 2018.
[iii] American Cancer Society. What is non-small cell lung cancer? https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/what-is-non-small-cell-lung-cancer.html. Accessed October 3, 2018
[iv] American Cancer Society. Lung cancer (non-small cell) detailed guide. https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html. Accessed October 3, 2018.
[v] The Clinical Lung Cancer Genome Project (CLCGP) and Network Genomic Medicine (NGM). (2013). A genomics-based classification of human lung tumors. Science Translational Medicine, 5(209), 209ra153.
[vi] American Cancer Society. (August 8, 2016). What is cancer immunotherapy? https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/what-is-immunotherapy.html. Accessed October 11, 2018
[vii] Roth, J.A., Goulart, B.J., Ravelo, A., Kolkey, H., & Ramsey, S.D. (2017). Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: Progress and opportunities. Oncologist (22)3: 304-310.