Lung cancer used to be the most common malignancy in the United States but has dropped to number three behind prostate and breast cancers respectively. Each year approximately 173,800 Americans will be diagnosed with lung cancer and approximately 160,440 will die of their cancer. In Iowa, there will be about 2,000 new cases of lung cancer each year. At Mercy Medical Center, 251 new cases of lung cancer were diagnosed in 2004. Those 251 cases are the subject of this report.
At one time lung cancer used to be seen predominantly in men. However, as women began to smoke in increasing numbers, the incidence of lung cancer in women has risen significantly. At Mercy Medical Center, 45 percent of the 2004 cases were women
compared to 34 percent in 1997.
Lung cancer can be divided into different histologies based on the microscopic appearance of the cells. Small cell carcinoma was noted in 18 percent of the cases. Of the remaining 81 percent which would be classified as non-small cell carcinoma, adenocarcinoma comprised 30 percent of the cases. Non-small cell lung, NOS, accounted for 19 percent of the cases. Squamous cell carcinoma was seen in 18 percent of cases. Other histologies (large cell, adenosquamous, bronchoalveolar, and other) made up the other 15 percent of the cases.
Historically, surgery represented the major treatment of lung cancer. During the past decade the use of chemotherapy and radiation therapy in the management of lung cancer has increased. Initial therapy is now often multimodal. More than 34 percent of the 251 cases diagnosed at Mercy Medical Center in 2004 were initially treated with some combination of surgery, radiation therapy and/or chemotherapy compared to 27 percent in 1997.
Lung cancer remains a formidable challenge. It is often diagnosed only after it is in an advanced stage (82 percent of Mercy Medical Center cases were stage III or IV at the time of diagnosis). The overall survival rate remains poor. A statistical comparison of the survival of Mercy Medical Center (MMC) cases with the National Cancer Data Base (NCDB) is included. Overall survival is comparable in both sets of patients.
In an attempt to improve the outcome of patients with lung cancer, we at Mercy Medical Center are participating in a number of National Cancer Institute-sponsored clinical trials evaluating new combinations of surgery, chemotherapy and radiation therapy in the treatment of lung cancer. Prevention also is an important component. Smoking is the leading cause of lung cancer. Mercy Medical Center sponsors smoking cessation programs as well as education programs for the local schools to promote awareness of the risks of smoking. Mercy Medical Center will also become a Tobacco-free environment in 2006.