Dr. Shakun Malik: Lung Cancer Types and Treatments - [Video Transcription]
- What are the types of lung cancer?
A small cell is a more aggressive type of lung cancer. Most of the time, surgery is not an option for it. It is also a cancer that is responsive more to chemotherapy or with radiation with chemotherapy. Non-small cell lung cancer is slower growing tumors and depending upon the staging of the lung cancers, there are various treatment modalities for the non-small cell lung cancer.
- What are my options for lung cancer treatment?
Non-small cell lung cancer is also divided into various subtypes. Since it is slower growing, surgery may be an option if we catch the cancer earlier. Otherwise, we have other modalities which include chemotherapy with radiation therapy or chemotherapy alone. A newer exciting thing about non-small cell lung cancer is that we have various targeted therapies that are now approved by FDA for non-small cell lung cancer.
- How is lung cancer staged and what are the survival rates?
Lung cancer staging is based on the size of the tumor, whether it has spread to the lymph nodes or not, and whether it has gone to other parts of the body. Stage I is usually confined to the size of the tumor but once it has spread to the lymph nodes it has become Stage II or III. If it has gone to other parts of the body, it becomes Stage IV. The five year survival for Stage I varies. It may not be 100% but around 60 to 70%. For Stage IV, the five year survival becomes less than 5%.
- Am I going to be gasping for breath and in pain?
The concern is that "I have lung cancer. Am I going to be gasping for breath? Am I going to be in a lot of pain?". What I explain to the patients is that as the time comes if it is towards the end of the treatments, we have a service in Lombardi which is palliative care service. They help us a lot with end of life issues. The patient is usually comfortable. We do put them on oxygen and give them drugs that slow down their breathing. So the end is not in pain and they are not going to be gasping for breath.
- I have lung cancer and I have never smoked. Why?
About 50% of the patients that I treat now are either ex-smokers or have never smoked. About 15 to 20% have almost never smoked. Why they are getting lung cancer is a very intriguing field that people are studying. Could it be genetic or environmental? More women are getting lung cancer. Could it be hormonal? All of these have shown some links but have not been proven yet.
- What can I expect from my lung cancer team when I come to Georgetown University Hospital?
We in Georgetown have a dedicated group of physicians to the treatment of lung cancer. We have a pulmonologist, a radiation oncologist, medical oncologist, and radiologists all in one room talking with the patient once they are diagnosed with lung cancer. We closely organize and recommend treatment to the patients who come to our multi-disciplinary clinic.
- What clinical trials are available to me for lung cancer?
I am proud to lead the division of hematology and oncology here at Georgetown. I am proud mostly because of the people that I work with everyday. If one looks at our physicians that we have within this group, you see world leaders on a clinical front in the areas of lymphoma, breast cancer, GI cancer, lung cancer, and head/neck cancer. These people are clearly the best and the brightest that are out there. That is not really the reason I like them so much. The real reason I like them and are so proud about them is because they are people. They understand about talking to folks. People are scared and coming in for information. To see the number of lives that we touch on a daily basis, it is quite a team and I am really proud of them.
- Are there non-medical programs for me at Georgetown as I receive treatment for lung cancer?
People are taught how to feel better while they are undergoing chemotherapy. They are taught how to put their make-up on, make their hair up, and part of it how to deal with nutrition and exercise program.
