Save Your Breath

Lung cancer is one of the most

aggressive cancers, often evading detection methods and traditional cancer treatments. But it's also largely preventable.

Lung cancer is the leading cause of cancer death among women and men, projected to kill more than 12,440 Floridians this year alone. For years, the number of female smokers has been steadily rising, and the number of cancer deaths has followed suit. Meanwhile, smoking among men has been on the decline for about a decade. But recently lung cancer deaths among women have leveled off. This is good news to doctors, who remain convinced that prevention is the answer.

And the best prevention is avoiding smoking, says Dr. Mark Moskowitz, a medical oncologist with Florida Cancer Specialists in Naples. If you do smoke, it's not too late to stop: After 10 years of a smoke-free lifestyle, people reduce their chances of getting lung cancer by two-thirds.

There's a reason lung cancer is so virulent. Healthy lung cells have detoxifying attributes to combat the pollutants inhaled in a normal environment. That ability to fight off foreign invaders, while positive for healthy lungs, is also found in cancer cells. For that reason, they can resist many types of cancer treatments. "Lung cancer cells can put chemotherapy drugs out of commission," says Moskowitz.

So researchers and doctors look toward alternative treatments. Among the more promising are drug therapies such as Iressa, which aim to prevent the spread and growth of cancer cells.

"These drugs specifically target the molecular basis by which cancer spreads and grows," says Dr. James Reeves, a medical oncologist and hematologist with Florida Cancer Specialists of Fort Myers. "Our ability to control cancer is going beyond chemotherapy and radiation."

First approved by the FDA in 2003, such drugs come in pill form. They block the epidermal growth factor (a protein released by the body) from reaching the epidermal growth factor receptor, which stops the cancer cells from growing and promotes the multiplication of cells. The treatment is nontoxic, so patients don't face the severe side effects of other cancer treatments.

However, these drugs don't typically

kill cancer cells completely, which means patients have to continue treatment for the foreseeable future. And continued treatment can be costly-

up to $2,500 a month. Another

caveat: Nonsmokers are more likely to respond to these drugs, and they account for only 5 to 10 percent of lung cancer patients. When all is said and done, "it will be years before there's any real effective treatment," predicts Moskowitz.

New treatments are on the horizon. Drug therapies are being developed that would arrest the growth of the vessels needed for the cancer cells to grow and survive. And research by the Human Genome Project could help doctors determine on a patient-by-patient basis which cancer treatments will be most effective. New surgical practices also may prove beneficial-specifically, less invasive techniques such as keyhole surgery, which require only tiny incisions, aiding in the patient's recovery period. But because large portions of the lung must be removed once cancer cells are found, such techniques are still under scrutiny.

CAT scans and other traditional scanning methods can't detect lung cancer at its outset. In fact, by the time most patients begin to feel the physical effects of the disease, it's often too late to treat them effectively. "Fifteen out of 100 patients will survive five years after they've been diagnosed with lung cancer," says Ray Carson, spokesperson for the Florida division of the American Cancer Society.

"Treatments are progressing slowly," Moskowitz admits. "People need to realize they have to quit smoking or never start. To put their hopes in treatments is not the answer."

Quitline (1-877-U-CAN-NOW) offers counseling and pharmacy services.