LUNG CANCER RATES DECLINING IN THE INTERMOUNTAIN REGION, WITH A LONG WAY TO GO
Residents of the central Colorado mountain region can breathe easy. Overall, lung cancer rates in Garfield, Pitkin, Eagle, Grand, and Summit Counties have gone down from 37.1 per 100,000 people in 2014-2015 to 23.5 in 2015-2016, according to the most recent data available from the Colorado Health Institute. Early detection rates have also improved from 27.8 percent in 2014-2015 to 33 percent in 2015-2016.
Early detection of lung cancer is a topic medical oncologist Dr. Paul Bunn is particularly interested in. As the founding director of the University of Colorado Cancer Center and past president of the International Association for the Study of Lung Cancer (IASLC), he is credited with bringing personalized therapies to the forefront of lung cancer treatment. Dr. Bunn first started seeing patients at Valley View over 20 years ago. He continues to come to Glenwood Springs to see patients once a month at the Calaway•Young Cancer Center, sometimes more depending on the need.
“No one should feel guilty about getting cancer,” stresses Dr. Bunn. “The important part is to take action and get screened.”
The IASLC World Conference on Lung Cancer recently presented findings by the Nelson Lung Cancer Screening Study, which confirms results from the National Lung Screening Trial, showing that annual lung cancer screening with low dose computed tomography (CT) in high-risk patients reduced lung cancer deaths by 26 percent in men and up to 61 percent in women. Given that the American Cancer Society predicts 160,000 lung cancer deaths in the U.S. in 2018, widespread screening could save up to 65,000 lives each year in the U.S. alone.
The findings have been welcome news to Calaway•Young Cancer Center radiation oncologist Dr. David Marcus, who treats patients who have been diagnosed with lung cancer. In addition to early screening, he credits breakthroughs in technology over the past two decades to improving lung cancer outcomes.
Stereotactic Body Radiation Therapy (SBRT) sounds like something out of a science fiction movie, but in reality, it has become the standard of care for the treatment of selected cases of lung cancer at the Calaway•Young Cancer Center at Valley View.
SBRT is a specialized form of cancer treatment that uses sophisticated targeting techniques to deliver a high dose of radiation to a tumor while avoiding nearby uninvolved tissues. With conventional radiation therapy, treatment is delivered in relatively small daily doses over the course of several weeks. With SBRT, radiation oncologists are able to deliver a higher combined dose of radiation over a much shorter period of time.
“SBRT has its roots in stereotactic radiosurgery, which has been around for a long time for brain tumors,” says Dr. Marcus. “There was a point in time when there was a technological limitation, where you could only do radiosurgery within the fixed structure of the skull. As the technology evolved during the early part of the 2000’s, it became feasible to deliver those high dose treatments to different areas throughout the body, including the lungs.”
The Calaway•Young Cancer Center performs SBRT throughout the body, but Dr. Marcus points to lung SBRT as the first application of this kind of treatment outside of the brain. “SBRT really started out as an alternative therapy for early stage lung cancer in patients who were not able to undergo surgery. Recently, clinical trials have suggested that survival with SBRT may be similar to that achieved with surgery, and there are now trials evaluating the question of whether SBRT may be an appropriate procedure for patients who are surgical candidates.”
The Calaway•Young Cancer Center has been treating with SBRT since it opened in 2012. As technology has continued to evolve, the center is continually updating the software and equipment necessary to deliver SBRT according to the most modern state of the art.
“It’s really part of the standard of care at this point,” Dr. Marcus says. “We have the expertise here in-house so our patients don’t need to travel to the front range to have SBRT. Of course, SBRT is just one approach we can take, and it’s important to note that we tailor our treatment to the individual characteristics of the cancer in each patient, regardless of stage, size and type.”
In addition to SBRT, the Calaway•Young Cancer Center provides a variety of advanced lung cancer treatment options customized for each patient, such as molecular therapy and immunotherapy. Molecular therapy acts on a specific molecular target associated with the cancer and is administered in pill form. This targeted approach allows healthy cells to survive, while cancerous cells are destroyed. Most standard chemotherapies act on all cells, not just the cancerous ones. Conversely, immunotherapy boosts the body’s natural defenses to fight cancer by using both natural and synthetic substances to stop or slow the growth of cancer cells. “Molecular (therapies) and immunotherapies have much fewer side effects than standard therapy,” Dr. Bunn explains.
As Dr. Marcus sums up, “it’s not just about one treatment or doctor, it’s about offering our patients a suite of services that allows us to evaluate a patient, decide what the best course of treatment is, and then deliver the highest level of care – that is our obligation and our responsibility, and it’s an honor.”