This article is a transcript of Dr. Eric Presser’s appearance on the American Health Journal. The American Health journal show brings you the latest information on prevention, diagnosis treatment and research from doctors throughout the United States. Watch the American Health journal each week on your local public television station.
Dr. Eric Presser is a leading thoracic surgeon in Palm Springs California who specializes in the treatment of cancers of the chest. He is also the author of a new book An Empowering Guide to Lung Cancer – Six Steps to Take Charge of Your Care and Your Life.
His book teaches the value of investing in your health with lifestyle choices that can help kick habits that increase your cancer risks.
Dr. Presser talks about why he wrote his book and what can lead to an increased risk of cancer…
Cancer is the uncontrolled growth of abnormal cells someplace in the body. Our cells are constantly dividing and what happens with cancer is all of a sudden you get a small mutation and we know that there are certain substances, toxic substances, that can cause these mutations.
We also know that genetics play a significant factor. When we see that person who never smoked, but everyone in their family had cancer, for example, we know that there’s a genetic component so what I tell my patients is that we’re all most likely prone to some kind of cancer, but by smoking or being exposed to certain toxic substances it revs up the process.
The fact that we have lung cancer screening now is a step, that’s all it is.
We’re trying to take the high-risk group and start with them but we need more education, we need people to understand that lung cancer is the number one cancer killer in the United States and the world.
So if 15 to 20 percent of people get lung cancer who never smoked we need to keep asking why?
We need more attention to research and we need more attention to screening and catching this killer earlier.
The reason why I wrote my book which is entitled An Empowering Guide to Lung Cancer was to educate not just patients, but physicians on all of the nuances surrounding lung cancer, lung cancer screening, and most importantly, minimally invasive chess surgery.
Minimally invasive chess surgery gives us so many more options in diagnosing and subsequently treating lung cancer.
Lung cancer is devastating because the body is so resilient that by the time lung cancer symptoms arise it’s usually too late.
What that means is that by the time you are having shortness of breath coughing up blood having some chest pain, the cancer is usually at a later stage, which means that your chance for survival and cure are decreased.
There’s about a 1 in 17 chance that you will get lung cancer during your lifetime. That goes down to 1 and 6 if you’re a smoker. It’s actually a 20% increase in getting lung cancer if you live with a smoker, from secondhand smoke and many people don’t realize that.
So how deadly is lung cancer? Right now it’s extremely deadly. There’s only a 15% five-year survival rate.
Rates of lung cancer in men or women have changed over time.
Whether you’re a man or a woman, you’re equally prone to obtaining lung cancer. Back when the GI’s came home from the wars and cigarettes were very popular, of course we saw a spike in men getting lung cancer. But as women are growing older and it became more glamorous in the 1970s and 80s more women are getting lung cancer.
So no, it doesn’t play favorites.
Lung cancer is the leading cause of cancer deaths for women.
True or false? See answer at the end of this article.
Do you know the symptoms of lung cancer?
Dr. Eric Presser discusses the symptoms of lung cancer and the importance of lung cancer screening to detect any problems.
Some of the symptoms of lung cancer are cough. Whether it’s chronic, whether it’s persistent, whether you’re coughing up blood, coughing up sputum. You could feel chest pain or pressure in your chest. You could also feel as if you’re suffocating, but most of the time these signs and symptoms are found in the later stages.
Our body is so resilient and if I tell you the importance of screening is to find these cancers when they are 8 millimeters, one centimeter. That’s less than a size of a quarter. that’s because they’re not causing any symptoms, but yet we have the option to resect for cure.
Now it doesn’t mean that if you have a cough or you’re coughing up blood that you should panic and you have lung cancer. But it definitely means that you should get it checked out. You should absolutely 100% see your doctor and if the symptoms persist and you’re not happy with the progression of care then you get a cat scan.
It’s that simple. A cat scan gives us so much more information than a chest x-ray. Many patients and physicians alike do not realize that insurance will cover a screening cat scan of the chest if you are between the ages of 55 and 77 and smoked a pack of cigarettes a day for 30 years or two packs a day for 15 years, and are an active smoker, or quit smoking within the last 15 years.
