LUNG CANCER REPORT: 2014 DATA

CAPABIL I T I ES AND OUTCOMES

The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) has granted a Three-Year Accreditation with Commendation to the Cancer Center at El Camino Hospital.

Improvements in local and systemic treatment modalities are leading to measurable improvements in survival. The El Camino Hospital Lung Cancer Program employs a multidisciplinary team approach and customizes comprehensive treatment strategies for each patient. The team includes surgeons, medical oncologists, radiation oncologists, pathologists and radiologists, nutritionists, and social workers. Patients are diagnosed and treated in a comfortable setting, using the most advanced technologies. The comprehensive treatment approach favored by El Camino Hospital lung specialists has yielded excellent results. We have quadrupled our 5-year survival rates for patients with Stage III and IV lung cancers of any kind. Our survival rates signifi-cantly exceed national benchmarks, at every stage.

Lung cancer is the most common cancer worldwide, with

1.8 million new cases each year

LUNG CANCER is the leading cause of cancer death for both men and women in the U.S. According to American Cancer Society projections, there will be about 221,200 new cases of lung cancer in 2015: 115,610 in men and 105,590 in women. An estimated 158,040 of these patients will succumb to the disease.

The risk of getting lung cancer varies considerably from one state to the next. California is one of the 12 states with the lowest incidence, 29.3 to 55.8 cases per 100,000 people. Not surprisingly, our state also has a comparatively low death rate from lung cancer, with 20.1 to 41.3 deaths per 100,000 people, compared to the national high of 52.2 to 69.1.

While cigarette smoking is by far the most common cause of lung cancer, there has been a troubling recent increase in lung cancers among people who have never smoked. Researchers have also noted an increase in lung cancers in young Asian women, some of which may be in part due to a recently identified genetic cancer risk in Asian women.

Lung Cancer Report: 2014 DATA

This chart highlights survival rates for El Camino Hospital patients treated for lung cancer over the last 5 years. Our outcomes are similar to other CoC accredited programs for Stage I patients, but we have substantially better outcomes for those who are diagnosed with more advanced disease, in Stages II, III and IV. Our collaborative approach helps us deliver a coordinated effort, and we treat lung cancer aggressively with a multidisciplinary approach.

Non-Small Cell Lung Cancer 5-Year Survival 2014

Sanjiv S., 77, had been smoke free for years when his former habit caught up with him: he was diagnosed with bladder cancer in 2005. Fortunately, Sanjiv’s first cancer was caught very early. El Camino Hospital Cancer Center oncologists treated Sanjiv with BCG, an inno-vative form of immunotherapy that involves introducing a weakened bacterial solution directly into the bladder to stimulate the immune system so that it kills cancer cells.

Although Sanjiv was cured of his bladder cancer, tobacco was not finished with him. In 2013, he was diagnosed with lung cancer. Fortunately, his cancer had not yet spread and doctors were able to treat it through surgery alone. Sanjiv has been cancer-free for two years and is leading a normal life, even traveling to high altitude locations without experiencing shortness of breath. Sanjiv has only the highest praise for the El Camino Hospital staff, and the excellent pre- and post-operative care he received. As a two-time cancer survivor, he knows the importance of catching cancer early. “Prevention and early detection?” Sanjiv says, “That’s all there is. Cancer is a very threatening disease. The earlier you detect and treat it, the better.”

Sanjiv S. LUNG AND BLADDER CANCER SURVIVOR

Two-time cancer survivor credits early detection for success.

60%

40%

20%

Stage 059.25%

Stage I48.67%

Stage II58.86%

Stage III26.67%

Stage IV11.40%

0%

EL CAMINO HOSPITAL’S lung cancer specialists take an aggressive approach to treating cancer, using the combined expertise of surgeons, radiation oncologists, and medical oncologists to develop a personalized treatment plan for each patient. The program excels at both prolonging life at all stages of lung cancer, and maintaining quality of life for patients in the advanced stages of the disease. El Camino Hospital’s lung cancer program consistently achieves better outcomes for early-stage cancers and exceeds national benchmarks in 5-year lung cancer survival rates.

Diligent follow-up is essential for patients who are at high risk for recurrences. We keep a close watch and monitor for any abnormalities so we can act swiftly if we find anything suspicious.

OVERVIEW OF THE LUNG CANCER PROGRAM

In addition to advanced therapies, El Camino Hospital offers a variety of specialized outpatient services, support, and assistance to address the psychological, emotional, and spiritual needs of cancer patients and their families throughout treatment and recovery.

