Testing It Up

Tobacco smoking has long been established as the primary risk factor of lung cancer. But it appears that the same danger cannot be said for those who smoke marijuana, whether occasionally or habitually.

In a study presented at the annual meeting of the American Association of Cancer Research, a group of researchers reported that regular cannabis smoking has no significant association with lung cancer risk.

Dr. Li Rita Zhang of the University of California, Los Angeles, and colleagues examined the role of cannabis smoking in lung cancer risk using data from six case-control studies in the United States, Canada, the United Kingdom and New Zealand. All of the studies were part of the International Lung Cancer Consortium (ILCCO), according to The Oncology Report.

The risk of lung cancer was assessed between the frequency, intensity, and duration of use, while adjusting for age, sex, sociodemographic factors and tobacco packyears. In the end, the researchers found that regular pot smokers had no significant increase in lung cancer risk when compared with marijuana smokers who also used tobacco.

“The conventional wisdom is that cannabis smoking is not as dangerous as cigarette smoking,” said pulmonologist Dr. Michael Alberts, chief medical officer of the Moffitt Cancer Center, Tampa, who wasn’t part of the study. Still, he cautioned that smoking anything can have some negative effects to the respiratory system.

Dr. Zhang, on the other hand, did not comment on the study but she noted that their findings “cannot preclude the possibility that cannabis may exhibit an association with lung cancer risk at extremely high dosage over long periods of continued exposure.”

The American College of Chest Physicians (ACCP) has released updated lung cancer guidelines, which recommend offering low-dose computed tomography (LDCT) scanning to people who are at higher risk of developing lung cancer.

“Our new lung cancer guidelines take into account the many advances and new information in the field by providing comprehensive and nuanced recommendations related to prevention, screening, diagnosis, staging, and medical and surgical treatments,” Guideline Panel Chair, W. Michael Alberts, MD, MBA, FCCP, Moffitt Cancer Center, Tampa, FL., said in a news release.

According to ACCP’s guidelines, smokers and former smokers age 55-74 with more than 30 pack-years of smoking should be offered low-dose CT screening. This is a clear change from the 2007 version of the guidelines, in which evidence that showed the importance of CT screening in reducing lung cancer deaths was not yet available.

The guidelines clearly indicated that CT screening should not be given to individuals with less than 30 pack-years of smoking; younger than 55 or older than 74; and those suffering from severe diseases in addition to a primary disease or disorder.

“Lung cancer screening offers a potential benefit for select individuals, but it is not a substitute for stopping smoking,” explained Frank Detterbeck, MD, FCCP, Yale University, New Haven, CT, and Vice-Chair of the Guidelines Panel.

Detterbeck added that the guidelines are also meant to educate both the patient and the physician about the screening in order to overcome misconceptions and misguided fears.

In addition to CT scanning, the guidelines underscore advances in treatment, including the benefits of minimally invasive surgery and treatment at specialized centers.

Three medical groups issued new screening guidelines for lung cancer, published online in the Journal of the American Medical Association.

The guidelines were written by an expert panel, chaired by Peter Bach of the Memorial Sloan-Kettering Cancer Center in New York, for the American College of Chest Physicians, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network.

The updated guidelines call for annual screenings, but only for current or former heavy smokers, aged 55 to 74. The guidelines indicate that the risks of screening younger or older smokers, or non-smokers, outweigh the benefits that may be derived from these tests.

The screening will consist of low-dose CT scans (a special kind of X-ray that can detect lung cancer early, but may provide false positive results). While regular chest X-rays can also detect lung cancer, these have less detailed images than CT scans. Regular X-rays may also provide false positive results, and have not been proven to save lives. As such, it is not recommended as a screening tool for lung cancer.

There is a possibility that widespread screening may result in some deaths, as abnormal results are usually followed by biopsies and other invasive tests that may prove to be fatal. The number of lives, however, that may be saved from death due to lung cancer by these screenings far outnumber these deaths.

Otis Brawley, chief medical officer at the American Cancer Society, shared: “Screening is a double-edged sword.” While CT cancer screening was able to prevent 80 lung cancer deaths among participants in a study conducted by the National Cancer Institute, 16 participants died after screening, six of whom did not have lung cancer.

The results of a study seem to confirm how addictive smoking can be, so much so that even patients suffering from cancer cannot give them up despite knowing that it is not good for them.

