Delving into Recent Advancements in Lung Cancer Care

CURE spoke with Dr. Daniel J. Boffa to highlight the current landscape of lung cancer care, sitting down with him in recognition of Lung Cancer Awareness Month, observed each November.

The awareness month serves as a platform to highlight lung cancer as a high-priority disease, encouraging patients, caregivers, and families to stay informed about emerging research, preventive measures, and available screening options. Boffa, a professor and division chief of Thoracic Surgery at Yale School of Medicine in New Haven, Connecticut, emphasizes that initiatives like this help draw attention not only to the progress made in lung cancer treatment but also to the challenges that remain, aiming to keep the disease at the forefront of public and clinical awareness.

CURE: To kick things off, in your opinion, what is the significance of Lung Cancer Awareness Month, and other initiatives like it?

Boffa: The significance of Lung Cancer Awareness Month is that it calls attention to lung cancer as a high-priority disease, encouraging patients, their families, and caregivers to become familiar with new developments and to consider any screening or testing that might be relevant to them or their loved ones. It’s a way to shine a light on lung cancer, both on what has already been accomplished and on what still needs to be done, helping to move it to the top of our lists, so to speak.

Lung cancer research has evolved rapidly in recent years. From your perspective, what are some of the most significant advancements in the treatment of the disease that patients should know about?

The first is the realization that some people who have a particularly high risk, such as smokers, can reduce their chance of developing lung cancer and potentially shortening their life by participating in screening. There is a yearly CT scan, which takes only a few minutes, and if you are eligible (typically 50 or older and have smoked in the past or are still smoking) you can receive this scan. It allows us to catch lung cancers earlier, when treatments are easier and patients are much more likely to be cured. I think that’s the first big discovery.

The second relates to how we are able to treat people. At early stages, we now know that minimally invasive surgical and non-surgical approaches can help eliminate the cancer. For small tumors, removing less lung tissue is safe and effective, allowing people to retain more of their normal lung function. For cancers that have already spread to lymph nodes or vital organs, we now have completely new ways of targeting the cancer cells. In the past, we would use chemotherapies that affected many different cell types in the body, causing widespread side effects. The new generation of lung cancer treatments is much more specific to the cancer cells, resulting in fewer side effects and greater effectiveness.

Immunotherapy is one approach that is particularly exciting, as it allows patients to use their own immune system to fight cancer. Targeted therapy is another, taking advantage of genetic changes that cancer cells have but are absent in the rest of the body. These drugs attack only the cancer cells, making them highly effective. While these treatments don’t work for everyone, they do work for subsets of patients, and the more options we have, the more patients have the opportunity for highly effective, personalized care.

For patients who have recently been diagnosed, the idea of biomarker testing or molecular profiling can seem confusing. Can you explain what this testing involves and how it can impact a patient’s treatment plan?

Biomarker testing looks for characteristics of the cancer that represent vulnerabilities, or the “Achilles heel” of the tumor, which can allow us to use new treatments that take advantage of these features while hopefully minimizing side effects to other parts of the body. Genetic testing can be performed on a biopsy, where a part of the tumor or lymph nodes is removed, or more recently, in many patients through a simple blood test. As tumor cells divide, they can release DNA into the bloodstream, and new technology can detect these genetic codes, identifying opportunities to use targeted therapies.

Typically, biomarker testing provides a comprehensive look at the genetics of the cancer or certain proteins the tumor may produce to determine if there is a therapy that is particularly effective. It is a way of personalizing treatment to target what is most likely to work for each patient specifically.

Many people still associate lung cancer primarily with smoking. How is that perception changing, and what are some of the other risk factors or causes patients should be aware of?

Smoking is still the big story in lung cancer, as about 80 to 85% of patients who develop lung cancer will have smoked at one point in their lives. But one out of seven lung cancers happen in somebody who never smoked. There's a variety of things that have been associated with cancer in never smokers. One of them is radon, which is an odorless gas that can seep into your home from the ground, so certainly when you're buying a new home, or if it hasn't been done in a while, it's important to test radon levels because there are ways of reducing those levels.

There are other environmental exposures, some that are less clear, but anything that irritates your throat and lungs when you're breathing is probably not a good thing. So, you want to minimize the time that you're working with chemicals in poorly ventilated areas. When there's wildfire smoke that's particularly thick, you could wear a mask or have a filter until the air clears.

The other category of lung cancer in never smokers can relate to genetics. There are some cancers that run-in families, but a lot of cancers that happen in people who never smoked, they are the first family member to have this. So, if you have a family member who never smoked and developed lung cancer, you do have a somewhat increased risk of lung cancer, and that's something to check in with your primary care provider about. There's no screening guidance for that group yet, but there probably will be in the next few years.

At the same time, even if you don't have a family member who developed lung cancer as someone who never smoked, and you’ve never smoked, if you develop a cough that doesn't go away after four weeks, or if you're coughing up blood, check in with your primary care provider, and you might need some imaging of your chest.

Reference

1. “Understanding That Not All Lung Cancer Cases Are Linked to Smoking,” by Dr. Daniel J. Boffa. CURE; Nov. 14, 2025. https://www.curetoday.com/view/understanding-that-not-all-lung-cancer-cases-are-linked-to-smoking

Transcript has been edited for clarity and conciseness.

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