That’s the criteria that we have now. The importance of screening is to catch lung cancer early. With 85 percent of lung cancers diagnosed at stage, we need to do better.
We need to catch this killer earlier. And right now, we do not have a blood test, we do not have any other tests other than imaging to show if there is some kind of abnormality within the chest that needs to either be removed or watched.
If you’re an active smoker I highly recommend that you get your cat scan of the chest as soon as possible. And make sure that you follow up year after year as per the recommendations. Not every mass or spot will be a cancer, but if it is, and we catch it early, then it increases the chance for cure dramatically.
Stopping smoking is crucial to your health and your lifespan.
Researchers are investigating third hand smoke to understand the risk factors for lung cancer. Third hand smoke is residual or left over nicotine and other chemicals that remain on clothing and surfaces and may be the link in more lung cancer cases.
One study found that being exposed to third hand smoke may cause damage and breaks in human DNA which can increase your chances of disease.
Smoking kills almost a half million Americans each year with more than 40,000 of these deaths from exposure to secondhand smoke
We asked Dr. Presser if smoking anything is safe…
Any kind of smoke that enters through your lips is bad. We all know that there is a definite correlation between smoking and lung cancer. One in six smokers will get lung cancer, that’s a fact!
Wanting to quit is the first step. It’s very difficult to quit. Smoking affects every organ system, not just our lungs but our circulation, our skin by the time you quit smoking you you can actually see an effect a week or two later.
There are studies that show that when I’m gonna operate on somebody that if they quit smoking and we operate on them two weeks later, that it decreases their chance of getting a post-operative pneumonia. Just from those two weeks of not smoking.
But don’t think that just because you have lung cancer you shouldn’t quit. But more importantly, if you don’t have lung cancer and you’re a smoker you need to quit.
It’s very difficult to quit. Nicotine is a very addictive drug.
There are methods to help people stop smoking
There are drugs out there everyone knows, chantix and it actually manipulates the neurotransmitters in our brain.
Whenever someone has a cigarette, it triggers neurotransmitters that make you feel good and that’s what chantix does. It duplicates the feeling that you get from the nicotine rushing into your blood system.
What most people don’t understand is that there’s a severe and significant oral fixation. Smokers love to have something in their mouth.
What I’ve told many of my patients after they’ve tried everything is to get a bag of lollipops. The lollipops take care of the oral fixation, and I tell them to get a nicotine patch. And the nicotine patch takes care of the nicotine that their body is craving.
I then tell them to take a picture of their loved one and their wallet. And every time they go to reach for a cigarette reach for a lollipop and take out that picture. Because smokers live 14 years less than non-smokers.
And you should see the look on my patients faces when I ask them if they want to see their children grow up, or if they want to see their kids graduate from college, or get married.
They look at me like I’m crazy, of course they do. I ask them why they’re smoking then? Because if I gave you a knife or a cigarette, you choose the cigarette. But they’re doing the same thing.
Is vaping safer than regular cigarette smoking?
Don’t do either one. We know what smoking does and the verdict is still out on vaping. We know what goes into the cigarette. We know what comes out of the cigarette. We know about the statistics relating lung cancer to cigarettes.
We also know that radon, asbestos, a lot of different things cause lung cancer. As a physician and a thoracic surgeon I cannot help but tell anyone do not put anything into your mouth that goes into your lungs that’s not supposed to be there.
Patients sometimes need to understand how smoking affects their family before they are able to quit
One of the most memorable patients I have was a ex NFL athlete and he smoked. And he smoked while he was in the NFL. And what’s amazing is that he went to his doctor he had an x-ray which showed a spot and a subsequent cat scan which showed a suspicious lesion and he was sent to me to discuss what the options were.
We decided to take it out and it was a lung cancer. And I did a proper cancer operation. And he was out of the hospital within a day or two and he was back to his normal routine.
But what’s amazing is that up until the operation he told me he was never gonna be able to stop smoking. And I said but you have lung cancer, we know you have lung cancer.
What’s it gonna take? He said I don’t know but I can’t stop smoking. Well let me tell you… Those two days after the operation in the hospital, he stopped smoking.