These services include disease management, treatment, symptom management, nutritional assessments and education, psychosocial evaluations, counseling, and care coordination.

Our collaborative team includes a variety of experts:

• Oncology Certified Nurses to assess patients, deliver injections, administer chemotherapy, and perform blood draws through ports and other venous access devices

• Certified Medical Assistants (CMA) to perform the technical aspects of patient care within a defined scope of practice upon authorization and supervision of a nurse

• Cancer risk assessments and genetic testing by a genetic specialist

• Clinical Research Coordinator to provide information on available clinical trials

• Social Worker to assist patients in accessing in-home, family, and medical resources, and emotional support to patients and their loved ones

• Community Outreach Coordinator to provide integrative care options such as concierge services and information on resources and support groups

• Oncology Nutritionist to counsel patients on nutrition, dieting, and coping with changes in taste and appetite that can accompany cancer treatment

OUTPATIENT SERVICES

Improvements in local and systemic treatment modalities are leading to measurable improvements in survival. The El Camino Hospital Lung Cancer Program employs a multidisciplinary team approach and customizes comprehensive treatment strategies for each patient. The team includes surgeons, medical oncologists, radiation oncologists, pathologists and radiologists, nutritionists, and social workers. Patients are diagnosed and treated in a comfortable setting, using the most advanced technologies. The comprehensive treatment approach favored by El Camino Hospital lung specialists has yielded excellent results. We have quadrupled our 5-year survival rates for patients with Stage III and IV lung cancers of any kind. Our survival rates signifi-cantly exceed national benchmarks, at every stage.

Lung cancer is the most common cancer worldwide, with

1.8 million new cases each year

LUNG CANCER is the leading cause of cancer death for both men and women in the U.S. According to American Cancer Society projections, there will be about 221,200 new cases of lung cancer in 2015: 115,610 in men and 105,590 in women. An estimated 158,040 of these patients will succumb to the disease.

The risk of getting lung cancer varies considerably from one state to the next. California is one of the 12 states with the lowest incidence, 29.3 to 55.8 cases per 100,000 people. Not surprisingly, our state also has a comparatively low death rate from lung cancer, with 20.1 to 41.3 deaths per 100,000 people, compared to the national high of 52.2 to 69.1.

While cigarette smoking is by far the most common cause of lung cancer, there has been a troubling recent increase in lung cancers among people who have never smoked. Researchers have also noted an increase in lung cancers in young Asian women, some of which may be in part due to a recently identified genetic cancer risk in Asian women.

Lung Cancer Report: 2014 DATA

This chart highlights survival rates for El Camino Hospital patients treated for lung cancer over the last 5 years. Our outcomes are similar to other CoC accredited programs for Stage I patients, but we have substantially better outcomes for those who are diagnosed with more advanced disease, in Stages II, III and IV. Our collaborative approach helps us deliver a coordinated effort, and we treat lung cancer aggressively with a multidisciplinary approach.

Non-Small Cell Lung Cancer 5-Year Survival 2014

Sanjiv S., 77, had been smoke free for years when his former habit caught up with him: he was diagnosed with bladder cancer in 2005. Fortunately, Sanjiv’s first cancer was caught very early. El Camino Hospital Cancer Center oncologists treated Sanjiv with BCG, an inno-vative form of immunotherapy that involves introducing a weakened bacterial solution directly into the bladder to stimulate the immune system so that it kills cancer cells.

Although Sanjiv was cured of his bladder cancer, tobacco was not finished with him. In 2013, he was diagnosed with lung cancer. Fortunately, his cancer had not yet spread and doctors were able to treat it through surgery alone. Sanjiv has been cancer-free for two years and is leading a normal life, even traveling to high altitude locations without experiencing shortness of breath. Sanjiv has only the highest praise for the El Camino Hospital staff, and the excellent pre- and post-operative care he received. As a two-time cancer survivor, he knows the importance of catching cancer early. “Prevention and early detection?” Sanjiv says, “That’s all there is. Cancer is a very threatening disease. The earlier you detect and treat it, the better.”

Sanjiv S. LUNG AND BLADDER CANCER SURVIVOR

Two-time cancer survivor credits early detection for success.

60%

40%

20%

Stage 059.25%

Stage I48.67%

Stage II58.86%

Stage III26.67%

Stage IV11.40%

0%

EL CAMINO HOSPITAL’S lung cancer specialists take an aggressive approach to treating cancer, using the combined expertise of surgeons, radiation oncologists, and medical oncologists to develop a personalized treatment plan for each patient. The program excels at both prolonging life at all stages of lung cancer, and maintaining quality of life for patients in the advanced stages of the disease. El Camino Hospital’s lung cancer program consistently achieves better outcomes for early-stage cancers and exceeds national benchmarks in 5-year lung cancer survival rates.