According to new data published in the online version of the journal Cancer, a large number of patients who have been diagnosed with colon cancer and lung cancer carry on with their cigarette smoking habit, even if they know that it has an adverse effect on their condition.

Doctors say, however, that quitting smoking is imperative after being diagnosed with cancer, as it can hinder the results of treatment.

The study involved an investigation into the smoking rates of approximately 5,300 lung and colorectal cancer patients. At the time of diagnosis, 39 percent of patients suffering from lung cancer and 14 percent of patients suffering from colon cancer smoked. Five months after diagnosis, it was determined that 14 percent of lung cancer patients and 9 percent of colon cancer patients continue to smoke.

Dr. Elyse R. Park of the Massachusetts General Hospital/Harvard Medical School in Boston, lead researcher for the study, shared: “These findings can help cancer clinicians identify patients who are at risk for smoking and guide tobacco counseling treatment development for cancer patients.”

The researchers determined that lung cancer patients who continued to smoke after diagnosis were usually heavy smokers prior to diagnosis, were usually on Medicare, and had very little treatment for their condition. Colon cancer patients who continue to smoke, on the other hand, were also usually heavy smokers prior to diagnosis; they were usually uninsured and undereducated males.

November is Lung Cancer Awareness Month, and as in other observances, now is a good a time as any to focus on sharing information about this disease, and about the important role that early detection plays in its treatment and management.

It is the goal of the American Lung Association (ALA) to increase public awareness about lung cancer, as well as to urge everyone to proactively make an effort to prevent its onset, or treat it in time if it does occur. Irwin Berlin, M.D., Board Chair of the American Lung Association in New York, shared: “Lung cancer is the number one cancer killer of both men and women in New York State.”

Dr. Berlin shared further: “Lung cancer affects both smokers and nonsmokers. Regardless of smoking history, no one deserves lung cancer and that’s the message we need all New Yorkers to hear and embrace. We need New Yorkers to do what they can to limit their risk and be aware of the resources that are out there to help them should they or a family member face a lung cancer diagnosis. The more we can raise awareness about lung cancer and gain the public’s support to help fight this disease, the more lives we can save and the more we can improve the quality of life for those patients suffering from this disease.”

Lung cancer is known to be caused by cigarette smoke, exposure to radon, and industrial exposure to such hazardous materials as asbestos and arsenic. In order to prevent lung cancer and lower one’s risk for developing the disease, the ALA makes the following suggestions:

• Do not smoke; and if you are, stop.
• Avoid exposure to second-hand smoke.
• Be aware about exposure to industrial compounds, and if you are, find out how you are being protected.
• Test your home for radon.
• Be active in the fight against pollution.

A team of researchers from the University of Strasbourg reported that they found promise in a possible vaccine against lung cancer. The vaccine is said to work by triggering the immune system to attack the most common type of lung cancer.

The results of early clinical trials, conducted on 148 study participants, indicated that adding the vaccine to chemotherapy was able to slow the progression of the cancer. Its effect on overall survival, however, was limited, and this has prompted the need for further trials.

The vaccine used in the study is called TG4010, which is a modified pox virus. The virus is distantly related to smallpox, and has been genetically modified into a “cancerous” surface protein.

The study participants consisted of patients suffering from advanced non-small-cell lung cancer. All the patients underwent standard chemotherapy treatment, but half of them were also infected with the virus.

Results of the trial showed that after six months, the condition of vaccinated patients proved to be more stable when compared against those who only underwent chemotherapy. “Progression free survival” among vaccinated patients was 43 percent, and 35 percent or those who were only given chemotherapy treatment.

Prof. Peter Johnson, of Cancer Research UK, shared: “There’s a lot of interest in harnessing the power of the immune system to treat cancer. This early-stage study shows that combining a vaccine with chemotherapy is possible, and may have some benefits for some people with lung cancer.”

Recent studies have suggested that heavy smokers exposed to low-dose CT scans lessen their risk to lung cancer deaths by 20%. The National Lung Screening Trial has been studying smokers since 2002 and their findings today suggest that low-dose celical computed tomography can help reduce lung cancer mortality.

In the United States, approximately 94 million are at risk of the disease. When symptoms of lung cancer begin to manifest on individuals, they are often diagnosed to be in the later stage of the disease and treatment usually becomes too late.

