Silent Killer

I went to a funeral of a dear patient today. She was 72 years old, she was married for 54 years, and she had one son. She loved to play golf, to over-decorate the house for the holidays, and to spend time with her family. But she also loved to smoke her cigarettes despite our many discussions about the risks of smoking.

She had been fine until 3 months ago when she presented with abdominal pain. Shortly thereafter she was diagnosed with widespread lung cancer that was growing by the day. Six weeks is all that she had from the time of her lung biopsy to her death.

Lung cancer scares me because I know that no matter how complete a physical exam or how many tests that I perform, there is a chance that it may still be awaiting my patient. Lung cancer kills more people around the world than any other cancer. 10 million new lung cancer diagnoses are made each year. Most of these cases are diagnosed too late in the course for effective treatment. Over three quarters of all lung-cancer patients are/were long-term regular smokers. The only means of diagnosing lung cancer is by chest xray or chest CT scan. Neither of these tests is effective in detecting the cancer at an early stage.

A recent study in the Journal of Thoracic Oncology, however, has concluded that a blood test may be able to predict early non-small cell lung cancer with an accuracy rate of 87%. The cancer may be present 3-5 years before it is detected on the imaging tests. Although it is too late for this particular patient, there is promise that others may have a chance of earlier detection and therefore of cure of lung cancer by a simple blood test. More studies will be needed to better define the role of this technology in clinical context.