Take on using genetic differences to organize lung cancer cases.
Breaking it down this way can point ways to better treat specific cases.
Confronting a lung cancer diagnosis is a difficult process.
To help get your bearings about the illness and better understand the
treatment process ahead of you, it is important to seek guidance and
information from your doctor. As such, there are a number of pertinent
questions that you may want to ask.
As with any medical consultation, it is recommended you write down or
print out all questions you intend to ask your doctor so that you
don’t forget some of them during the actual patient visit.
Additionally, you may want to have a friend or relative accompany you
to the appointment. Doing so may help you keep track of all the
pertinent information your doctor has given you. For added benefit,
you might consider asking your doctor if you can record the meeting so
that you can review his or her answers once you get home.
Below is a list of common questions you may want to ask following a
lung cancer diagnosis:
When screening for lung cancer, which screening test is more effective – chest x-ray or spiral CT scan? While both tests have been shown to be effective in diagnosing lung cancer earlier than would be possible without screening, neither has been shown to reduce a patient’s probability of dying from the illness. Due to this fact, experts are still unsure whether an x-ray is more advantageous or disadvantageous than a spiral CT scan.
In an effort to find an answer to this question, the National Cancer Institute initiated the National Lung Screening Trial (NLST) in 2002. Through February 2004, the trial enrolled 53,000 former smokers into the study and subjected them randomly to either a CT scan or x-ray to check for lung cancer. Participants were culled from 30 different sites across the United States.
The data collected from the study is presently being analyzed and reviewed. The goal of the trial is to determine if either test results in a 20 percent or greater decrease in mortality rates of lung cancer patients.
Currently, lung cancer is responsible for more annual deaths than any other type of cancer. This fact is partially due to the high advancement of the illness once symptoms become visible. Due to this fact, much of the research associated with lung cancer has been focused on finding ways to catch the illness earlier in its progression. Despite this previous research, no definitive survival benefits have been identified for either CT scans or chest x-rays.
Due to the scope and randomized process of the NLST, it is believed that the potential benefits of one or both methods will finally be identified. Beyond this central goal, the NLST also attempts to answer a number of other questions. These questions include:
Presently, the study is in its final stages of data collection. NLST researchers had decided to collect information on patient deaths through 2009. Since notice of death and validation of cause of death can take up to 18 months, it is estimated that final results of the study will be available in mid-2011.
Current and former smokers who were given an annual spiral CT scan were shown to be 20 percent less likely to die from lung cancer, according to a large study sponsored by the U.S. National Cancer Institute (NCI). This reduction in deaths is due to an earlier diagnosis of the illness.
According to Dr. Douglas Lowy of the NCI, “This is the first clear demonstration that a screening procedure can be effective in reducing deaths from lung cancer.” In fact, Lowy and colleagues were so impressed by the results that they actually terminated the study early and mailed letters to each of the 53,000 participants to inform them of the results.
The findings come as good news to the hundreds of thousands of individuals who are at risk for developing lung cancer. An estimated 157,000 lives in America will be lost to the disease this year – a number that makes lung cancer the number one cause of death among all types of cancer.
Of those who are currently diagnosed with lung cancer, 85 percent die from the illness. The average survival time following diagnosis is between 12 and 14 months.
As a result of the findings, researchers predict a dramatic increase in CT scan screenings for adults who have a long history of heavy smoking. However, experts caution that the positive findings should not be viewed as an excuse to keep smoking.
Dr. Harold Varmus, director of the NCI, states that these findings do not insinuate, “it is safe to continue to smoke or to start smoking. We can reduce deaths by 20 percent, but screening does not prevent lung cancer or prevent the large majority of deaths from lung cancer.”
To reach their findings, NCI researchers split the 53,000 study participants into two groups – those that received three spiral CT scans a year and those that received an annual chest X-ray. Participants included middle-aged and elderly smokers who had no previous history of lung cancer.
