Sometimes I can't help but feel, especially as one with a steadfast interest in lung pathology (and lung cancer, in particular), that attention and funding for lung cancer research is the neglected ugly sister to breast cancer.
Well, November is Lung Cancer Awareness Month!
The numbers are staggering and worth considering: lung cancer is the most frequent cause of cancer deaths in the U.S. It is estimated in 2010 that about 222,000 men and women will be diagnosed with lung cancer and about 157,000 will die from the disease. Compare these numbers with breast cancer (207,000 diagnosed, 40,000 deaths), prostate cancer (218,000 diagnosed, 32,000 deaths), and colon cancer (143,000 diagnosed, 53,000 deaths). In other words, more people will die from lung cancer this year than breast, prostate and colon cancer combined. This from SEER Stat Fact Sheets.
Moreover, only 15% of lung cancer patients are diagnosed with early stage, localized disease compared to 60% of breast cancer patients, 80% of prostate cancer patients, and 39% of colon cancer patients. The overall relative survival of lung cancer patients is 15.8% at 5 years (89% breast, 99.1% prostate, 65.0% colon). Clearly, despite admirable improvements in outcomes for other common cancers, there has been grudgingly little progress--so far!--in improving the outcomes for lung cancer patients. Finally, the historically poor treatment outcomes and the inimical tendency to blame lung cancer patients for their disease have created an atmosphere of nihilism amongst the medical community, the public and the media, as Dr. Fred Hirsch points out currently in an editorial from November 2010 issue of Journal of Thoracic Oncology.
Also, there are significant sex, racial/ethnic and geographic differences in the incidence in lung cancer. The Morbidity & Mortality Weekly Report just last week released a report detailing these differences. The incidence of lung cancer in black men is scandalous. In addition, despite the fact that lung cancer kills more women than breast cancer, lung cancer involving women is virtually ignored as a "women's issue." Why is this?! There is ripe material here to explore the differences in the ways breast cancer and lung cancer are perceived and treated as metaphors, hmm?
In spite of the above, I believe that we are turning the corner on fighting this disease and there are significant albeit incremental findings being reported almost every week. Unfortunately, the proportion of lung cancer patients who are enrolled in clinical trials is lower than that for other cancers, perhaps as a consequence of the attitudes expressed above. Folks, we--doctors, nurses, other health care providers, patients, the public--we all can certainly do better than this! Advocate, teach, donate, research--whatever it takes.
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