Diligent follow-up is essential for patients who are at high risk for recurrences. We keep a close watch and monitor for any abnormalities so we can act swiftly if we find anything suspicious.

OVERVIEW OF THE LUNG CANCER PROGRAM

In addition to advanced therapies, El Camino Hospital offers a variety of specialized outpatient services, support, and assistance to address the psychological, emotional, and spiritual needs of cancer patients and their families throughout treatment and recovery.

These services include disease management, treatment, symptom management, nutritional assessments and education, psychosocial evaluations, counseling, and care coordination.

Our collaborative team includes a variety of experts:

• Oncology Certified Nurses to assess patients, deliver injections, administer chemotherapy, and perform blood draws through ports and other venous access devices

• Certified Medical Assistants (CMA) to perform the technical aspects of patient care within a defined scope of practice upon authorization and supervision of a nurse

• Cancer risk assessments and genetic testing by a genetic specialist

• Clinical Research Coordinator to provide information on available clinical trials

• Social Worker to assist patients in accessing in-home, family, and medical resources, and emotional support to patients and their loved ones

• Community Outreach Coordinator to provide integrative care options such as concierge services and information on resources and support groups

• Oncology Nutritionist to counsel patients on nutrition, dieting, and coping with changes in taste and appetite that can accompany cancer treatment

OUTPATIENT SERVICES

ALTHOUGH a small number of lung cancer cases occur in people who don’t smoke and have not been exposed to toxic substances, the overwhelming majority of lung cancer deaths are due to cigarette smoking. According to the American Lung Association, 80 percent of lung cancer deaths in women and 90 percent in men are linked to cigarette smoking. Others may be tied to second hand smoke, a work environment, or living in a city with high pollution levels. Prevention of most cases of lung cancer is clear cut: people should avoid smoking and exposure to carcinogens including secondhand smoke, radon (radioactive gas), asbestos, talc (talcum powder is safe), and other chemicals or fumes found in some workplaces.

There are many common symptoms of lung cancer:

• A cough that doesn’t go away and gets worse over time

• Constant chest pain

• Coughing up blood

• Shortness of breath, wheezing, or hoarseness

• Recurring cases of pneumonia or bronchitis

El Camino Hospital offers a convenient online risk assessment tool, which can be found on our website. Standard screening begins with a standard chest X-ray and sputum sample. If further testing is needed, the doctor generally orders a bronchoscopy or CT scan.

Advanced imaging techniques are necessary to accurately diagnose the type of lung cancer and the stage to which it has progressed. In addition to standard imaging techniques, such as CT scans, El Camino Hospital lung cancer specialists offer advanced diagnostic imaging tests to identify suspicious lung nodules and lymph nodes.

DIAGNOSTIC TESTING: These tests are used to locate and identify potential lung tumors.

X-RAY: X-rays have been used to diagnose lung cancer for decades. Tumors that are beginning to cause symptoms are usually visible on an X-ray. Occasionally, lung cancer is unex-pectedly spotted in a chest X-ray taken for another purpose.

NAVIGATIONAL BRONCHOSCOPY: Performed while the patient is under anesthesia, this new technique allows for biopsy of nodules in the chest that traditional bronchoscopy cannot reach. Via the patient’s mouth, the physician guides a bronchoscope down into the airways in the lungs to the suspicious lesions, using real time 3D imaging, 360° steering, and an electromagnetic sensor to navigate. Tiny surgical instruments are then passed through the bronchoscope to collect a tissue sample for biopsy.

LOW-DOSE CT LUNG CANCER SCREENING: El Camino Hospital is an early adopter of low-dose CT lung cancer screening. In 2011, results from research done by the National Cancer Institute’s National Lung Screening Trial (NLST) found that participants who received low-dose CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays. This proved for the first time that CT screening is an effective means to reduce lung cancer deaths. El Camino Hospital recently published a follow-up study — Community Low-Dose CT Lung Cancer Screening — that supports current recom-mendations to use low-dose CT screening for lung cancer detection in carefully defined circumstances.

SPECIALIZED SCREENINGS: These tests are used to learn more about the tumor after a person has been diagnosed.

ENDOBRONCHIAL ULTRASOUND (EBUS): Until recently, lung biopsies were performed surgically, through a procedure called mediastinoscopy. This required making a small cut in the neck or left side of the chest. EBUS eliminates the need for surgery. The physician performs a needle biopsy on lymph nodes using a bronchoscope inserted through the mouth. The ultrasound display transmitted by the bronchoscope provides real-time imaging of hard-to-reach airways, blood vessels, lungs, and lymph nodes. Tiny tissue samples can be taken from lymph nodes in the chest to determine the type and stage of a lung cancer.

