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A Dramatic Expansion in Lung Cancer Treatment

Date: April 23, 2015

Johns Hopkins’ rapidly expanding lung cancer treatment program is helping to improve and extend patients’ lives, says Lonny Yarmus.
Johns Hopkins’ rapidly expanding lung cancer treatment program is helping to improve and extend patients’ lives, says Lonny Yarmus.

For decades, lung cancer has remained the top cancer killer in the United States, accounting for about 27 percent of cancer deaths in this country—more than colon, breast and prostate cancers combined.

But the good news, says Lonny Yarmus, clinical chief of Johns Hopkins’ Division of Pulmonary and Critical Care Medicine and director of interventional pulmonology at Johns Hopkins Bayview Medical Center, is that more patients are surviving—and living longer—due to a series of sweeping changes in the field.

In the last few years, says Yarmus, researchers have identified several new genetic markers that influence many forms of nonsmall cell lung cancers. Other teams discovered therapies that are highly effective at targeting these specific mutations, leading to better patient outcomes. Several of these drugs are pills, sparing patients the pain and inconvenience of intravenous chemotherapy and its side effects.

At the same time, new research—including a large, influential study published in 2011 in the New England Journal of Medicine—showed a significant dip in mortality when doctors screen for lung cancer using low-dose CT scans in high-risk populations. Recent changes in Medicare rules cover the expense of screening.

These changes have led Johns Hopkins Medicine to dramatically expand its lung cancer treatment program. Bringing together experts from interventional pulmonology, thoracic surgery, medical oncology and radiation oncology, Johns Hopkins now offers a comprehensive multidisciplinary lung cancer program that encompasses all aspects of patient care—from screening to minimally invasive diagnostic techniques to novel treatments.

The program has grown rapidly, resulting in the multidisciplinary lung cancer clinic seeing more than 200 new patients over the past year. Such growth necessitated a major expansion for the lung cancer and thoracic oncology program, which is based at Johns Hopkins Bayview. New buildings to house the program, adding more than 15,000 square feet of clinical space, opened in February. The program is recruiting two thoracic oncologists and a radiation oncologist to expedite patient care. The thoracic multidisciplinary group is also looking to expand its clinical research portfolio at the Hopkins Bayview campus.

In addition to the lung cancer screening clinic, the program offers a pulmonary nodule clinic to guide referring physicians and patients through the care necessary after screening picks up an abnormal finding. The clinics feature an expert panel that reviews each patient’s imaging and develops a clinical decision tree to direct patients to appropriate follow-up tests and procedures.

The lung cancer program is also making strides in the lab. Physician-researchers are running the first National Institutes of Health-funded interventional pulmonology trial in the country, investigating a new way to combat tumors that obstruct the airway in patients with advanced lung cancer. Using a minimally invasive protocol that combines tools to clear away the obstruction with a novel injection device to place chemotherapy directly in that area, they’re hoping to prevent removed tumors from growing back. In addition, the medical and radiation oncology teams offer cutting-edge therapies and many clinical trial opportunities for patients.

All of these components of Johns Hopkins’ bigger and better lung cancer screening and treatment program are helping to improve and extend patients’ lives, Yarmus says: “Ten years ago, a lung cancer diagnosis was considered a death sentence. Now, more and more, we talk about survivorship, and that’s a tremendous leap. The next leap is a cure. I think we can do that in the next 10 years.”

Watch a video on Yarmus at