Lung Cancer Treatment and Follow-Up
- Comedian Kathy Griffin is celebrating clean scans six months after treatment for stage 1 lung cancer.
- Lung cancer is the second most common type of cancer and it can develop in both smokers and non-smokers, though smokers have an increased risk.
- One of SurvivorNet’s experts says lung cancer survivors will undergo very careful surveillance for at least the first five years after their diagnosis. But each person’s follow-up schedule can vary, so it’s important to establish expectations with your doctor.
The 61-year-old revealed her stage 1 lung cancer diagnosis via social media on Aug. 2. Thankfully, the cancer seemed to be contained to one part of her lung, so she underwent surgery to have half of her left lung removed shortly after sharing the news and has been recovering since.
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“6 month lung cancer scan is CLEAN!!!” Griffin wrote in her caption. “No more #cancer!!! And yes, i'm skinny dipping in the pool while shaking my boobs and butt.”
Understanding Lung Cancer
Lung cancer, the second most common type of cancer, is the leading cause of cancer deaths for men and women in the United States. Diagnosis and treatment of the disease can be tricky since symptoms often don't appear until the cancer has spread. An initial symptom, for example, could be as serious as a seizure if the lung cancer has already spread to the brain. But other symptoms can include increased coughing, chest pain, unexplained weight loss, shortness of breath, wheezing, losing your voice or persistent infections like bronchitis or pneumonia.
The two main types of lung cancer are non-small cell, which makes up 85 percent of cases, and small-cell. These types act differently and, accordingly, require different types of treatment. Dr. Patrick Forde, a thoracic oncologist at Johns Hopkins Medicine, tells SurvivorNet about how distinguishing between the two types and their subtypes can be very beneficial.
What Happens When You've Been Newly Diagnosed With Lung Cancer
"Within that non-small cell category, there's a subtype called non-squamous adenocarcinoma, and that's the group of patients for whom genetic testing is very important on the tumor," he explains. "Genetic testing is looking for mutations in the DNA, in the tumor, which are not present in your normal DNA."
Lung Cancer for Non-Smokers like Kathy Griffin
Declining smoking rates have lead to an improved outlook for lung cancer since cigarette smoking is the number one risk factor for the disease. In fact, the Centers for Disease Control & Prevention states that cigarette smoking is linked to about 80 to 90 percent of lung cancer deaths, and people who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who don't smoke.
It's important to remember, however, that even people like Kathy Griffin who've never smoked before can still get lung cancer. The CDC reports that in the United States, about 10 to 20 percent of lung cancers, or 20,000 to 40,000 lung cancers each year, happen in people who've never smoked.
"Some lung cancers are from unknown exposure to air pollution, radon, or asbestos," Dr. Raja Flores, system chair of thoracic surgery at Mount Sinai previously told SurvivorNet in a previous interview. "We also see more never-smokers with lung cancer who have a family history of it."
Radon is the second-leading cause of lung cancer. It's responsible for anywhere from 3 to 16 percent of cancer cases depending on the levels present in a given area, according to the World Health Organization, but smokers are still 25 times more at risk from radon than non-smokers.
Another possibility for the cause of lung cancer in a non-smoker can be second-hand smoke. The American Cancer Society estimates that about 7,000 adults die of lung cancer annually from breathing secondhand smoke.
Air pollution, family history, HIV or AIDs can also all impact the chances of a non-smoker getting lung cancer. No matter what, it's important to not rule out the disease just because you don't smoke a fact that Donna Hunting knows all too well.
Just like Griffin, Hunting was a non-smoker when she was diagnosed with lung cancer. But the active 54-year-old's cancer had progressed further given that she had stage four non-small cell lung cancer.
If You Have Lungs, You Can Get Lung Cancer Survivor Donna Hunting Shares Her Story
"That day was shattering to my family and to me," she previously told SurvivorNet. "It's not a smokers' disease. If you have lungs, you can get lung cancer."
Fortunately for Hunting, testing revealed that her tumors had a mutation in a specific gene called EGFR. This meant that doctors were able to give her a pill to block those mutations and effectively rid her body of the disease.
"After 50 days, miraculously, my PET scan showed no evidence of disease," she said.
Hunting was on took the drug for over a year, until it stopped working as well. Now she's on a different daily medication, but thanks to advancements in treatment she's able to live with the disease.
"Cancer is a part of my life now, but it isn't my whole life. I'm not letting cancer define me," Hunting said.
Monitoring after Lung Cancer Treatment
Completing treatment for lung cancer is an exciting milestone that deserves celebration. But even when treatment is over, there are still important cancer-related steps to take that have to do with monitoring for recurrence. According to the American Cancer Society, people with no signs of lung cancer remaining will have follow-up appointments that may include CT scans and blood tests about every three months for the first couple of years after treatment. After that, your doctor might recommend follow-up visits every six months for the next several years and then at least yearly after five years.
How Likely Is It That My Lung Cancer Will Return?
Dr. Ken Miller, director of outpatient oncology at the University of Maryland, Greenebaum Cancer Center, previously told SurvivorNet the risk of a recurrence lowers as the length of time since your diagnosis grows.
“The greatest risk of recurrence is typically in the first several years after diagnosis,” he said. “We continue very careful surveillance, at least for the first five years… During that time, again, physical exams, laboratory studies, X-ray studies, looking for any sign of recurrence.
“As we start to reach five years and beyond, the risk of recurrence is lower.”
Follow-up schedules can differ on a case by case basis, so it’s important to ask your doctor for a survivorship care plan that might include:
- A suggested schedule for follow-up exams and tests
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- A schedule for other tests you might need to look for long-term health effects from your cancer or its treatment
- Suggestions for things you can do that might improve your health, including possibly lowering your chances of the cancer coming back
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