POSI TRON EMISSION TOMOGRAPHY (PET SCAN): A PET scan is an exceptionally effective way to diagnose lung cancer. While other forms of imaging show the size and location of a tumor, a PET scan can determine whether a growth is benign or malignant. During a PET scan, a radioactive tracer is used to help identify malignant cells more precisely.

BRAIN MRI: In the treatment of lung cancer, brain MRIs (magnetic resonance imaging) are used to look for metastases indicating the cancer has spread to the brain. A brain MRI is an imaging test that uses powerful magnets and radio waves to take images of the brain. Some brain MRIs require the injection of a special dye (contrast) to help the radiologist see tiny abnormalities more clearly.

PREVENTION AND EARLY DETECTION OF LUNG CANCER

NON-SMALL CELL LUNG CANCERThis form of lung cancer accounts for about 85 to 90 percent of lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of non-small cell lung cancer, each affecting a different type of cell.

• Squamous cell (epidermoid) carcinomas start in the flat cells lining the inside of the airways in the lungs. They are often central and linked to cigarette smoking.

• Adenocarcinomas are slow growing and usually found in the outer parts of the lung. These cancers start in the cells that normally secrete mucus. This type of lung cancer is more common in current or former smokers, but it is also the most common type of lung cancer in non-smokers.

• Large cell carcinoma can appear in any part of the lung and is especially virulent and quick to spread.

SMALL CELL LUNG CANCERSmall cell lung cancer, also called oat cell cancer, accounts for roughly 10 to 15 percent of lung cancers. Rarely found in people who have never smoked, this type of cancer spreads quickly and early. Small cell lung cancer often starts in the bronchi near the center of the chest.

LUNG CARCINOID TUMORLung carcinoid tumors, also known as lung neuroendocrine tumors, account for only 5 percent of lung cancers. These cancers are slow growing and rarely spread. They are generally cured by surgery. Atypical carcinoid tumors are less common and somewhat more aggressive.

Smoking – Smoking increases the risk of lung cancer, as well as cancers of the bladder and pancreas. The risk increases based on the quantity and duration one smokes.

> Find smoking cessation classes at www.elcaminohospital.org

Exposure to secondhand smoke – Even people who have never smoked are at risk from long-term exposure to someone else’s cigarette smoke.

Exposure to radon gas – A byproduct of the natural breakdown of uranium in soil, rock, and water, radon eventually becomes part of the air you breathe. Radon is odorless and colorless, and unsafe levels of it can accumulate in buildings undetected. Radon testing kits can determine whether levels are safe.

Exposure to asbestos and other carcinogens – Workplace exposure to asbestos, arsenic, chromium, or nickel also increase lung cancer risk, particularly in smokers.

Family history of lung cancer – Having a close relative with lung cancer may indicate a familial risk for the disease.

RISK FACTORS FOR LUNG CANCER

THERE ARE three main types of lung cancer, and treatment varies depending on the type.

At 45 years old, Tony E. was diligent about seeing his primary care doctor regularly, since his father and uncle had suffered from lung cancer. During a routine appointment, the doctor sent Tony for an X-ray, despite his showing no outward symptoms of the disease. Tests revealed that Tony did, in fact, have lung cancer, and additional tests revealed it had already spread to Stage III. Tony was treated successfully but needed careful attention going forward to watch for a recurrence.

He was referred to Dr. Shane Dormady at the El Camino Hospital Cancer Center. The lung cancer program is renowned for excellent outcomes, especially with late-stage disease. Tony went regularly to the Cancer Center, receiving ongoing scans and evaluation. He says, “I was so grateful for the great care I received. They were all incredibly supportive at every step.” Tony just met with Dr. Dormady and the rest of the team for a 10-year “graduation” visit and he is happily breathing a welcome sigh of relief.

Tony E. / LUNG CANCER SURVIVOR

Breathing easier after bout with lung cancer.

TYPES OF LUNG CANCER

ALTHOUGH a small number of lung cancer cases occur in people who don’t smoke and have not been exposed to toxic substances, the overwhelming majority of lung cancer deaths are due to cigarette smoking. According to the American Lung Association, 80 percent of lung cancer deaths in women and 90 percent in men are linked to cigarette smoking. Others may be tied to second hand smoke, a work environment, or living in a city with high pollution levels. Prevention of most cases of lung cancer is clear cut: people should avoid smoking and exposure to carcinogens including secondhand smoke, radon (radioactive gas), asbestos, talc (talcum powder is safe), and other chemicals or fumes found in some workplaces.

