Sitha Maliwa
Lung cancer has long carried a grim reputation, often associated with late diagnoses and limited treatment success. Its symptoms can be subtle, like a persistent cough, and are frequently mistaken for minor ailments. As a result, many patients only receive a diagnosis once the disease has reached an advanced stage, making effective treatment more challenging.
In South Africa, lung cancer is the leading cause of cancer-related deaths. The most significant risk factor remains tobacco use, with 33.4% of males and 8.3% of females over the age of 15 identified as tobacco consumers. Other contributing factors include a family history of cancer, poor diet, chronic obstructive pulmonary disease (COPD), ionising radiation, HIV infection, occupational hazards, and exposure to air pollution. Despite these risks, South Africa lacks a formal lung cancer screening programme. Nonprofit organisations such as the Cancer Association of South Africa (CANSA) play a vital role by offering support for research, public education on symptoms, early detection, screening efforts, and risk reduction.
However, there is encouraging news.
Portia Mmenu, Medical Affairs Manager at Johnson & Johnson Innovative Medicine South Africa, shared: “In recent years, lung cancer treatment and its diagnosis have undergone a significant transformation. Awareness amongst the general public has to be increased, however, as lung cancer is still largely perceived as a ‘death sentence’, which it needn’t be.”
She continued: “Patients need to be aware, however, that advancements in medical research, technology, and personalised medicine are rapidly changing the landscape of lung cancer care.”
One of the most critical shifts in lung cancer management is a renewed emphasis on early detection. More than two-thirds of patients are currently diagnosed at a late stage, when the cancer has already metastasized. But the introduction of low-dose computed tomography (LDCT) for high-risk individuals is proving to be a game changer.
Studies have shown that LDCT screening can reduce lung cancer mortality by up to 20% compared to traditional chest X-rays. This non-invasive method enables the identification of small, asymptomatic tumours, allowing for earlier and more effective intervention.
Another major breakthrough in lung cancer care is a deeper understanding of the genetic mutations that drive tumour development.
“Significant research in this area is pushing new boundaries of hope,” Mmenu noted reassuringly. “Other discoveries are also paving the way for the development of targeted therapies that are less invasive, and lead to more personalised and effective treatments.”
While chemotherapy, radiation, and surgery remain important treatment options, researchers are increasingly focusing on less aggressive, more refined approaches.
“EGFR inhibitors and ALK inhibitors demonstrated remarkable results in patients with the two most prominent types of lung cancer,” said Mmenu. “These therapies have demonstrated improved survival rates and reduced side effects, compared to the more conventional options.”
Immunotherapy has also emerged as a promising avenue.
“This approach,” Mmenu explained, “harnesses the body’s immune system to recognise and attack cancer cells. By blocking the proteins that prevent immune cells from attacking cancer cells, these drugs enable the immune system to mount a stronger and more sustained response against the tumour. This branch of treatment heralds a quantum leap forward in lung cancer care.”
Tracking how a tumour responds to treatment is crucial in personalising care. In this regard, liquid biopsies are gaining attention as a breakthrough technology.
“Cancer treatment isn’t only about attacking the cancer cells,” Mmenu informed us, “but is also very concerned with the ongoing tracking of tumour progression, and the therapeutic response thereto.”
Unlike traditional biopsies, which can be invasive and uncomfortable, liquid biopsies allow for frequent and less invasive monitoring by analysing tumour DNA in the bloodstream.
Modern lung cancer treatment no longer relies on a single specialist. Instead, a multidisciplinary care model is becoming standard. Oncologists, radiologists, thoracic surgeons, pathologists, and pulmonologists now work collaboratively to design individualised treatment plans that meet each patient’s specific needs.
This integrated care approach is another sign of how lung cancer treatment is evolving beyond a one-size-fits-all framework. Alongside clinical advances, there is growing recognition of the psychological toll of a cancer diagnosis.
“What we should never forget,” cautioned Mmenu, “is that, in the midst of all this research and new treatments and technologies, is the patient; a person who is plagued with anxiety about a premature mortality, as well as other matters, such as reduced vitality and physical activity, and a drop in real income, caused either by treatments, an inability to work, or both. Support groups such as CANSA supply guidance in these areas, which can prove invaluable to both patients and those who are close to such individuals.”
The landscape of lung cancer care is undergoing a paradigm shift. Early detection through LDCT, targeted therapies based on genetic insights, the rise of immunotherapy, the use of liquid biopsies, and a holistic, team-based approach to treatment are all combining to transform outcomes. For patients, this means lung cancer is no longer an automatic death sentence. With increased awareness, timely screening, and access to these modern treatments, there is real hope for longer, better-quality lives. – @NewsSA_Online