Early detection is critical to winning the fight against lung cancer.

Screening for lung cancer is vitally important because lung cancer does not start causing symptoms until it has spread. The National Lung Screening Trial, of which Ochsner was an original participant, showed that screening is an effective way to improve people’s chances of surviving lung cancer, since lung cancer is most treatable before it causes symptoms.

Screenings are recommended for adults ages 50+ that are currently a smoker or who were a heavy smoker. Our lung cancer screening uses the lowest radiation CT scan available, which produces a 3D image of your lungs. The screening is non-invasive, and you do not have to do anything special to prepare. There are no injections or dyes to drink. The scan takes less than five minutes.

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After the scan:

• The results are reviewed by an experienced team, including a radiologist and pulmonologist
• You will be notified about the results along with any follow-up recommendations, and you will receive a copy of your screening report
• Results will also be shared with your primary care physician

Can Lung Cancer Be Prevented?

Although not all lung cancers can be prevented, there are things you can control to lower your risk.

Quit smoking. The best way to reduce the risk of lung cancer is to not smoke and avoid breathing in the smoke of others (secondhand smoke). If you quit before a cancer develops, your damaged tissue will gradually repair itself. No matter your age or the length of time you’ve smoked, quitting may lower your risk.

Our smoking cessation clinics offer services to our patients to help them kick their smoking or vaping habit for good. If you’re ready to make a healthy lifestyle change, learn more here.

Avoid radon exposure. Radon is a colorless, odorless, radioactive gas. It forms naturally from the decay of radioactive elements found in soil and rock. Most radon exposure comes from being inside homes and commercial buildings. Radon gas can enter through cracks in floors, walls or in gaps in the foundation of a building. If you’d like to hire a professional to test radon levels in your home, qualified contractors can be found through state radon offices listed on the U.S. Environmental Protection Agency’s website.

Avoid exposure to asbestos and other harmful cancer-causing agents. Those who are exposed to large amounts of asbestos have a greater risk of developing mesothelioma. In recent years, government relations have reduced the use of asbestos in commercial and industrial products. It is still found in many homes and older buildings but is not considered harmful as long as it is not released into the air by deterioration, demolition or renovation.

Other cancer-causing agents that can increase the risk of lung cancer include:

• Radioactive ores such as uranium
• Inhaled chemicals such as arsenic, beryllium, cadmium, silica, vinyl chloride, nickel compounds, chromium compounds, coal products, mustard gas and chloroethyl ethers
• Diesel exhaust

Eat a healthy diet. Healthy diets filled with fruits and vegetables may reduce your risk of lung cancer.

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Each treatment plan is personalized for each patient and includes many factors such as health status, the type of tumor and how far it has spread. Lung cancer is a challenging cancer to treat, and survival rate is determined by critical factors such as cell type and stage. If the cancer is confined to the lung, the cancer may be curable. Unfortunately, most people are diagnosed when the cancer cells have spread outside of the chest. The lungs are a very sensitive organ, and some forms of treatment may be more difficult. The overall two-year survival rate of those diagnosed with lung cancer is 25%. At five years the survival rate drops to 15%.

Lung cancer treatment goals should be discussed with your doctor. Some treatments are used to improve quality of life and reduce symptoms while others are used to control the cancer.

Chemotherapy, Targeted Therapies, and Immunotherapy

Chemotherapy, also known as chemo, is a treatment for cancer that uses drugs to kill cancer cells. It is a systemic treatment, where the drugs travel throughout the whole body to reach cancer cells that may have spread to other areas of the body. Chemotherapy may be injected directly into a vein intravenously (IV), given through a catheter (thin tube placed into a large vein) or in a pill form taken orally. It is used to cure, control and relieve symptoms caused by the cancer.

Ochsner Health offers a free chemotherapy class for patients who will be receiving chemotherapy as part of their treatment plan. These classes are available online and in-person.

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As researchers learn more about the molecular make-up of lung cancer, we have identified dozens of mutations in cancer cells that drive the growth and spread of lung cancer. At Ochsner, we perform molecular testing from tumor biopsies for all of our patients with non-small cell lung cancer. Often we identify a mutation from this testing that can be targeted with a therapy specific for that patient. This individualized approach to cancer treatment for each patient’s cancer is called precision cancer medicine. Targeted therapies are a newer class of drugs that act against cancer cells with a specific mutation. These can be taken orally or by IV.

