Jayme Monacelli: This is Med Talk, presented by HCA Midwest Health. I'm Jayme Monacelli. November is Lung Cancer Awareness Month. That means raising awareness of the disease that is by far the leading cause of cancer death among both men and women, making up almost a quarter of all cancer deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. Here's some numbers for you. During 2020, the American Cancer Society estimates that lung cancer in the US will have about 228,820 new cases. That's 116,300 in men, and 112,520 in women. It'll kill about 135,720 people, that breaks out to about 72,500 in men and 73,220 women. Jayme Monacelli: Dr. Joseph Stilwill, a board certified medical oncologist at Sarah Cannon Cancer Institute at HCA Midwest Health is here to talk about lung cancer signs and symptoms, prevention, technology advances in screening, and a warning about how COVID-19 affects the lungs. So Lung Cancer Awareness Month comes as we're all trying to stay safe, to avoid exposure to and contracting COVID-19. You've got some important messaging on how the highly contagious respiratory infection presents challenges for those with lung cancer and affects the lungs overall. But before we get to that, can you give us a snapshot of who exactly is diagnosed with lung cancer? Joseph Stilwill: Well, so the short answer is that really anybody could be diagnosed with lung cancer, but we know that lung cancer affects older patients more often. So we know that the average age that patients are diagnosed with lung cancer is about 70. We know that obviously lung cancer affects smokers more than non-smokers. And we know that there's some predilection for African-American men over Caucasian men, actual predilection for Caucasian females over African-American females. Jayme Monacelli: What about the prevalence of lung disease here in Missouri and Kansas? Joseph Stilwill: So we know that actually in Missouri, the predilection is a bit higher than the national average. In Kansas it's a bit lower. But in both cases, it's still right around the national average. So it's still clearly, as you said, the number one cause of cancer mortality in adults in the United States, and that's true in both Kansas and Missouri. Jayme Monacelli: What is happening to lung cancer rates overall? Up or down? Joseph Stilwill: They're going down. And I think that that's obviously related to smoking cessation. And so that tracks over time and it's gone down over several years, especially in men. I think the other really exciting part for us is that the rate of lung cancer death is going down. And so probably saw a few months ago that the largest decrease year over year in cancer mortality in the history of th Jayme Monacelli: We also know that there's been some advances with early detection and treatment like low dose CT screening. Tell us about that. What is low dose CT screening? Joseph Stilwill: So low-dose CT uses about a quarter of the dose of radiation of a normal CAT scan, and it doesn't involve any IVs or anything like that. And it is done once a year in patients that are at high risk for lung cancer. And it's shown to significantly reduce the risk of dying of lung cancer in patients that are at high risk. Jayme Monacelli: Who qualifies for that kind of screening? Joseph Stilwill: Patients age 55 to 74 qualify, and it's patients who are current smokers, or who have quit within the last 15 years. Also, patients who have smoked the equivalent of one pack per day for a total of 30 years. So if you smoked two packs per day for 15 years, that also qualifies. Jayme Monacelli: Give us some of the signs and symptoms of lung cancer, and we'll also talk about how to prevent it. Joseph Stilwill: Shortness of breath, cough that won't go away, what you think might be a cold or a respiratory infection that won't going away. Certainly if you cough and have blood, that's something that we really worry about. It could be pain or weakness, especially in the shoulder, and sometimes it will be associated with a fever that won't go away, and they're non-specific symptoms. But I think the big thing is that are symptoms that don't just kind of come and go, they continue on. And I think if somebody has symptoms that are really persistent, that really warrants medical attention. Jayme Monacelli: What are the best ways to prevent getting lung cancer? Joseph Stilwill: Well, the number one way is obviously smoking cessation. Smoking is clearly strongly associate with lung cancer. And there are really programs now that can significantly help patients to quit smoking, whether that's via pills or whether that's via counseling or support groups, all those things are really helpful. And so I think that's the number one thing to really take home is that smoking cessation makes a big difference. Even if you're 60 or 70, it's still makes a big difference. It still significantly reduces your risk. Jayme Monacelli: Let's talk about COVID-19 now. How does COVID-19 affect the lungs? Joseph Stilwill: COVID-19 can cause pneumonia in the lungs and can really compromise lung function. And so obviously that has an overlap with lung cancer because in patients whose lungs aren't perfect, they're more at risk for complications from COVID-19. Jayme Monacelli: And let's get into that a little bit more. What challenges does COVID specifically present for patients with lung cancer? Joseph Stilwill: So I think, beyond the fact that patients with lung cancer have less pulmonary reserve or less ability to make up for some loss of lung function, it's also that a lot of patients who are undergoing treatment for lung cancer are immunosuppressed. And so their immune system isn't as able to fight the virus. And so it definitely presents challenges and definitely important for patients with lung cancer to do the best that they can from a social distancing perspective. Jayme Monacelli: Thanks a bunch to Dr. Joseph Stilwill, MD, board certified medical oncologist with the Sarah Cannon Cancer Institute at HCA Midwest Health. This has been Med Talk presented by HCA Midwest Health. I'm Jayme Monacelli.