November is National Lung Cancer Awareness Month

Lung cancer is one of the most widespread types of cancer found in the US.  One out of eight tumors reported in the US in 2008 (the year of the most recent national data available) were lung neoplasms.  The two main types of lung cancer, based on microscopic examination of the cells, are small cell lung cancer and non-small cell lung cancer.  Non-small cell lung cancer is the most common, and is subdivided into squamous cell carcinoma, large cell carcinoma and adenocarcinoma.

It is projected that one in 14 Americans will be diagnosed with lung cancer in their lifetime.  According to the National Cancer Institute, over 221,000 new cases are expected to be diagnosed in the US in 2011.  Smoking has been proven to be the most common cause of lung cancer.  Other risk factors include secondhand smoke, exposure to asbestos and radon.  Living in an area with higher air pollution has also been linked to increased non-small cell lung cancer.

Lung cancer is the third most common cancer at St. Alexius (following prostate and breast tumors) and the second most frequently diagnosed in the nation.

Top Cancer Sites
at St. Alexius
# 2010 % 2010 # 2002
- 2010
% 2002
- 2010
% US
Prostate 116 18.6% 649 14.8% 11.9%
Breast 100 16.0% 710 16.2% 17.9%
Lung 80 12.8% 667 15.2% 13.8%
Bladder 40 6.4% 210 4.8% 4.1%
Colorectal 31 5.0% 365 8.3% 9.5%
Hematopoietic 30 4.8% 198 4.3% 4.1%
Kidney 25 4.0% 162 3.7% 3.5%
Thyroid 20 3.2% 192 4.4% 2.8%
Leukemia 18 2.9% 105 2.4% 1.2%
Corpus Uteri 17 2.7% 136 3.1% 3.1%












Nationwide, lung cancer incidence is decreasing in men, from a high of 102.1 cases per 100,000 people in 1984 to 71.3 cases in 2006.  In women, the rate is approaching a plateau (63.1 per 100,000) after a long period of increasing incidence.  At St. Alexius, however, the proportion of men versus women is increasing from 29 of 54 lung cancer diagnoses (54%) in 2002 to 49 out of 80 tumors (61%) in 2010.

Lung cancer is the leading cause of cancer related deaths in both men and women.  It is estimated that 157,300 lung cancer related deaths occurred in the US in 2010, accounting for approximately 28 percent of all cancer deaths.  The death rates are following the diagnosis rates between the genders, with death among men declining, while the rate among women is reaching a plateau.  Of the 80 lung cancer cases here in 2010, 73 patients have been identified as current smokers or had used tobacco in their lifetime.

Nearly half of the lung cancers diagnosed at St. Alexius in 2010 were in patients between ages 70 and 79.  Only three patients were at less than 50 years old.

The stage of cancer describes the extent of the disease in the body, both in size and how much the cancer has spread through the body.  This is a common language for physicians to discuss the disease and how to treat it.  Using broad generalizations, the stages are:

Stage I - The tumor is confined to the lung.  The tumor is smaller than 3 cm.

Stage II - The cancer is confined to the chest including lymph nodes.  The tumor is between 3 and 7 cm in size.

Stage III - The tumor is larger than 7 cm and is still confined to the chest.

Stage IV - The cancer has spread (metastasized) beyond the chest.

Stage at diagnosis is critical to the prognosis of all cancer, and even more so in lung cancer.  The earlier it is detected, the better the chance of survival.  Unfortunately, lung cancer is often diagnosed in later stages, both at St Alexius and nationwide.

Nearly one out of four lung cancers are diagnosed in Stage I at St. Alexius and one in seven is identified in Stage II.  Sixty percent of lung cancers that are found at St. Alexius have reached Stage III or IV.  The first course of treatment of lung cancer following diagnosis includes surgery, chemotherapy and/or radiotherapy.  If the disease is too advanced, pain management (palliative care) may be the only course of treatment pursued.

The survival rates for the four most frequently diagnosed neoplasms in the US are also very close to the survival rates at St Alexius.  St. Alexius shows a seven percent greater success rate in the survival of lung cancer patients during the first two years following diagnosis, and continues to have a three percent higher rate after five years.

One of the most significant factors in the longevity of lung cancer survival is the stage of the disease at the time of diagnosis.

Lung cancer is one of the most life threatening tumors, and has a risk of occurrence that can be almost directly traced to smoking.  St. Alexius Medical Center and the affiliated physicians at Mid Dakota Clinic and the Bismarck Cancer Center are identifying and treating lung cancer with more success than national statistics show.  From smoking cessation program provided by St. A’s Respiratory Therapy department to the detection of the disease at an earlier stage to the surgical, systemic and radiological treatments available, St. Alexius Medical Center and its staff are working diligently to improve the diagnosis and treatment of lung cancer in central and western North Dakota and the neighboring states of South Dakota and Montana.