Stanford medical professor Bryant Lin founded the school's Center for Asian Health Research and Education, advocating for better lung cancer screening in particular. Then two years ago Lin became a Stage IV patient of the very disease he long crusaded against. "Super ironic that I would be co-leading the center that supports research and education in this disease, and I get diagnosed myself," he says.
Lin, who is a non-smoker, tells students he considers himself lucky — even hopeful: "I think the future is really bright, because we're creating all of these personalized, specialized precision therapeutics for lung cancer," he says."My hope is if we're not able to cure lung cancer, we can at least turn it into a chronic disease." Notable improvements are shifting the prognosis for a disease once considered a death sentence. Much of the recent progress is so new, it is only starting to shift the statistics on survival. While the five-year survival rate across all stages of lung cancer has doubled in three decades, it still remains at a low 30%. (Stage of disease makes a huge difference; early, localized cancer survival rates over 5 years was 67% between 2015 and 2021.) The genetics of lung cancers are very diverse and complex relative to other cancers, making it historically tricky to treat.
One key technological development underlying many new treatments is the ability to identify, through genetic testing, the specific mutation driving a person's abnormal cell growth, according to UCLA oncologist and researcher Jonathan Goldman. "We can pick a drug that's really been developed for that type of cancer," he says. Not only can that manage or even shrink tumors, because the drugs are better targeted, they also cause less collateral damage, making side effects typically more tolerable for patients.
"Survival used to be under a year, and now it's often several years and sometimes many years," Goldman says. Whether it's breast, liver or lung cancer, targeting treatments by genetic subtype is far more effective than generalized treatments of the past, Goldman says, because the medicines are designed to focus their attack on specific mutated cells driving the abnormal growth. Since the medicines are targeted, they also tend to have fewer harsh side effects compared to chemotherapy.
Want the latest stories on the science of healthy living? Subscribe to NPR's Health newsletter. Tests to identify a patient's specific cancer subtype – a procedure called comprehensive genomic testing – are already available, and Goldman served as principal investigator on a recent study published in the New England Journal of Medicine, showing dramatic reductions in recurrence, when patients with rare subtypes receive targeted medicines as their first treatment.
However, access to such testing is spotty. Goldman says fewer than half of lung-cancer patients in the U.S. get their cancer genetically tested prior to treatment because that evaluation is not yet considered "standard of care." Plus, doctors themselves may not be aware it exists; Goldman says treatment technology is changing so rapidly, general oncologists may not be up-to-date on some of the most recent developments specific to lung cancer. "The next step is not just these scientific discoveries, but learning how to implement these findings," he says.
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