The chest X-ray and scans were given over a period of five years, beginning in August 2002. As of October 2010, 354 patients who were given CT scans had died of lung cancer. In contrast, 442 patients who received X-rays suffered the same fate. A quick crunching of numbers results in a 20.3 percent reduction in deaths for those given CT scans.
Presently, researchers are not yet recommending routine CT scans as a method for lung cancer detection. They are withholding this endorsement until a full analysis of the study is completed.
Sources: Los Angeles Times, MSN, NY Times
In early trials, a class of lung cancer patients that exhibits a specific genetic mutation has shown positive responses to a chemotherapy drug known as crizotinib, according to a team of researchers based in New England.
Crizotinib is a targeted drug treatment that works by blocking the function of a specific gene called anaplastic lymphoma kinase (ALK). As a result of this blockage, the cancer tumor is unable to continue its growth. Patients who exhibit a unique mutation on the ALK gene are those who are likely to benefit from the new drug.
According to Dr. Geoffrey Shapiro, director of the Early Drug Development Center and co-author for the study, “The cancer cell is actually addicted to the activity of the protein for its growth and survival…the idea is that blocking that protein can kill the cancer cell.”
Though lung cancer patients who exhibit the required mutation are in the minority (82 non-small-cell lung cancer patients out of 1,500 study participants were found to carry the mutation), the results of early studies are quite promising. Of the 82 patients, more than half exhibited tumor shrinkage that averaged 30 percent after six months. Additionally, 27 patients exhibited a complete halt of tumor growth. One patient also benefited from a complete elimination of tumor signs.
Overall, the research team reports a 72-percent success rate in shrinking or stabilizing tumors over a period of six months. These success rates give hope to patients who have historically not responded well to current treatment methods.
ALK mutations are estimated to occur in approximately two to seven percent of all lung cancer cases. However, since the mutation occurs in other types of cancer such as breast cancer, colon cancer, childhood neuroblastoma and certain types of lymphomas, it is believed that crizotinib may offer applications beyond the scope of lung cancer.
Shapiro and team also report a relative low number of side effects, with mild gastrointestinal problems being the most common reported symptom.
While the Boston research findings suggest remarkable benefits of crizotinib, other independent studies suggest that tumors may adapt and overcome the effects of the drug over time. For example, one study found that some lung cancers quickly mutated to overcome the debilitating benefits of crizotinib.
To gain further insight into this and other issues, the Boston team is currently in the process of beginning larger Phase III clinical trials. The study was funded in part by the National Cancer Institute, as well as Pfizer – the manufacturer of crizotinib.
Sources:
http://www.businessweek.com/lifestyle/content/healthday/644995.html
http://blogs.forbes.com/robertlangreth/2010/10/28/pfizer-drug-powers-cancer-treatment-into-the-dna-age/
For more on treatment of lung cancer, see http://www.lung-cancer.com/treatment.html
As the second leading cause of lung cancer in the world, and the leading cause of lung cancer among non-smokers, radon gas is a threat that few people know about. Approximately 21,000 deaths are caused each year by radon gas. These deaths were often a long time in the making, because radon is a clear, odorless gas that most people don’t even suspect they’re breathing in. The onset of lung cancer due to radon poisoning is slow and gradual over the years, because many people don’t know about the precautions and renovations they need to make in order to ensure that their homes are safe.
Radon comes from the natural breakdown of uranium, a radioactive element found in trace amounts in the earth’s soil. When uranium breaks down, radon gas forms and can make its way up through the soil, through cracks in your home’s pipes, foundation or siding, and gets inside your house. When breathed in the lungs it can emit harmful radiation that causes tissue damage or other pre-cancerous mutations in the lungs.
