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Here’s Why Lung Cancer Death Rates are Improving in the U.S.

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The latest research shows that lung cancer deaths have been decreasing over the past decade and that’s partially due to innovations in treatment. Getty Images
  • New research shows that lung cancer mortality rates have been starkly decreasing over the past decade.
  • The data coincides with strides made in more targeted, advanced immunotherapies and treatments for lung cancer.
  • Experts suggest the mortality rate will continue to drop in the coming decade as more becomes known about how to treat and cure lung cancer.

In the spring of 2017, Larry Whipple, 75, was going in for a routine medical visit when his primary care physician suggested he visit a specialist to take a look at his lungs.

Years before, a small “speck or spot” was found on one of his lungs, and she thought it would be wise to have a specialist look at his file and see if anything changed with his lungs.

Whipple, who currently lives with his wife in Cary, North Carolina, took his doctor’s advice, and after some testing it was found the spot expanded.

A biopsy followed that fall. Overnight, the left side of his neck swelled “to the size of a ping pong ball.” It was his lymph nodes. Further testing led to a diagnosis of 3B non-small cell lung cancer in September 2017.

Whipple told Healthline that the news brought a shock, adding that it “was almost like getting an email that says you are going to die — it was bad news.”

The loving grandfather and retired lawyer found himself staring down a difficult diagnosis and said it caused him to turn to one of his self-described “Whippleisms”: “Life is what happens to you when you are planning for something else.”

Using his legal training and analytical mind, Whipple did his research and sought out a second opinion — something that he encourages everyone to do upon receiving a cancer diagnosis. It was something he took seriously. His younger sister’s husband received a pancreatic cancer diagnosis in May 2016 and died that October.

Eventually, he sought treatment at The University of Texas MD Anderson Cancer Center in Houston as well as in its affiliated hospital system in New Jersey, receiving a regimen of Keytruda (pembrolizumab) immunotherapy and chemotherapy treatments.

He concluded his last therapy in August 2018. He has remained cancer-free ever since.

Whipple’s story is a sign of how far treatment has come for lung cancer. It’s the third most common cancer in the United States and more people die from it than any other kind of cancer, according to the Centers for Disease Control and Prevention (CDC).

Despite these bleak statistics, mortality rates for lung cancer appear to be dropping.

Research published last month in The New England Journal of Medicine shows that lung cancer deaths have been decreasing and suggests it is partially due to innovations in treatment over the past decade that have made recovery stories like Whipple’s less rare.

The researchers used data from the national Surveillance, Epidemiology, and End Results (SEER) registry. They found that mortality rates for non-small cell lung cancer declined across the board. For men, mortality rates from this subtype of lung cancer went down by 3.2 percent annually from 2006 to 2013 and then 6.3 percent from 2013 to 2016.

When it came to women, mortality rates declined by 2.3 percent from 2006 to 2014 and then went down by 5.9 percent from 2014 to 2016. Two-year survival escalated from 26 percent for diagnoses in 2001 to 35 percent in 2014 for men and then from 35 percent to 44 percent for women over the same time frame.

When it came to small cell lung cancer, which is less common, mortality was down along with fewer diagnoses. That being said, survival rates did not improve during that time.

What accounted for these changes? In their conclusion to the study, the researchers write that “a reduction in incidence along with treatment advances — particularly approvals for and use of targeted therapies — is likely to explain the reduction in mortality observed during this period.”

Nadia Howlader, PhD, study co-author and mathematical statistician in the Data Analytics Branch (DAB) within the Division of Cancer Control and Population Sciences (DCCPS) at the National Cancer Institute (NCI), told Healthline that it was well known that lung cancer death rates were decreasing rapidly in the past decade at the same time that novel and targeted therapies were improving.

She said that the research team thought it would be interesting to see where mortality rates where shifting due to treatment advancements for these subtypes of lung cancer and paint an overall picture for where the data was trending over time.

Howlader said it was striking to step back and see the data, taking into account various factors like declines in smoking over time for this change. Since that has remained at a steady decline in recent decades, it couldn’t quite account for the rather steep drops in the past decade.

She said it was then important to take into account how targeted therapeutics and drug trials could be lowering mortality rates and improving survival.

“It was very exciting to see what the numbers are showing,” she added.

Dr. Vamsidhar Velcheti, director of thoracic medical oncology at NYU Langone’s Perlmutter Cancer Center, said that lung cancer treatments have taken tremendous strides in recent years.

“Even just four years ago, we had very limited treatment options. Now we have a lot of targeted therapies based on specific gene mutations of lung cancer. We have immunotherapies that have overall improved survival responses,” Velcheti told Healthline.

“There have been incredible advances in the last few years, so I was not surprised at all to see such dramatic improvements in lung cancer survival,” he added.

Dr. James Stevenson, an oncologist at Cleveland Clinic, echoed those thoughts that a lot has changed in a short amount of time. He recalls practicing in the early 2000s and seeing a shift in “how we look at lung cancer patients.”

“It was an outlook that was considered bleak for patients with lung cancer, there were very few treatment options, very few diagnoses in the early stages,” Stevenson said. “Now we have better drugs that are more targeted to individual patients and fewer side effects. Chemotherapy was our only option back then.”

Stevenson added that this is “all really just the beginning” in terms of seeing the impact of modern targeted treatments in conjunction with improved earlier diagnoses. He said that if we have this conversation again in 5 years, “the outlook will be that much better” than it is now.

So, what might the future hold? Velcheti said that we will get to a point of even more personalized treatments for lung cancer. Oncology will get to the point where it will “understand the specific molecular fingerprints” of cancer and “target a treatment based on a person’s molecular profile.”

As more is known about how cancers respond to specific therapies and cancer research and targeted therapies increasingly zoom in at this “granular level,” he said these mortality rates could look even more hopeful in the next decade.

Howlader added that it’s important we keep our eyes on clinical trial data and seeing the efficacy of new cancer therapies.

Velcheti agreed, saying that clinical trials provide “the best opportunity to get treatments that are more cutting edge out there.”

Howlader stressed that it’s important the general public realize lung cancer is complex. It’s not just “one disease” but a “collection of many diseases.” You and your doctor must discuss a personalized, targeted treatment approach for the subtype of lung cancer you are living with.

For his part, Whipple said he often thinks, “Why me?”

“I have the recollection of the date my brother-in-law died and I think ‘why did I survive this, is there some reason why God, who I have great belief and faith in, decided I survive this and for what purpose?’” he said.

Whipple thinks a big part of it is to share his story and inform others about lung cancer.

“Be alert, listen to your body, make sure you get proper testing no matter how young you are. This disease affects all kinds of people at all ages. It’s age blind, it’s race blind, it’s gender blind,” Whipple added. “Early detection is really the solution. I just want people to know there are therapies out there today that can heal you.”

New research shows that lung cancer mortality rates have been starkly decreasing over the past decade.

The data coincides with strides made in more targeted, advanced immunotherapies and treatments for lung cancer.

Experts suggest the mortality rate will continue to drop in the coming decade as more becomes known about how to treat and cure lung cancer.

There are multiple kinds of lung cancer, and there isn’t a sole approach to treatment for everyone who is diagnosed.

This is why the medical community says it’s important to come up with a specialized, targeted plan if you are diagnosed with lung cancer.