The Weekly Check-Up Atlanta

Dr. Suresh Ramalingam

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Dr. Suresh Ramalingam

Dr. Ramalingam received his MB/BS from Kilpauk Medical College, University of Madras, Madras, India in 1992. He completed his Residency in Internal Medicine from Wayne State University in 1996, where he was also named Chief Medical Resident in the Department of Internal Medicine in 1996. He completed his Hematology-Oncology Fellowship from University of Pittsburgh Cancer Institute in 2002.

Dr. Ramalingam serves as the principal investigator on several early phase clinical trials in lung cancers, many of which are sponsored by the NCI. He is widely published in peer-reviewed scientific journals and serves as a reviewer for a number of medical journals. Dr. Ramalingam is a member of the Thoracic Core Committee of the Eastern Cooperative Oncology Group and serves on the editorial board of the journal Clinical Lung Cancer.

Dr. Ramalingam is the Associate Professor, Hematology & Medical Oncology
Director, Translational Thoracic Malignancies Program at Emory University Medical School.


Dr. Ramalingam is a member of the following organizations:

  • American Society of Clinical Oncology
  • American Association for Cancer Research
  • International Association for Study of Lung Cancer
  • Eastern Cooperative Oncology Group


Dr. Ramalingam is a recipient of the following awards:

  • Clinical Research Career Development Award, American Society of Clinical Oncology, 06/2006
  • University of Pittsburgh Cancer Institute Leadership Award for Excellence in Clinical Trials Program Development, 05/2005
  • Recipient, AMGEN Fellows Award, to participate in the Third International Lung Cancer Congress, Hawaii, 06/2002
  • Participant, Berlex Oncology Foundation Ninth Annual Clinical Pharmacology of Anti-Cancer Drugs Course, Leesburgh, Virginia, 10/2001
  • Participant, ASCO AACR Methods in Clinical Cancer Research Workshop, Vail, Colorado, 07/2001
  • Teacher of the Year Award, Department of Internal Medicine, Wayne State University, Detroit, Michigan, 1999-2000
  • Chief Medical Resident, Wayne State University, Detroit, Michigan, 1997
    Indian Medical Association Award for Proficiency in Internal Medicine, General Surgery and OB/GYN, 1991
  • Proficiency Award in General Surgery, Kilpauk Medical College, Madras, India, 1990
  • Proficiency Award in Preventive Medicine, Kilpauk Medical College, Madras, India, 1989

Myths about Lung Cancer and Risk Factors

*sources: CDC, WebMD

Myth: Only smokers get lung cancer

In fact, the majority of people that develop lung cancer are ex-smokers. Ten percent of people overall, and 20% of women with lung cancer are lifelong non-smokers.

Myth: More women die from breast cancer than lung cancer

Nearly half of lung cancer cases occur in women, and more women die from lung cancer than any other form of cancer. In 2005 (the most recent year where statistics are available), 69,078 women died from lung cancer, whereas 41,116 died from breast cancer.

Myth: There is nothing I can do to lower my risk for lung cancer

Certainly avoiding smoking can lower your risk of developing lung cancer, but an awareness of other factors that may raise or lower your risk is helpful as well. Some environmental exposures such as radon can raise your risk, and occupational exposures account for 13% to 29% of lung cancers in men. On the bright side, a healthy diet and exercise appear to lower risk.

Myth: If I already have lung cancer, it doesn’t pay to quit smoking now

There are several reasons to quit smoking after a diagnosis of lung cancer. Kicking the habit can raise the success rate of surgery, makes treatment more effective, and lowers your risk of dying from causes other than lung cancer.

Myth: I am too old for my lung cancer to be treated

Chronological age alone shouldn’t determine whether or not a lung cancer is treated. It appears that the elderly are often able to tolerate chemotherapy as well as their younger counterparts, and have a similar quality of life following surgery. Performance status (a measure of how well a person is able to carry on ordinary daily activities) is a better indicator of how well someone will tolerate various treatments.

Myth: Light cigarettes are better for you than normal cigarettes

The reality is that light cigarettes are just as dangerous as regular cigarettes, if not more. In fact, research has shown that menthol cigarettes are more dangerous since smokers end up inhaling them deeper.