Another recent development in the treatment of lung cancer is immunotherapy. The role of the immune system is to defend the body against microorganisms (bacteria, viruses, fungus) and cancer cells. Specialized immune cells, called T cells, can learn and remember specific foreign proteins called antigens. Many cancers are probably recognized and eliminated by our immune system, but some cancer cells can outsmart it. While chemotherapy and tumor-targeted drugs directly affect the growth and spread of cancer cells, immunotherapies are designed to re-activate our T cells to attack and destroy cancer. Immune checkpoints are natural markers on our immune cells designed to turn off the immune system to prevent damage to healthy cells. Cancer can hijack these markers to turn our T cells off when they try to attack a cancer cell. Intravenous medications known as immune checkpoint inhibitors (ICI) allow a patient’s immune system to fight cancer.

Ochsner’s thoracic medical oncologists have extensive experience and specific expertise in these newer treatments.

Radiation Therapy

Radiation therapy is the use of high energy X-rays to kill cancer cells. For early-stage non-small cell lung cancer in patients who may not safely tolerate surgery, high-dose focused radiation known as Stereotactic Body Radiation Therapy (SBRT) is often used as primary treatment. For more advanced non-small cell lung cancers and small cell lung cancer, radiation therapy is often given in combination with chemotherapy. In very advanced disease it may be used to provide relief from pain, blocked airways, or bleeding. Side effects depend on the part of the body that is treated but may include sore throat, difficulty swallowing, inflammation of the lung, fatigue or skin changes at the site of treatment.

Surgery

Surgery may be used to treat early stages of lung cancer. This allows removal of the tumor and surrounding tissues to give patients the best chance for a cure. Surgery is performed by our specialized thoracic surgeons who will determine if the tumor is removable. If a patient has a history of medical issues or poor lung function, surgery may not be recommended. Our multidisciplinary team of pulmonologists, medical oncologists and radiation oncologists work together to determine if surgery is the best option.

Types of surgery include:

• Limited resection – An operation to remove only a small portion of the lung.
• Lobectomy – Removal of a defined section of the lung. This is the most common surgery for lung cancer.
• Pneumonectomy – The removal of the entire lung.
• Robotic surgery - Instead of making large incisions as in traditional surgery, the robot only requires a series of small incisions.

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Clinical Trials

Participating in a clinical trial may be a treatment of choice for some patients. Ochsner has over 100 cancer clinical trials both in early and late phases. Phase 1 clinical trials are conducted to find out if new cancer treatments are safe, which is usually reserved for patients with advanced cancer and limited treatment options. When treatments are deemed safe during Phase I, Phase II clinical trials are conducted to find out how effective these newer treatments can be. Phase II trials usually add newer study drugs to already accepted standard treatment regimens in an effort to improve responses and survival. If a treatment regimen in Phase II is found to be very effective, randomized Phase III clinical trials are conducted to compare the newer regimen to already existing standard treatments.

Clinical trials are designed to ensure patients enrolled are either receiving standard treatments or a potentially more effective study treatment regimen. The standard treatments we use today were effective on earlier clinical trials. Our patients who enroll in a clinical trial may be the first to receive a cutting edge, prospective new treatment. These patients also help improve the way cancer will be treated in the future. If the trial does not lead to new treatments that are more effective than standard, they still pave the way for our researchers to answer important questions moving forward that will help future cancer patients.

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There are now indications for chemotherapy, surgery or radiation, targeted therapies, and immunotherapy for both early and advanced stages of lung cancer. Sometimes these treatments are used alone, in combination, or in sequence. We use a multidisciplinary approach to tailor a treatment plan specific for each patient with lung cancer at Ochsner.

In 1939, Dr. Alton Ochsner, one of Ochsner's founders, was one of the first to discover the link between tobacco use and lung cancer. He then dedicated the rest of his life to educating the world on the dangerous effects of smoking.

When Drs. Alton Ochsner and Michael DeBakey published their groundbreaking paper linking smoking and lung cancer in 1939, even the idea that lung cancer cases were increasing was controversial. Plenty of physicians did not accept or believe the mounting evidence that lung cancer was on the rise.

But Alton Ochsner was seeing more and more lung cancer patients in the operating room, and many of them were heavy smokers. Proving the link between smoking and lung cancer, treating the disease, and finding a cure became the focus of his research and put him at the center of a scientific controversy.

“In our opinion the increase in smoke with the universal custom of inhaling is probably a responsible factor [in the increase in pulmonary carcinoma], as the inhaled smoke, constantly repeated over a long period of time, undoubtedly is a source of chronic irritation to the bronchial mucosa.”
- Alton Ochsner, MD and Michael DeBakey, MD, 1939

Our History