Advancements in treatment reduce lung, skin cancer death rates

Credit: India Duke

Recent studies show reduction in some cancer related deaths due to advancements in treatment, tumor analysis, and less aggressive surgeries.

Credit: India Duke

Deaths from lung and melanoma skin cancer — two of the most common and life-threatening cancers — have declined in the past 20 years, according to a recent National Cancer Institute report.

The decrease is attributed to fewer smokers and treatment changes, including drugs and therapies, fewer surgeries and tumor analysis. Earlier diagnoses also are leading to better outcomes, said Dan Suffoletto, spokesman for Public Health-Dayton & Montgomery County.

“Earlier diagnosis of the cancer will lend itself to having the treatments work better,” Suffoletto said.

Men and women of all racial and ethnic groups experienced a decline in deaths nationally, according to the report. The death rate of men declined 1.8% per year between 2001 to 2015 and 2.3% decline per year from 2015 to 2018. Women experienced a decline of 1.4% per year from 2001 to 2015 and 2.1% per year during 2015-2018.

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In Ohio, over the past 10 years lung cancer claimed the lives of about 7,000 people and is the leading cause of cancer-related deaths. But even with that, death rates decreased by 25%, according to the Ohio Department of Health.

For Montgomery County, lung cancer related deaths decreased from 45.5 to 38.6 per 100,000 people between 2016-2017.

However, skin and melanoma cancer deaths increased by 3.3 per 100,000 people between during those years, according to data from Public Health Dayton and Montgomery County.

The use of immunotherapies that boost the patients’ immune system to fight the cancer has been used for several years as a treatment option, likely another cause of the decrease.

“What we’ve seen in the last several years is a multitude of drugs that have very specific targets and ways to boost the immune system,” said Dr. James Ouellette, surgical oncologist at Premier Health. “So, lung cancer for sure has seen improvement because of immunotherapy and directed treatments.”

Dr. James Ouellette, surgical oncologist, performs a surgery at Miami Valley Hospital.
Dr. James Ouellette, surgical oncologist, performs a surgery at Miami Valley Hospital.

Credit: Ron Alvey

Credit: Ron Alvey

The cultural push to stop smoking and the implementation of lung cancer screenings to find abnormalities sooner are also contributing factors to the decrease, Ouellette said.

Melanoma is the most dangerous skin cancer and new cases have increased by 72% but the death rate in the state has remained consistent at 2.7% between 1996 to 2017.

“We have completely changed the paradigm in how we treat melanoma by staying current with research, by changing the treatment and monitoring and implementing new therapies when they become available,” said Ouellette.

Identifying which patients are high risk and low risk through tumor analysis has helped, he said. With tumor analysis physicians can look at the composition of the growth to determine which drugs would be the most effective in treating patients. However, the biggest change is rooted in surgical procedures.

Over the years studies revealed that there wasn’t a significant difference in survival if the patient received surgery with only a small amount of lymph node involvement with their melanoma.

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“We used to move forward with surgery right away in those patients,” he said. “Now, to minimize the surgical complications and long-term changes when we remove large areas of lymph nodes, we start to monitor those patients with ultrasound, and we monitor people to see if something develops and that’s what cues a more major surgery.”

A wave of new drugs have been made available to treat melanoma and skin cancers. Unlike lung cancer where smoking, asbestos, and environmental factors can increase risk, skin cancers are largely predetermined in patients with light skin, light eyes and even freckles.

“The only real factor we know that can be a contributor is of course sun exposure, sunburns, UV exposure, those kinds of things are more under our control and those are really the main education points for patients who have a melanoma,” Ouellette said.

The declines in lung cancer and melanoma death rates are the result of progress across the entire cancer continuum — from prevention to targeted drug therapies, Karen E. Knudsen, American Cancer Society CEO said in a statement.

“While we celebrate the progress, we must remain committed to research, patient support and advocacy to make even greater progress,” she said.