Fighting for air: Lung cancer surpasses breast cancer as the deadliest type for women

During the past decade, lung cancer has surpassed breast cancer as the deadliest cancer among women.

Dr. Olivia Aranha, an oncologist at Saint Francis Medical Center-affiliated Cape Medical Oncology, said in 2015, almost twice as many women are expected to die from lung cancer as from breast cancer.

In her practice, she said she's seen a steady increase in lung-cancer mortality rates in women since 2004.

Aranha said her patients who have developed lung cancer usually are active smokers, and smoking is the No. 1 cause of lung cancer.

"Women started smoking in significant numbers during and following World War II," Aranha said. "Although smoking rates have declined since their peak in the 1960s, the current prevalence of smoking among women in the United States is still too high, with an estimated 16.5 percent of women smoking in 2011."

Dr. Andrew Moore, a medical oncologist at Southeast- HEALTH, said 85 to 90 percent of his female patients with lung cancer are active or former smokers.

Moore said women have continued to smoke, while more men have quit.

"Women's smoking rates remain constant and even rose in the '90s, while men have declined," he said. "So what we're seeing is kind of a catch-up from the '80s and '90s."

Other factors, such as hormone replacement therapy, can contribute to the development of lung cancer.

"Large randomized studies suggest that estrogen-plus-progestin therapy is associated with an increased risk of lung cancer," Aranha said. "Endocrine factors also may have an impact on the natural history of disease if lung cancer does develop."

Research has offered some clues as to what contributes to developing lung cancer.

"Data over the past decade has given us some insight as to what may be driving those cancers," Moore said.

"Genetics are proving to play a big part in the development of lung cancers. epidermal growth factor receptors (EGFR) is one of many genetic mutations linked to lung cancer. EGFR just happened to be the first one."

Anaplastic lymphoma kinase (ALK) is another mutation that has gained attention over time.

"We are now able to differentiate the type of lung cancer and determine what is likely to be the most effective treatment and what chemotherapy regimens are likely to be most effective," Moore said.

Traditionally, the biggest breakdown of lung cancer is small-cell as opposed to non-small-cell, which is determined by examining the cells under a microscope.

"Small-cell lung cancer tends to be more aggressive and fast-growing compared to non-small-cell lung cancers and is more difficult to cure," Moore said.

Small-cell lung cancer is difficult to detect before it has become advanced.

"Typically, it is not found at an early stage," Moore said. "It grows much faster."

With this type of cancer, patients usually don't show symptoms until the cancer already has grown beyond the lungs, he said.

"First and foremost, the treatment for lung cancer depends on the stage," Moore said.

Although there are fewer diagnosed cases of lung cancer than breast cancer, lung cancer is deadlier because it often goes undetected until it is too late for effective treatment.

Early detection is key in treating the cancer effectively, and it can be detected using low-dose CT scans of the chest.

Moore said it's a good idea for smokers to request one at their annual physicals.

The Centers for Medicare & Medicaid Services issued a decision Feb. 5 that eligible Medicaid recipients ages 55 to 77 may get those lung-cancer screenings. Moore said he hopes the approved Medicaid reimbursement will result in more people getting low-dose scans.

St. Francis Medical Center offers a free lung-cancer screening program using a low-dose helical CT.

"We are the first hospital in Southeast Missouri to offer this community-based screening program, and next screening is scheduled in March," he said.

For more information on the next lung cancer screening or to determine eligibility, call the Consumer Call Center at 331-3996.