There are many common symptoms of lung cancer:

• A cough that doesn’t go away and gets worse over time

• Constant chest pain

• Coughing up blood

• Shortness of breath, wheezing, or hoarseness

• Recurring cases of pneumonia or bronchitis

El Camino Hospital offers a convenient online risk assessment tool, which can be found on our website. Standard screening begins with a standard chest X-ray and sputum sample. If further testing is needed, the doctor generally orders a bronchoscopy or CT scan.

Advanced imaging techniques are necessary to accurately diagnose the type of lung cancer and the stage to which it has progressed. In addition to standard imaging techniques, such as CT scans, El Camino Hospital lung cancer specialists offer advanced diagnostic imaging tests to identify suspicious lung nodules and lymph nodes.

DIAGNOSTIC TESTING: These tests are used to locate and identify potential lung tumors.

X-RAY: X-rays have been used to diagnose lung cancer for decades. Tumors that are beginning to cause symptoms are usually visible on an X-ray. Occasionally, lung cancer is unex-pectedly spotted in a chest X-ray taken for another purpose.

NAVIGATIONAL BRONCHOSCOPY: Performed while the patient is under anesthesia, this new technique allows for biopsy of nodules in the chest that traditional bronchoscopy cannot reach. Via the patient’s mouth, the physician guides a bronchoscope down into the airways in the lungs to the suspicious lesions, using real time 3D imaging, 360° steering, and an electromagnetic sensor to navigate. Tiny surgical instruments are then passed through the bronchoscope to collect a tissue sample for biopsy.

LOW-DOSE CT LUNG CANCER SCREENING: El Camino Hospital is an early adopter of low-dose CT lung cancer screening. In 2011, results from research done by the National Cancer Institute’s National Lung Screening Trial (NLST) found that participants who received low-dose CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays. This proved for the first time that CT screening is an effective means to reduce lung cancer deaths. El Camino Hospital recently published a follow-up study — Community Low-Dose CT Lung Cancer Screening — that supports current recom-mendations to use low-dose CT screening for lung cancer detection in carefully defined circumstances.

SPECIALIZED SCREENINGS: These tests are used to learn more about the tumor after a person has been diagnosed.

ENDOBRONCHIAL ULTRASOUND (EBUS): Until recently, lung biopsies were performed surgically, through a procedure called mediastinoscopy. This required making a small cut in the neck or left side of the chest. EBUS eliminates the need for surgery. The physician performs a needle biopsy on lymph nodes using a bronchoscope inserted through the mouth. The ultrasound display transmitted by the bronchoscope provides real-time imaging of hard-to-reach airways, blood vessels, lungs, and lymph nodes. Tiny tissue samples can be taken from lymph nodes in the chest to determine the type and stage of a lung cancer.

POSI TRON EMISSION TOMOGRAPHY (PET SCAN): A PET scan is an exceptionally effective way to diagnose lung cancer. While other forms of imaging show the size and location of a tumor, a PET scan can determine whether a growth is benign or malignant. During a PET scan, a radioactive tracer is used to help identify malignant cells more precisely.

BRAIN MRI: In the treatment of lung cancer, brain MRIs (magnetic resonance imaging) are used to look for metastases indicating the cancer has spread to the brain. A brain MRI is an imaging test that uses powerful magnets and radio waves to take images of the brain. Some brain MRIs require the injection of a special dye (contrast) to help the radiologist see tiny abnormalities more clearly.

PREVENTION AND EARLY DETECTION OF LUNG CANCER

NON-SMALL CELL LUNG CANCERThis form of lung cancer accounts for about 85 to 90 percent of lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of non-small cell lung cancer, each affecting a different type of cell.

• Squamous cell (epidermoid) carcinomas start in the flat cells lining the inside of the airways in the lungs. They are often central and linked to cigarette smoking.

• Adenocarcinomas are slow growing and usually found in the outer parts of the lung. These cancers start in the cells that normally secrete mucus. This type of lung cancer is more common in current or former smokers, but it is also the most common type of lung cancer in non-smokers.

• Large cell carcinoma can appear in any part of the lung and is especially virulent and quick to spread.

SMALL CELL LUNG CANCERSmall cell lung cancer, also called oat cell cancer, accounts for roughly 10 to 15 percent of lung cancers. Rarely found in people who have never smoked, this type of cancer spreads quickly and early. Small cell lung cancer often starts in the bronchi near the center of the chest.