When he went home his wife and his children got on him and said… Are you crazy? Stop smoking!
He threw away his packs. He never went back. And when I saw him at the two-week follow up, not only did he thank me for taking out his lung cancer and ultimately resecting for cure and saving his life, but he thanked me for being persistent by insisting that he would quit smoking. Because he knew that it was so bad for him, but yet he kept doing it. So in essence he was scared straight. And it worked!
Advantages of undergoing minimally invasive surgery
Minimally invasive surgery has become an important part of treating lung cancer patients, helping them recover faster with less pain. Dr. Eric Presser gives us a patient’s story.
I recently saw a patient in the office who has breast cancer, and on one of her follow-up PET scans they found a single mass in her lung. Now her oncologist, who I’ve been working with for years, knows that minimally invasive chest surgery can come into play because I can go in there and resect this mass.
No matter what it is, we will have plenty of tissue for diagnosis and it will be taken out completely. So, in this case it’s the best option for this patient considering she’ll come in, she’ll have the mass removed, and she’ll go home the next day.
What are some of the advantages of using minimally invasive surgery?
Minimally invasive chest surgery means that I’m using 1 centimeter incisions to perform the operations. I perform operations using one incision, I call it single incision. That or video-assisted thoracic surgery, to three or four incisions, depending on how extensive the operation is.
Every surgery is different. I use as many small incisions as necessary to perform the operation at hand. Now, I can and I’m able to make larger incisions but I know how devastating that is on the patient. When we have to crack ribs and make large incisions it puts the body under a significant amount of stress. By using small incisions the body is under less stress which means that you have less pain, less hospital time, and you get back to your normal routine quicker.
I had a patient who was in a car accident he presented to the emergency room after the airbag deployed and he was complaining of chest pain. They did a cat scan of the chest. Everything was fine except they found a mass. Now, this gentleman was about 70 years old. He smoked and he was quite concerned. So they sent him to me and I saw him in the office.
In the office we looked at the images together. There were some suspicious findings so I offered him all the options from observation to resection. He told me he wouldn’t sleep at night unless he knew exactly what was going on.
So I resected the mass. While he was asleep in the operating room, I sent it to the pathologist. The pathologist was able to tell me if it’s cancer and I then proceeded with a formal, proper cancer operation by resecting the mass, the remaining lobe, and the surrounding lymph nodes.
The patient was out of the hospital in two days. He was back to his normal way of life that week. And he was able to follow up with an oncologist and start treatment in this case because his incisions had already healed.
It’s amazing what we can do nowadays using minimally invasive surgery
Dr. Presser discusses alternative therapies for treatment
Not a day goes by where someone doesn’t approach me and ask about alternative therapies. I always stick to the same basic facts which is diet, exercise, eat right, don’t do anything in excess.
When people ask me about super foods, or antioxidants, or any of these supplements… there isn’t enough information out there to really hang our hat on something. But it really depends on the patient.
For example, I had a 34 year old gentleman who was a smoker who was unfortunately diagnosed with metastatic lung cancer. I did everything I could to make him comfortable, meaning, I couldn’t resect his lung cancer 4 cure, but his chest cavity kept filling up with fluid and there are other procedures that I can do that allow him to be more comfortable
When he came to my office one day holding a bag full of supplements and antioxidants and asking me about all these therapies, I just looked at him and I said, go ahead, you’re able to do whatever it is that makes you feel better. And in this case I had no evidence that said what he was doing was going to be more detrimental.
Thirty-four years old and had lung cancer, so anything that he wanted to do or anything that he did to give himself hope I wasn’t about to take that away
I will never take away someone’s hope and in this case because he actually felt better, he could breathe better, and he had hope, he lived longer than the average person would under the circumstances.
How the patient their family friends and the doctor worked together for the best outcome
When facing a diagnosis of lung cancer or any serious condition allowing support from family and friends can help relieve some of the stress. Dr. Eric Presser recommends that a good surgeon is also a teacher, helping to guide the patient through their cancer journey.
If you are ever unfortunately diagnosed with lung cancer make sure you involve as much of your family as possible. People think they’re protecting their loved ones, but in actuality, in the long run you need them. You need their love, you need their support.
