Survival Improves Slightly for Advanced Lung Cancer

Modest Improvement No Cause for Celebration, Researcher Says

Medically Reviewed by Louise Chang, MD on December 02, 2009
From the WebMD Archives

Dec. 2, 2009 -- Survival for the advanced stage of the most common form of lung cancer is slightly better than it was 20 years ago, a new study says.

Reporting in the November issue of the Journal of Thoracic Oncology, researchers say one-year survival of people with stage IV non-small-cell lung cancer has improved from 13% in 1990-1993 to 19% in 2002-2005 -- but still is less than 20%.

Lead author Daniel Morgensztern, MD, of the Washington University School of Medicine, tells WebMD that he feels the improvement is “only modest” and rather disappointing. The article calls the findings “sobering.”

“There has been a small but statistically significant improvement in survival for patients with stage IV non-small-cell lung cancer over the last 16 years,” he tells WebMD. “In absolute numbers, however, the survival improvement ... is hardly a reason to celebrate.”

Morgensztern and colleagues analyzed patients over four equally divided time periods between 1990 and 2005, identifying 129,337 people with stage IV non-small-cell lung cancer from the Surveillance, Epidemiology and End Results (SEER) registry. Non-small-cell lung cancer is the most common type of lung cancer. Stage IV means that the cancer has spread to distant areas of the body.

Better Lung Cancer Survival

In the first period, 1990-1993, the study says 13.2% of patients with this stage of the disease survived a year and 4.5% survived two years. By the fourth period, covering 2002-2005, one-year survival had improved to 19.4% and two years to 7.8%.

That’s significant, he tells WebMD, but much more improvement is needed.

“With so much effort and research on lung cancer, we hope for more robust improvements soon,” he says.

The study attributes some of the improvement to the development of new chemotherapy agents and treatment regimens, such as the introduction of targeted therapies. “The main tasks are to identify which treatment fits best for individual patients and develop new treatments with increased efficacy and decreased toxic effects,” he tells WebMD.

Smoking Still a Factor

Lung cancer is the most common cause of cancer-related death in the U.S., killing an estimated 162,000 people in 2008, the researchers write. The use of positron emission tomography (PET scan) has been associated with increased detection, the researchers write, and Morgensztern tells WebMD such scans should be considered more often.

Still, he tells WebMD, the outlook for lung cancer patients is chilling.

“In terms of new hope, you should remember that the median survival remains very poor, less than seven months in the general population,” he tells WebMD.

Smokers, he adds, should quit.

“The probability of developing lung cancer decreases in former smokers, although it remains unclear if it ever reaches the probability of the general nonsmoking population,” Morgensztern says.

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Morgensztern, D. Journal of Thoracic Oncology, November 2009, vol 4.

Daniel Morgensztern, MD, division of medical oncology, Washington University School of Medicine.

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