LUNG CARCINOID TUMORLung carcinoid tumors, also known as lung neuroendocrine tumors, account for only 5 percent of lung cancers. These cancers are slow growing and rarely spread. They are generally cured by surgery. Atypical carcinoid tumors are less common and somewhat more aggressive.

Smoking – Smoking increases the risk of lung cancer, as well as cancers of the bladder and pancreas. The risk increases based on the quantity and duration one smokes.

> Find smoking cessation classes at www.elcaminohospital.org

Exposure to secondhand smoke – Even people who have never smoked are at risk from long-term exposure to someone else’s cigarette smoke.

Exposure to radon gas – A byproduct of the natural breakdown of uranium in soil, rock, and water, radon eventually becomes part of the air you breathe. Radon is odorless and colorless, and unsafe levels of it can accumulate in buildings undetected. Radon testing kits can determine whether levels are safe.

Exposure to asbestos and other carcinogens – Workplace exposure to asbestos, arsenic, chromium, or nickel also increase lung cancer risk, particularly in smokers.

Family history of lung cancer – Having a close relative with lung cancer may indicate a familial risk for the disease.

RISK FACTORS FOR LUNG CANCER

THERE ARE three main types of lung cancer, and treatment varies depending on the type.

At 45 years old, Tony E. was diligent about seeing his primary care doctor regularly, since his father and uncle had suffered from lung cancer. During a routine appointment, the doctor sent Tony for an X-ray, despite his showing no outward symptoms of the disease. Tests revealed that Tony did, in fact, have lung cancer, and additional tests revealed it had already spread to Stage III. Tony was treated successfully but needed careful attention going forward to watch for a recurrence.

He was referred to Dr. Shane Dormady at the El Camino Hospital Cancer Center. The lung cancer program is renowned for excellent outcomes, especially with late-stage disease. Tony went regularly to the Cancer Center, receiving ongoing scans and evaluation. He says, “I was so grateful for the great care I received. They were all incredibly supportive at every step.” Tony just met with Dr. Dormady and the rest of the team for a 10-year “graduation” visit and he is happily breathing a welcome sigh of relief.

Tony E. / LUNG CANCER SURVIVOR

Breathing easier after bout with lung cancer.

TYPES OF LUNG CANCER

DESPITE THE very serious prognosis for lung cancer, more than 430,000 people who were diagnosed with the disease at some point in their lives are still alive today. People who were diagnosed in the earliest stages of the disease, before it had a chance to metastasize, usually have a better prognosis. Our team factors in the stage and type of the tumor, as well as the patient’s overall health, to create a personalized treatment plan tailored to each individual patient. We find creative and effective ways to combine treatments, using surgery, radiation therapy, chemotherapy, and highly targeted therapies. Once treatment is complete, we monitor patients closely to watch for any abnormalities or signs of reoccurrence.

SURGERY: Surgery may involve removing the entire lung or just the section around the tumor. Depending on a tumor’s location and size, patients may be eligible for minimally invasive surgery, which means less pain, fewer days in the hospital, a shorter recovery and smaller scars. For early-stage tumors, our lung surgeons may perform a minimally invasive video-assisted thoracic surgery (VATS). During a VATS proce-dure, a tiny camera (thoracoscope) and special long surgical instruments are inserted into the chest through several small incisions, as opposed to a single large incision. To guide the procedure, the surgeon uses real-time images transmitted by the thoracoscope. For larger tumors, the surgeon makes a bigger incision on the side of the chest to reach and remove the tumor.

RADIATION THERAPY: El Camino Hospital offers all available radiation treatment options, with treatment decisions based on what will provide the most effective results with the fewest side effects. In keeping with our exceptionally collaborative approach, our radiation oncologists and oncologists work in tandem to craft the optimum treatment plan for each patient. Radiation therapy may involve either traditional external-beam radiation or stereotactic radiosurgery, which allows delivery of radiation beams with submillimeter accuracy. Radiation is delivered via advanced CyberKnife® and RapidArc® technologies, both known for their high levels of precision and ability to spare healthy tissue surrounding the tumor. Experts at our Center for Advanced Radiotherapy and CyberKnife Radiosurgery

offer consultations within 24 hours and have performed more than 5,000 radiosurgery treatments for multiple types of cancer. Another technique used by our radiation oncologists is the implantation of radioactive pellets, or brachytherapy. El Camino Hospital specialists were the first in the world to use a robotic-assisted procedure to place radioactive pellets up against a lung tumor.