In my book I mentioned a story about my own father, who went on a business trip, or so I thought. And I received a phone call a few days later that he had open-heart surgery. And I flew on the first plane back to New York and I was angry. I was happy that he was alive but I was very angry that he didn’t allow me the opportunity to partake in the situation. Because the first thought in my brain was… what if I never saw him again? I never had an opportunity to say goodbye.
The point I was making is make sure that you don’t keep secrets. Make sure that you allow people to love you, to help you. Make sure that you have all the shoulders that you need to lean on. Don’t isolate anybody.
Empathy with the patient and their family is an important part of the surgeons work
When I have to walk out of the operating room and tell a family that we found cancer, it’s one of the most difficult things to do because you know that you just changed, not just the patient’s life, but everyone in their families life as well. It’s devastating. But a good surgeon, a good doctor tries to show, not just compassion, but also empathy. And if they can see it in your face, that you are actually on their team, that you actually care, that you’re actually part of them, that you have their back, then they know that moving forward you’re going to take a difficult situation and make it as simple and pleasant possible.
A detailed plan of options to treat cancer helps to empower the patient
So what I tell all my patients is we have to attack every situation in a step-by-step fashion. After an operation the next step is getting the patient out of the hospital.
Most important because if you don’t get the patient out of the hospital there is no further treatment. So once the patient’s out of the hospital. Then you guide them. You make sure they see the proper oncologist. You make sure that they follow up with their other doctors. You make sure that they tell their family. You make sure that their support system is available and that everyone understands what the next steps are.
It’s overwhelming. Cancer is overwhelming and that’s why many patients need a guide. It’s another reason why I wrote my book an Empowering Guide to Lung Cancer.
If you follow the six steps it actually will guide you through this devastating course that you didn’t ask for. And it’s not just about lung cancer. If you actually read steps four, five, and six, they applied to anyone with cancer.
How the surgeon helps patients and their families understand the best options
In Dr. Eric Presser book an empowering guide to lung cancer there are six steps to take charge of your care and your life
- increase awareness
- get a proper diagnosis
- know your options
- ask the right questions
- remove toxic substances from your life and
Dr. Presser shares another patient story and another reason why he wrote his book
Because I’m based out of Palm Springs in California, I see patients from all over the country and all over the world.
I recently saw a patient who was treated in Washington State for her lung cancer. Unfortunately she’s in the later stages and her chest keeps filling up with fluid. They drained her chest over 12 times with a needle. And when she came to see me I offered her a procedure that I do which took care of her problem once and for all.
When she asked me… how come no one else offered her this procedure? I said I don’t know, but it’s one of the reasons why I wrote my book
Patients need information for the best choices in treating their cancer and having the best quality of life they can have
Not everything is curable, not every cancer is curable, but every cancer is treatable and that’s what I make sure to tell all my patients. They need hope. They want to know that everything that can be done will be done until it’s time for them to stop.
Everyone says “you have to fight cancer, you have to fight cancer”. Well, sometimes you want to stop fighting cancer and that’s okay also. So my job as a surgeon and a physician is to make sure that the patient and their family know what the best options are, and also, what they can and can’t do throughout their journey.
Dr. Presser reveals that establishing a personal bond with patients is a key part of being a good doctor
I was recently treating a patient and I was explaining to him what the options are, and when I told him that I would treat him as if he was my family, as if he was my brother, and I asked him to decide and let me know. We ended up performing the operation. He did very well, but afterwards he looked me in the eye and he said, “you didn’t have to convince me about what needed to be done, but when you told me that you would treat me as if I was your own family member, as if I was your brother, I knew that I was going to be in good hands.
So being a good doctor is not just wanting to know what you need to do. And being a good surgeon is about having a proper plan and execution. But many times you have to gain the trust of the patient. It’s a privilege to operate on somebody and I make sure that I relay that to all my patients, every day. And the day that I walk into the hospital and I don’t feel that way I’m going to quit.
The correct answer is true. Lung cancer kills over 71 thousand women in the United States annually. One and a half times as many as breast cancer.