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HM_StJude_Fall2024_FinalLR_spread

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10 | Health Matters: Providence St. Jude Medical Center Despite the sometimes dramatic improvements that have been made in other cancers, lung cancer survival has only slightly improved over the past several decades. Fortunately, that 's beginning to change, as a small number of comprehensive lung cancer programs are creating breakthroughs, advances and new hope. " We're at an inflection point in lung cancer survival," explains Daniel Oh, MD, medical director of the hospital's Center for Thoracic Diseases, whose expertise in robot-assisted lung cancer surgery made Providence St. Jude one of the nation's first centers of excellence in the groundbreaking technique. "Our progress in treating lung cancer—early detection and targeted therapies that attack cancer on a molecular level—is how we are creating meaningful advances in sur vival." With few, if any, symptoms in its early stages, lung cancer is often diagnosed at stage III or IV, meaning the cancer has already spread. The hospital's Lung Cancer Screening Program is designed to make low-dose CT scans—the gold standard for detecting lung cancer at its earliest and most curable stage—convenient and easy. For those most at risk—former and current smokers—the screening is covered by insurance, yet nationally, only about 6% of those eligible have gotten a low-dose CT scan. Compare that with breast cancer screening, where more than 80% of eligible women have had a mammogram in the past two years. "Screening is how we shift lung cancer diagnoses from stage IV to stage I," explains Dr. Oh, a Harvard-trained thoracic surgeon. "It can be the difference between a survival measured in months and one measured in decades." Who should be screened? Longtime or heavy smokers between the ages of 50 and 80 are urged to consider a low-dose CT scan, even if you quit decades ago. Previous recommendations from the American Cancer Society excluded those who quit smoking more than 15 years ago, a restriction that was dropped after data showed that, while former smokers' risk decreases over time, when compared with never-smokers, their risk remains three times greater even 20 or 30 years after quitting. The new guidelines apply to anyone who has smoked more than 20 so-called pack-years, the equivalent of a pack a day for 20 years or two packs a day for 10 years. "For example, a 60-year-old who quit at 42 after smoking two packs a day for over a decade should be screened," Dr. Oh says. Targeting cancer on a molecular level The hospital's cancer experts are also helping move the goalposts on survivability of later-stage lung cancers. Dozens of clinical trials at the hospital have helped bring new immunotherapies and molecularly targeted "missiles"—designed to identify and attack a cancer's specific genetic markers—to the treatment of lung cancer. Moving the Goalposts on Lung Cancer Survival Lung cancer kills more Americans than the next three cancers—breast, colon and prostate—combined.

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