Lung Cancer " Ask the Expert" with Syed Quadri, MD

November 7, 2011 at 7:33am

Ask the Expert

Topic: Lung Cancer: Early diagnosis, different stages, new advances & treatment options

Expert: Syed Quadri, MD

10 - 11 am on Facebook 


Syed Quadri, MD, thoracic surgeon at UMass Memorial Medical Center and assistant professor of surgery at the University of Massachusetts Medical School, answers your questions about lung cancer, the importance of early diagnosis, the different stages of cancer, the best treatment options , minimally invasive surgery and more. He is known by patients and colleagues as a highly skilled surgeon and a compassionate doctor. He sees patients in Worcester and in Leominster and works closely with primary care doctors and other physicians across the region to make sure their lung cancer patients receive the best care possible. Learn more about our Ask the Expert sessions:


Question: Are there new ways to detect lung cancer before it starts to spread?

Answer: There is new emerging evidence suggesting better survival with screening CT (computed tomography) scans for patients at high risk who do not have any symptoms.  This is still very new and not yet standard of care.  However, there is great hope that we may be able to save lives by screening people who used to smoke heavily and hopefully finding lung cancer at an early, more curable, stage before it has started to spread.


Questions: What are the most common symptoms of lung cancer?

Answer: Most patients with early stage lung cancer have no symptoms.  This is why it is so difficult to find at an early stage.  However, when patients do have symptoms, they may develop some of the these symptoms:  a persistent cough that does not clear up within a week or two, pneumonia that does not clear up within a week or two of treatment, coughing up sputum (or mucus) tinged with blood, chest pain, head aches, dizziness, bone pain, or abdominal pain.


Are there clinical trials available for new lung cancer treatments?

Answer: There are many clinical trials for patients with lung cancer.  UMass Memorial surgeons and physicians enroll patients with all different stages of lung cancer into clinical trials for surgery, medical management, radiation therapy, or a combination of these options.


Question: Can you explain why some people who are diagnosed with Stage 2A lung cancer may have to receive chemotherapy and/or radiation therapy after surgery?

Answer: Stage 2A patients have lung cancer which has already spread to lymph nodes around the tumor.  Because the tumor has already "started" to spread, the thinking is that microscopic tumors remain in different areas of the body.  Surgery removes the large tumor in the lung while chemotherapy can "mop up" the microscopic disease which may have already spread.  There is evidence that these patients have a lower risk of recurrent disease and a higher survival if they receive chemotherapy after their surgery.  However, this needs to be balanced with the risks associated with chemotherapy. Every patient is unique and needs to talk to his or her doctor about their specific plan of care.


Radiation is not usually recommended for patients with Stage 2A lung cancer after their surgery.  However, in certain select cases, it may be necessary to kill cancer cells around the border of the tumor that were not removed during the surgery.


There are a variety of treatment options, and for our upcoming event on November 16 (Lung Cancer: Hope, Health and Healing) we’ve convened a panel of experts to discuss them and how we take a team approach to treatment for each patient.


Question: My husband (age 46) used to smoke a pipe--about two bowlfuls a day; a habit that lasted almost five years. He quit more than a year ago. Is he still at increased risk for lung cancer? (He has a family history of cancer--his mother had both breast and then esophageal cancer.) Should he be screened?

Answer: Patients who smoke a pipe or chew tobacco are at slightly higher risk for lung cancer--usually not as high as cigarette smokers because pipe smokers usually do not inhale the smoke as deep into their lungs.  However, pipe smokers are at higher risk of cancer of the lips, mouth, oral cavity, and esophagus.  The question of screening for your husband is still unknown.  I would recommend that you discuss the pros and cons of screening with your doctor.


Question: How long would someone have to stay on maintenance chemotherapy and why? 

Answer: This really depends on what stage the cancer was and if previous chemotherapies were successful or not.  Maintenance chemotherapy can be lifelong in some instances.  One of the topics we’ll discuss at the November 16 (Lung Cancer: Hope, Health and Healing) symposium is “Intelligent Survivorship” and how best to use all the tools available to stay healthy.


Question: I hear a lot about meditation and stress reduction. Are they really helpful for someone dealing with lung cancer? It's hard to have a positive attitude during treatment; so how important is it; really?

Answer: This is another topic we’ll talk about at our upcoming event on November 16 (Lung Cancer: Hope, Health and Healing). There is evidence that suggests that patients who have a positive attitude and use meditation and stress reduction techniques do cope better with the diagnosis and treatment of lung cancer.  They may be able to deal with the situation more efficiently and get through the treatment with less anxiety. 


However, it is not proven that these patients live any longer due to these techniques.  Sometimes, families expect too much from their family member and want them to "fight the cancer."  This might be placing undue pressure on the patient, so family members should keep this in mind and do everything to be supportive while allowing the patient to make decisions to guide their treatments.


Question: What is the difference between small cell or non-small cell lung cancer? Which is more common?

Answer: Non-small cell lug cancer is much more common (approximately 75-80% of all lung cancer).  Non-small cell lung cancer can present in the lung only and can be treated with surgery and/or chemotherapy and radiation.  If the patient has early stage non-small cell lung cancer and if it can be completely removed by surgery, the chances for disease recurrence is usually reasonably low (5 year survival of 40-80%).


However, small cell lung cancer is almost always present in multiple spots when it is found.  There is usually no role for surgery in small cell lung cancer.  Patients usually get chemotherapy and radiation only.  While most patients with small cell respond to chemotherapy and radiation, unfortunately, the cancer comes back in many of these patients; the 5-year survival is less than 5%. 


Question:  I worked as a waitress in a bar for 15 years (back when smoking inside was legal) and it was very smoky to say the least. I've always been concerned about the effects of second hand smoke and the risk of lung cancer. Should I consider a lung cancer screening? I am early 50's and have a history of cancer in my family.

Answer: There is evidence that second hand smoke also causes lung cancer.  However, there is no known data about screening patients who have been exposed to smoking in the work place.  Again, please discuss the pros and cons of lung cancer screening for you with your physician.