Myth: Smoking marijuana doesn’t increase your lung cancer risk

Marijuana smoking may increase lung cancer risk, but more research is needed. Many people who use marijuana also smoke cigarettes, and marijuana smoking exposes a person to more tar and other cancer-causing substances that you would find in cigarettes.

Myth: Talcum powder increases lung cancer risk

Researchers have found no association between lung cancer and breathing in talcum powder. However, occupational exposure to asbestos, vinyl chloride, and other substances do increase lung cancer risk.

Myth: Air pollution is a leading cause of lung cancer

Outdoor air pollution is responsible for only about 5% of lung cancer cases. Tobacco smoke remains by far the biggest killer.

Myth: Other healthy habits can make up for a smoking habit

Some smokers justify their habit by insisting that proper nutrition and lots of exercise are enough to keep them healthy. Not so.

"Research shows that eating a healthy diet and exercising don’t reduce the health risks associated with smoking," says Ann M. Malarcher, PhD, senior scientific advisor in the CDC’s Office on Smoking and Health. "Smoking affects every organ system in the body, and thinking that you’re going to find the perfect lifestyle to counteract the effects of smoking is just not realistic."

"You could take a truckload of vitamins a day and still not undo the deadly effects of tobacco," says Michael C. Fiore, MD, professor of medicine and director of the Center for Tobacco Research and Intervention at the University of Wisconsin in Madison, Wis.

Myth: I’m the only one harmed by my smoking

Tobacco smoke also harms the people around you. In the U.S., secondhand smoke causes about 50,000 deaths deaths a year, the American Lung Association estimates. It’s been estimated that a waiter or waitress who works a single eight-hour shift in a smoky bar inhales as much toxic smoke as a pack-a-day smoker, Fiore says.

Talking Points:

In 1998 the tobacco industry was forced to reimburse states and insurance groups in a settlement worth billions of dollars. The tobacco industry was accused of misleading the public about the dangers of smoking and of suppressing their research on nicotine and other health-related subjects.

What is the future of lung cancer research, treatment?

Lung cancer treatment is based on the type and stage of tumor present and the patient’s overall health. Options include surgery, radiation, chemotherapy or a combination of treatments.

*Targeted treatments that work on the molecular level. Ask Dr. Ramalingam about current clinical trials

What are the different types of lung cancer?

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It usually grows and spreads more slowly than small cell lung cancer.

There are three common forms of NSCLC:
Adenocarcinomas are often found in an outer area of the lung.
Squamous cell carcinomas are usually found in the center of the lung next to an air tube (bronchus).
Large cell carcinomas can occur in any part of the lung. They tend to grow and spread faster than the other two types.

About 15% of all lung cancer cases are SCLC. Small cell lung cancer is slightly more common in men than women.
Almost all cases of SCLC are due to cigarette smoking. SCLC is rare in people who have never smoked.
SCLC is the most aggressive form of lung cancer. It usually starts in the breathing tubes (bronchi) in the center of the chest. Although the cancer cells are small, they grow very quickly and create large tumors. These tumors often spread rapidly (metastasize) to other parts of the body, including the brain, liver, and bone.

How is lung cancer detected?

Many times, lung cancer is found when an x-ray or CT scan is done for another reason.

When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn’t always) suggest cancer.
Tests that may be performed to diagnose lung cancer or see if it has spread include:
Bone scan,
Chest x-ray,
Complete blood count (CBC),
CT scan of the chest,
MRI of the chest,
Positron emission tomography (PET) scan,
Sputum test to look for cancer cells,
Thoracentesis (sampling of fluid build-up around the lung)

In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy.

What are the current statistics for lung cancer (incidence, etc.)?

Lung cancer is the leading cause of cancer death, and it is estimated that smoking is the principle cause of about 90% of lung cancer in men and almost 80% in women.

In the United States in 2006 (the most recent year for which statistics are available), 106,374 men and 90,080 women were told they had lung cancer, and 89,243 men and 69,356 women died from it.

Among men, black men were diagnosed with lung cancer most often, followed by white, American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic men. Overall, 82.7 out of every 100,000 men were told they had lung cancer in 2006.

Among women, white women had the most new cases of lung cancer, followed by black, American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic women. Overall, 55.0 out of every 100,000 women were diagnosed with lung cancer in 2006.