CRH medical oncologist discusses importance of lung cancer screenings, smoking prevention, treatment advances

Columbus Regional Health is hoping to screen more local residents for lung cancer, one of the biggest cancer killers in Bartholomew County, which officials say is largely driven by the high smoking rate in the community.

From 2011 to 2020, 457 Bartholomew County residents died from lung cancer, accounting for nearly 30% of all cancer deaths in the community over that time period, according to the most recent figures from the Indiana Department of Health.

At the same time, about 24% of adults in Bartholomew County are smokers, compared to 21% of adults in Indiana and 16% of adults nationwide, according to a January 2020 policy brief on CRH’s tobacco awareness website.

Dr. Nadeem Ikhlaque, a medical oncologist and hematologist who specializes in lung cancer at CRH, spoke with The Republic about why Bartholomew County tends to have more lung cancer patients than the national average and the importance of getting screened. The conversation has been edited for length and clarity.

Q: How does our local lung cancer rate compare to state and national levels?

A: It is actually slightly on the higher side as compared to the national average just because, in Indiana, the prevalence of smoking is higher, and that’s why we see more lung cancer patients than the national average. And Columbus, the city itself, also has a higher prevalence of smoking. Unfortunately, that is leading us to see higher numbers of lung cancer patients.

Q: You’ve mentioned that smoking is one of the main causes of lung cancer. Are there any other common causes?

A: When I teach my students, I always tell them that the first 10 risk factors for lung cancer are smoking. The majority of the patients that we see (are smokers.) But unfortunately, we are understanding more that there is a small percentage of lifelong nonsmokers who can develop lung cancer. It is either related to some specific genes, which can potentially lead to lung cancer, or there is some type of environmental exposure, which can potentially lead to lung cancer.

Q: You’ve talked about the risk that smoking poses, what about vaping?

A: Vaping is as dangerous, if not more so, than smoking. I know this is the new fashion, but it truly has turned out to be as dangerous as smoking, and in some studies, actually even more toxic to the lungs.

Q: Why get screened for lung cancer?

A: There is a much higher chance of detecting lung cancer at an early stage as compared to an advanced stage, because by the time lung cancer begins to cause symptoms, 90% of the time it is a stage 4 or stage 3 disease. If we pick it up at an early stage … we can offer a curative surgery or a very specifically focused radiation therapy for those patients who cannot undergo a major surgery. … Both of those treatments are available at CRH.

Q: To what extent have you noticed a decrease in lung cancer screenings during the COVID-19 pandemic?

A: That was a big issue. … The pandemic did influence all the screenings and all the preventive stuff. And … we did actually see a significant rise in the numbers of stage 4 lung cancer patients because these patients probably were not able to go through screening the last couple of years before they presented with symptoms.

Q: Where can someone get screened for lung cancer?

A: Their primary care office. And we have here at CRH a Lung Institute as well. So, they can easily either contact their primary care office, or they can just contact the Lung Institute to get your screening CTs done.

Q: Who should get screened?

A: Those who have a history of smoking or are current smokers. Those who quit smoking within the last 15 years, and those within the age group of 50 to 75.

Q: What does a lung cancer screening entail?

A: It is a CT scan without any dye or anything, so there is no risk. It’s a low-radiation, low-risk CT scan.

Q: What else do you think people should know about lung cancer?

A: It is so important to have an anti-smoking campaign throughout the community, targeting the younger generation so they never start smoking. …When someone smokes for so many years, we see that the toughest part is to quit smoking. So, targeting the school-age group to develop that awareness, kind of that hatred against smoking, and that it can potentially cause some fatal illnesses, including lung cancer. I think that is the number one message in terms of community outreach for lung cancer. And then the second message I wanted to give is for patients who are actually diagnosed with lung cancer. There is hope. There is optimism. There are multiple new treatments which are much better, more tolerable, and much more effective than what we used to see. That is what’s making me excited as a lung cancer doctor, my patients can benefit, and we see the difference both in terms of quality of life and improvement in overall survival.