Radon exists everywhere, though it tends to be most concentrated in basements and enclosed spaces that don’t see a lot of airflow. Some places have more uranium in the soil than others. Examples are Iowa City, Iowa and Appalachian Pennsylvania in the U.S., Mallow, County Cork in Ireland and Misasa, Tottori prefecture in Japan. The EPA strongly recommends that people living in these places conduct radon checks to see if they are living with dangerous levels of the gas. Similarly, the EPA recommends that basements with a lot of stagnant air be tested for radon contamination.
Simple short-term radon test kits are often available for under $20 in hardware stores. These kits can be hung up in your house for anywhere from two days to ninety days, and will give you a reading in picocuries per liter (pCi/L). It should be noted that radon levels tend to fluctuate over the course of a year, so if a commercial radon test kit shows a number over 4 pCi/L, the EPA recommends purchasing a long-term radon test kit. If the long-term test kit shows dangerous levels of radon in the air, there are a variety of fixes you can make to solve the problem. Contact your local EPA office for more detailed information.
If your home has over 4 pCi/L, you have an increased chance of contracting lung cancer as you get older. For smokers, the risk of lung cancer is compounded. If your home has over 4 pCi/L, you are twice as likely to get lung cancer. With every successive doubling (8 pCi/L, 16 pCi/L), you are twice again as likely. This is a serious health risk that many people don’t think about until it is too late. However, by simply checking to make sure your home is okay, then fixing it before it becomes a problem, you can reduce your risk.
Do heavy metals cause lung cancer? The human body requires some metals such as zinc, selenium, and copper, but only in trace amounts. It is when the body accumulates large quantities of toxic metals that health problems will occur.
Heavy metals refers to metallic, high density elements that are toxic and poisonous at low concentrations. Some heavy metals are arsenic, lead, mercury, chromium, and cadmium. Heavy metals enter into the body through water and food, and even through skin contact. The metal concentration in the body increases with exposure, as they remain in the body. Heavy metals are absorbed in the body faster than they can be discharged. That build-up effect is the reason heavy metal exposure is so toxic and dangerous.
The body requires proper minerals and nutrients for proper function. Toxic metals in the body interrupt the function of essential nutrients. Different types of cancers, including lung cancer, have been linked to toxic metals accumulating in the body
Cancer results from the heavy metals attaching to a cell’s DNA and causing mutations. The direct and indirect damage to the DNA means an increased risk of cancer. This process is called genotoxicity. Several heavy metals are known to be carcinogenic.
Heavy metals are in the environment. Being aware of the potential for cancers and leading a healthy lifestyle can mitigate some of the damaging factors of heavy metals.
Lung cancer strikes over 180,000 Americans every year and kills about a million people around the world annually. It is responsible for thousands of deaths each year. Unfortunately, it is can be difficult to detect until the later stages when it has become impossible to treat. The good news it that there have been recent advancements in medical science and technology that have aided in the detection of lung cancer.
A variety of tests and techniques is used to detect this tragic disease. However, they all limitations that prevent doctors from making a definitive diagnosis of lung cancer until it is advanced.
Anyone with lung cancer concerns are advised to see a doctor. Outside of that, lifestyle changes, such as quitting smoking, are the strongest weapon against this disease.
The majority of patients undergoing chemotherapy do experience related nausea and vomiting, and not all of the cases can be prevented – 70-80% of people on chemotherapy still face some risk. But thanks to better treatment, most people in chemotherapy are able to go about their normal lives, working and caring for their families.
Ginger is often advocated as beneficial for the relief of nausea and vomiting. For years people have used the herb to mitigate the nausea and vomiting associated with seasickness, morning sickness and chemotherapy induced vomiting. Ginger has been used in China to aid digestion and treat stomach upset, diarrhea, and nausea for more than 2,000 years. The herb has also been used to help treat arthritis, colic, diarrhea, and heart conditions. Recent studies have confirmed what your grandmother knew about the effectiveness of ginger.
Researchers, supported by the U.S. National Cancer Institute, enrolled 644 cancer patients who had already experienced nausea after chemotherapy. All participants had to still be facing at least three rounds of chemo.
