Cancer - Oncology

Women’s Lung Cancer Program

The incidence of lung cancer in women has been rising since the 1930s. In 2016, approximately 71,280 women died of lung cancer in the United States each year, which is more than the number of lives lost to breast, ovarian, and uterine cancer combined.

The team at Mount Sinai Women’s Lung Cancer Program recognizes lung cancer as a significant women’s health issue. For that reason, we focus on creating a personalized approach to treatment and acknowledging gender-specific issues in lung cancer in order to achieve the best possible results of care.

Causes and Risks for Women

Although smoking is the primary cause of lung cancer, women who have never smoked also get lung cancer. About 20 percent of women diagnosed with lung cancer have never smoked, while approximately only 10 percent of men with lung cancer never smoked. In addition, of the 3,400 people who die from lung cancer caused by secondhand smoke, 65 percent are women. The following findings clarify the reason for the relatively high number of lung cancer cases in women.

Non-smoker susceptibility: Lung cancer among women who have never smoked is related to a genetic mutation (EGFR TK domain) associated with non-small cell lung cancer, which is more common among women than it is in men. This particular mutation is associated with a more favorable prognosis and a better response to specific treatments for patients with lung cancer.

Tobacco use statistics: Smoking is still the predominant risk factor responsible for most lung cancers. While smoking among women peaked at 33 percent in 1965, currently 18 percent of women smoke, which is only 15 percent fewer women smoking today. In contrast, of the more than 50 percent of men who smoked in 1965, today only 23 percent of men smoke, which is a 27 percent reduction.

Smokers: Women appear to be at higher risk for smoking-related lung cancer than men are. Genetic mutations associated with more aggressive lung cancers in smokers (KRAS G12C) occur in women at a younger age, and aggressive cancers tend to occur in women who smoked less than men.

Smoking cessation: Women face different barriers to quitting smoking than men. Fear of weight gain in particular may be a more dominant issue among women. Moreover, data suggest that women tend to rely more heavily on cigarette use to reduce stress and depression than do men. Hormone fluctuations related to ovulation, pregnancy, and menses correlate with cigarette craving. Some controlled trials of nicotine-replacement therapy to facilitate smoking cessation have been less effective among women smokers as compared to men.

Hormone replacement: The effects of female hormones (estrogen and progesterone) may explain why various tumors, including lung cancer tumors develop in the female body. Current data suggest that supplemental estrogen/progesterone may be associated with increased incidence of non-small cell lung cancer, while estrogen alone does not appear to have an effect. Current studies continue to explore the roles of circulating estrogen, estrogen receptors, and anti-estrogen therapy.

Treatment response: Multiple institution- and population-based studies show that women have improved survival compared to men with treatment for non-small cell lung cancer, regardless of age, stage, therapeutic modality, or the type of cancer. Women experience a survival advantage with surgery for early stage lung cancer, and with radiation and/or chemotherapy treatments for advanced lung cancer.

Effects of Diagnosis on Women

The diagnosis of lung cancer can be frightening and difficult for women and their loved ones. Mount Sinai Health System offers hope, diagnosis, treatment, community outreach, education, social support, and research in the area of lung cancer in women.

We offer the following support groups, meetings, and educational conferences to patients and their caregivers, family, and friends:

Nonsmokers: While lung cancer is typically associated with smoking, one in five women with lung cancer has never smoked. We offer support groups, education, genetic testing, and the latest therapy options for nonsmokers who have been diagnosed with lung cancer along with other patients with lung cancer.

Smokers: Many patients who smoke strongly consider smoking cessation once they have a diagnosis of lung cancer. We offer medication and information regarding smoking cessation programs, nutrition, support groups, education, genetic testing, and the latest therapy options for smokers and other patients with lung cancer.

Women’s health: Through the Women’s Lung Cancer Program at Mount Sinai we connect patients with surgeons and oncologists specializing in lung cancer, based on the patient’s preference for a gender-specific specialist. We also offer access to Mount Sinai Women’s Health Services, including a variety of medical and social service programs dedicated to issues in women’s health.

Treatment

Both early and some later stage lung cancers may be amenable to a minimally invasive surgery known as video assisted thoracic surgery (VATS). For this surgery, we make three one-inch incisions on the side of the chest. With these incisions, we can perform the dissection necessary to remove the entire tumor, a section of lung if needed, and associated lymph nodes. In addition to favorable cosmetic incisions, VATS surgery results in decreased pain and a shorter hospital stay. In addition there are other lung cancer treatments available.