CHEMOTHERAPY: Chemotherapy uses drugs to destroy cancer cells. While chemo targets the fast-growing cancer cells, if normal cells are attached to the diseased cells, this can lead to side effects. The El Camino Hospital Cancer Center treats both the lung cancer and the unpleasant side effects of chemo-therapy. Symptoms are managed using anti-nausea and pain medication, as well as intravenous hydration.

TARGETED THERAPY: By analyzing a tumor’s proteins and chemical makeup, it is possible to determine which combi-nation of drugs will be most effective against a cancer. This is called targeted therapy. It is unusual for a community hospital to offer this advanced treatment, but El Camino Hospital has had success using targeted therapy against non-small cell lung cancer, the most common type of lung cancer.

CLINICAL TRIALS: The El Camino Hospital Cancer Center works with other medical centers and the National Cancer Institute to offer patients opportunities to participate in ongoing clinical trials. One example was “REACT,” a recent trial that combined the use of Respiragene,™ a new genetic test which identifies smokers at the highest risk of lung cancer, with low-dose CT scans. The test was intended to identify smokers and former smokers who were at highest risk of lung cancer and would benefit most from follow-up with low-dose CT scanning.

LUNG CANCER TREATMENTLUNG CANCER STATISTICS FOR THE U.S. AND EL CAMINO HOSPITAL

BY FAR the leading cause of cancer death in both men and women, lung cancer kills more people each year than colon, breast, and prostate cancers combined. The disease accounts for about 27 percent of all cancer deaths. Lung cancer survival statistics vary according to the stage of the cancer at the time of diagnosis.

Lung cancer occurs mainly in older people: The average age at the time of diagnosis is 70, and two out of three people diagnosed with lung cancer are 65 or older. Despite similar rates of cigarette smoking, African American men are about 20 percent more likely to develop lung cancer than Caucasian men. Both African American and Caucasian women have lower rates than men, and African American women are 10 percent LESS likely to develop the disease than Caucasian women.

HOW OUR OUTCOMES COMPARE TO THE NATIONAL STATISTICSECH = El Camino Hospital NCDB = National Cancer Database

FEMALEMALE

Sex ECHNCDB

0%

50%

60%

40%

30%

20%

10%

Age at Diagnosis ECH NCDB

ECHNCDB

12.8%16.49%

50–59

20.0%30.88%

60–69

4.0%3.64%

40–49

35.2%31.7%

70–79

.8%.44%

30–39

4.0%1.15%

>90

23.2%15.55%

80–89

0%.13%

20–29

0%2%

<20AGE

0%

25%

30%

35%

20%

15%

10%

5%

First-Course Treatment Methods ECH NCDB

No first-course treatment*

Other

Surgery, radiation, and chemotherapy

Radiation and chemotherapy

Surgery and chemotherapy

Radiation only

Surgery only

* Patients in this category were not candidates for successful treatment due to age or comorbidities.

Stage at Diagnosis ECHNCDB

** We strongly support improved screening tactics that will enable earlier detection for more successful treatment.

50%

60%

40%

30%

20%

10%

STAGE 0 I II III IV** Unknown

0%

0% 10% 20% 30% 40%

DESPITE THE very serious prognosis for lung cancer, more than 430,000 people who were diagnosed with the disease at some point in their lives are still alive today. People who were diagnosed in the earliest stages of the disease, before it had a chance to metastasize, usually have a better prognosis. Our team factors in the stage and type of the tumor, as well as the patient’s overall health, to create a personalized treatment plan tailored to each individual patient. We find creative and effective ways to combine treatments, using surgery, radiation therapy, chemotherapy, and highly targeted therapies. Once treatment is complete, we monitor patients closely to watch for any abnormalities or signs of reoccurrence.

SURGERY: Surgery may involve removing the entire lung or just the section around the tumor. Depending on a tumor’s location and size, patients may be eligible for minimally invasive surgery, which means less pain, fewer days in the hospital, a shorter recovery and smaller scars. For early-stage tumors, our lung surgeons may perform a minimally invasive video-assisted thoracic surgery (VATS). During a VATS proce-dure, a tiny camera (thoracoscope) and special long surgical instruments are inserted into the chest through several small incisions, as opposed to a single large incision. To guide the procedure, the surgeon uses real-time images transmitted by the thoracoscope. For larger tumors, the surgeon makes a bigger incision on the side of the chest to reach and remove the tumor.