In the study, doctors were able to prove that patients who are exposed to low-dose CT scan annually have better chances of survival compared to those who only underwent chest X-ray procedures. Early detection of tumors in CT scans is the main reason why lung cancer deaths are decreased by 20%.

In a helical CT, the process makes use X-rays showing many angles of a patient’s chest as a whole, while a regular chest X-ray only shows a single image of the chest which often fails to identify tumors at the early stages of the illness.

In an AFP report, Constantine Gatsonis, a statistician and chair of biostatistics at Brown University’s Warren Alpert Medical School, says that results of the study could open the doors of LDCT for lung cancer patients to decrease deaths related to the disease.

“For the first time, we have a study that says, ‘Yes, you can actually reduce lung cancer mortality in heavy smokers via screening.’ This is tremendous,” Gatsonis adds.

Complete results of the study are published in the online edition of New England Journal of Medicine where the relationship between CT scans and lung cancer mortality rates are further explained. The study could greatly impact the emotional and physical state of lung cancer patients.

A recent report from the American Cancer Society revealed a bit of good news: cancer death rates are on a decline, falling at a rate of 1.9 percent per year from 2001 to 2007 in men, and by 1.5 percent from 2002 to 2007 in women.

According to a feature on Reuters, the American Cancer Society predicts that 1,596,670 new cancer cases will be diagnosed in the United States this year, while there may be 571,950 deaths. The decline in cancer death rates, the group said further, means that an estimated 898,000 patients suffering from cancer, who would have died prematurely over the past 17 years, did not succumb to the disease.

The annual cancer report, however, also showed that Americans who had the least education are more than twice as likely to die from cancer, when compared against those who had the most education.

The groups that had the largest annual decline in cancer death rates are black and Hispanic men, whose rates fell by 2.6 percent among blacks, and 2.5 percent among Hispanics.

Lung cancer was identified as the number 1 cause of cancer death in both American men and women; it is expected to account for 26 percent of cancer deaths among American women this year. Breast cancer was identified as the second most common cause of cancer death in American women; for men, it is prostate cancer which holds the same rank. Meanwhile, colon cancer was ranked as the third leading cause of cancer deaths among both men and women.

While smoking in itself is not the only possible risk factor for lung cancer, it is by far the most preventable risk factor of all. Unfortunately, kicking the smoking habit is not an easy task, especially for the long-time smoker; so much so that, for some of them, even the diagnosis that they or their loved ones have lung cancer is not enough to make them quit.

According to a study sponsored by the U.S. National Cancer Institute, and shared on Bloomberg BusinessWeek, almost one in five patients diagnosed with lung cancer recently continue to smoke.

Kathryn E. Weaver, lead author of the study and assistant professor of social sciences and health policy at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, shared: “The biggest obstacle is fatalism, the belief that it is too late to quit smoking so why bother?” Weaver said further: “There are benefits to be gained by quitting that have important implications for survival, response to treatments, and quality of life.”

The study, which was published recently in Cancer Epidemiology, Biomarkers & Prevention, indicated that there is a need for family support, counseling, and medication for lung cancer patients and caregivers, who need assistance in kicking their smoking habits. Continued smoking by the patient and/or caregivers can have an adverse impact on the recovery and prognosis of a lung cancer patient.

The study looked into 742 patients and caregivers in various locations, and determined that 18 percent of lung cancer patients continued to smoke after diagnosis. Smoking is the leading cause of lung cancer.

When we talk about cancer, any news about survival is always good news. On Thursday, researchers shared this sort of good news, by revealing that the rate at which women die of lung cancer is going down.

A feature on The Washington Post shared that death rate from lung cancer has dropped at a rate of about 1 percent a year until at least 2007, since peaking in 2002.

The decline of death rate due to lung cancer for men started earlier than for women’s, and this is being attributed in part to the fact that women took up the smoking habit a little bit later than men. The decline is expected, as more and more women are beginning to give up smoking.

The decline was documented on Thursday by the National Cancer Institute. Brenda Edwards, of the National Cancer Institute, commented that women “took it [smoking] up a little later, so their increase has had a slow rise and now it’s finally starting to turn around… Lung cancer deaths in women are now showing a statistically significant decline. It’s the first time.”

The information was shared via an analysis of the country’s war against cancer, which is conducted every year by the National Cancer Institute, the American Cancer Society, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries.

The good news extended beyond women with lung cancer, as the analysis also indicated a decline in the rate at which Americans are diagnosed with, and succumbed to, leading cancers.