The trial is the largest of its kind, according to the researchers.
Participants were randomized to receive either a placebo or one of three doses of ginger supplement: 0.5 grams, 1 gram or 1.5 grams for three days before the start of chemo and three days after for the next two cycles. All also received traditional antiemetic drugs on the first day of treatment.
Most patients report the most severe nausea and vomiting on the first day of chemo. If nausea can be reduced during this critical time period, subsequent nausea is also less likely.
While all doses of ginger helped with nausea, the largest reduction in nausea occurred with 0.5 and 1 gram of ginger. The effect tended to wear off over the next 24 hours.
This was the latest and largest study that is still to be reported this summer but several studies in the past have found similar results on a smaller scale including findings that in comparative studies of ginger and metoclopramide (Reglan), (Bone 1990, Phillips 1993) no significant difference was found between treatments.
Adverse Reactions
Common: Heartburn and dermatitis
Toxicity: CNS depression and arrhythmias have occurred following overdose.
Herb-Drug Interactions
Anticoagulants / Antiplatelets: Ginger may increase the risk of bleeding.
H2-blockers / Proton pump inhibitors: Ginger may antagonize activity by increasing stomach acid production.
Antihypertensives: Ginger may cause additive hypotensive effects.
Hypoglycemics / Insulin: Ginger may cause additive reductions in blood glucose.
April 10 to April 16 marks National Minority Cancer Awareness Week. This public service campaign is designed to raise awareness of the climbing cancer rates among minority populations. The awareness program also seeks to educate minority groups about cancer, including the importance of early detection, improving access to diagnostic and treatment facilities and enabling those with cancer to find support groups within their local communities.
The campaign began in 1986. Dr. Lovell A. Jones, director of the Center for Research on Minority Health at M. D. Anderson Cancer Center in Houston, Texas, approached then-Senator Lloyd Bentsen and then-Congressman Mervyn Dymally to develop a Congressional resolution to place National Minority Cancer Awareness Week on the calendar for the third week of April. The resolution passed on 8 April 1987, and health care facilities around the nation have taken special measures to raise awareness of how cancer affects minority groups every year since.
Part of the Congressional resolution stated that minority community members are often at a severe disadvantage in dealing with cancer, noting “the disease has a disproportionately severe impact on minorities and the economically disadvantaged.” Many communities do not have adequate resources to diagnose, treat and support cancer patients. These communities, including those made up primarily of immigrants, also lack the social, emotional and psychological support structures upon which cancer patients must rely in order to combat the disease.
The Centers for Disease Control and Prevention has compiled statistics related to cancer deaths in minority communities. According to the CDC reports, African-Americans are more likely to die from cancer than any other ethnic group. African-American men have the highest rates for both new cancer cases and cancer deaths. African-American women also have the highest rate of cancer death among all women, regardless of ethnicity.
Some of the activities planned for this public awareness campaign include inserting information sheets into bulletins published by African-American churches, as well as allowing these churches to distribute educational CDs and DVDs. Other activities also involve fraternities and sororities at colleges and universities with a high rate of African-American enrollment. In some areas of the country, the American Cancer Society will host a series of forums to address the issues of cancer in the African-American community.
The Hispanic community is the fastest-growing minority community in America, and cancer rates for this group have also outpaced those of most other groups. The American Cancer Society reports that Hispanic women have higher rates of cervical cancer than any other ethnic group. Hispanics also have higher rates of infection-related cancers, including liver and stomach cancer. The report also states that Hispanics often have their cancers detected at later stages than most other groups.
The American Cancer Society has created a program to work with the consular offices of various Latin American countries to educate immigrants on the dangers of cancer, as well as the value of early detection. The group has also organized several Spanish-language educational efforts that account for cultural differences in a positive and sensitive manner.
Sources: dana-farber.org. cancer.net, michigancancer.org, mdanderson.org