RADIATION THERAPY: El Camino Hospital offers all available radiation treatment options, with treatment decisions based on what will provide the most effective results with the fewest side effects. In keeping with our exceptionally collaborative approach, our radiation oncologists and oncologists work in tandem to craft the optimum treatment plan for each patient. Radiation therapy may involve either traditional external-beam radiation or stereotactic radiosurgery, which allows delivery of radiation beams with submillimeter accuracy. Radiation is delivered via advanced CyberKnife® and RapidArc® technologies, both known for their high levels of precision and ability to spare healthy tissue surrounding the tumor. Experts at our Center for Advanced Radiotherapy and CyberKnife Radiosurgery

offer consultations within 24 hours and have performed more than 5,000 radiosurgery treatments for multiple types of cancer. Another technique used by our radiation oncologists is the implantation of radioactive pellets, or brachytherapy. El Camino Hospital specialists were the first in the world to use a robotic-assisted procedure to place radioactive pellets up against a lung tumor.

CHEMOTHERAPY: Chemotherapy uses drugs to destroy cancer cells. While chemo targets the fast-growing cancer cells, if normal cells are attached to the diseased cells, this can lead to side effects. The El Camino Hospital Cancer Center treats both the lung cancer and the unpleasant side effects of chemo-therapy. Symptoms are managed using anti-nausea and pain medication, as well as intravenous hydration.

TARGETED THERAPY: By analyzing a tumor’s proteins and chemical makeup, it is possible to determine which combi-nation of drugs will be most effective against a cancer. This is called targeted therapy. It is unusual for a community hospital to offer this advanced treatment, but El Camino Hospital has had success using targeted therapy against non-small cell lung cancer, the most common type of lung cancer.

CLINICAL TRIALS: The El Camino Hospital Cancer Center works with other medical centers and the National Cancer Institute to offer patients opportunities to participate in ongoing clinical trials. One example was “REACT,” a recent trial that combined the use of Respiragene,™ a new genetic test which identifies smokers at the highest risk of lung cancer, with low-dose CT scans. The test was intended to identify smokers and former smokers who were at highest risk of lung cancer and would benefit most from follow-up with low-dose CT scanning.

LUNG CANCER TREATMENTLUNG CANCER STATISTICS FOR THE U.S. AND EL CAMINO HOSPITAL

BY FAR the leading cause of cancer death in both men and women, lung cancer kills more people each year than colon, breast, and prostate cancers combined. The disease accounts for about 27 percent of all cancer deaths. Lung cancer survival statistics vary according to the stage of the cancer at the time of diagnosis.

Lung cancer occurs mainly in older people: The average age at the time of diagnosis is 70, and two out of three people diagnosed with lung cancer are 65 or older. Despite similar rates of cigarette smoking, African American men are about 20 percent more likely to develop lung cancer than Caucasian men. Both African American and Caucasian women have lower rates than men, and African American women are 10 percent LESS likely to develop the disease than Caucasian women.

HOW OUR OUTCOMES COMPARE TO THE NATIONAL STATISTICSECH = El Camino Hospital NCDB = National Cancer Database

FEMALEMALE

Sex ECHNCDB

0%

50%

60%

40%

30%

20%

10%

Age at Diagnosis ECH NCDB

ECHNCDB

12.8%16.49%

50–59

20.0%30.88%

60–69

4.0%3.64%

40–49

35.2%31.7%

70–79

.8%.44%

30–39

4.0%1.15%

>90

23.2%15.55%

80–89

0%.13%

20–29

0%2%

<20AGE

0%

25%

30%

35%

20%

15%

10%

5%

First-Course Treatment Methods ECH NCDB

No first-course treatment*

Other

Surgery, radiation, and chemotherapy

Radiation and chemotherapy

Surgery and chemotherapy

Radiation only

Surgery only

* Patients in this category were not candidates for successful treatment due to age or comorbidities.

Stage at Diagnosis ECHNCDB

** We strongly support improved screening tactics that will enable earlier detection for more successful treatment.

50%

60%

40%

30%

20%

10%

STAGE 0 I II III IV** Unknown

0%

0% 10% 20% 30% 40%

For more information or for referral to one of our specialists, please call or visit our website.

www.elcaminohospital.org/cancer 800-216-5556

Pictured above in the front row (left to right) are Larisa Peralta, APRN, FNP, OCN, Survivorship Program Coordinator; JoAnna Quan, LCSW, Oncology Social Worker; and Malti Kshirsagar, MD, Pathologist. In the back row (left to right) are Jiali Li, MD, PhD, Medical Oncologist; Shane Dormady, MD, PhD, Medical Oncologist; Robert Sinha, MD, Radiation Oncologist; Shyamali Singhal, MD, PhD, General Surgeon; and Samuel Dawn, MD, Radiologist.