Why Is Lung Cancer the Deadliest Cancer Today?

Did you know that cigarette smoking was first linked to the development of lung cancer way back in 1912? It’s a startling fact that highlights the dangers of smoking and the long-lasting impact it can have on our health. The first effort to reduce smoking in the United States started in 1964. Half a decade later, campaigning against smoking had successfully cut the smoking rate in the country by more than 50%. However, smoking remains, until today, the leading cause of lung cancer, accounting for 80-90% of all lung cancer cases.

According to the statistics from the World Health Organization (WHO) in 2022, lung cancer:

• is the most commonly diagnosed cancer
• the deadliest cancer

in both males and females worldwide.

“Lung cancer is by far the leading cause of cancer death, making up almost 25% of all cancer deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.”

– American Cancer Society.

What makes lung cancer the biggest cancer killer?

Sometimes, it's easy to miss the signs of lung cancer, like coughing and chest pain. It’s vital to prioritize your health and seek medical attention if you are experiencing any concerning symptoms. Most of the time, the disease only gets diagnosed when the symptoms persist and turn chronic. By then, the cancer may have spread and become too advanced to cure. Only 16% get diagnosed early. And only 22% of patients with lung cancer survive the 5-year mark, compared with over 80% of prostate and breast cancer patients.

In the US, 10-20% of lung cancer patients have never smoked or smoked less than 100 cigarettes in their lifetime. A study presented at the 2022 World Conference on Lung Cancer has shown that about 75% of lung cancer patients in the 20-29 age group were diagnosed with stage IV. Due to the strong association between smoking and lung cancer, the awareness of lung cancer and its other risk factors is low among non-smokers, especially the younger age group. In these instances, other risk factors for lung cancer are in play: family history, underlying lung disease, and exposure to secondhand smoke, radon, asbestos, or air pollution.

The current bias against lung cancer is a regrettable reality that impacts timely detection. The association of lung cancer with smoking has resulted in its labeling as a "smokers' disease," which can be a challenging stigma for individuals who develop the condition despite never having smoked. It's crucial to acknowledge that lung cancer can affect anyone and to foster a supportive environment for those facing it.

The poor survival rate of lung cancer contributes to the perception of the disease as a "death sentence." This results in delayed diagnosis, as well as undertreatment. A 2018 study found that nearly two-thirds of elderly aged 75 and above do not receive standard treatment. These patients were also less likely to survive as long as their counterparts receiving standard treatment.

There are many “concerns over the usefulness of therapy for patients with competing risk factors” due to their advanced age. Current clinical studies are investigating the effects of targeted and immunotherapy as initial treatment in treating non-metastatic lung cancer. The researchers noted that these treatments could be beneficial for older lung cancer patients for their milder side effects compared to traditional chemotherapy.

“Lung cancer is different. These people are older, poorer and they live shorter lives. They have had much less power to advocate for themselves,"

- Dr. Bernardo Goulart, researcher and oncologist with Fred Hutchinson Cancer Research Center.

Treating lung cancer has always been believed to be a difficult task. The primary reason is the rapid rate of drug resistance development by cancer cells. Among the cancer types, lung cancer, particularly small cell lung cancer, is known to be aggressive and can spread rapidly. Resistance occurs when there is a molecular change in the cancer cells, which means they are no longer sensitive to the planned treatment. Drug resistance can occur in chemotherapy, immunotherapy, and targeted therapy for lung cancer.

For this reason, lung cancer treatments have evolved from the "one size fits all" approach of chemotherapy to more precise treatment options offered by personalized or precision medicine. In the last two decades, advances from research to FDA approval have given rise to companion diagnostics, the biomarker-driven tests that guide treatment decisions. Lung cancer patients now have a more comprehensive range of options and choices to improve their treatment outcomes.