Early Symptom Lung Cancer








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Early Symptom Lung Cancer - sign symptom Lung Cancer - Lung Cancer Symptoms and Treatment
Update: 15.09.2008

Genetic region linked to a five times higher lung cancer risk

 A narrow region on chromosome 15 contains genetic variations strongly associated with familial lung cancer, says a study conducted by scientists at Washington University School of Medicine in St. Louis and other institutions in the United States and the United Kingdom.

 The researchers found a more than five times higher risk of lung cancer for people who have both a family history of the disease and these genetic variations. The risk was not affected by whether the study participants smoked or didn't smoke.

 Published in the September 13 issue of the Journal of the National Cancer Institute, this study is the fourth since April 2008 to implicate this genetic region in the development of lung cancer, and it strengthens the possibility that testing for variations in this region could become a valuable way to warn individuals of their higher risk.

 "Many smokers don't get lung cancer, which suggests there is a genetic difference in smokers who do get the disease," says senior author Ming You, M.D., Ph.D., a researcher in cancer chemoprevention at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "We also know that some families have a high incidence of lung cancer. If we can identify the genetic factors linked to lung cancer in such people before they get the disease, we can take steps to help prevent it. This genetic region might be part of the answer."

 Lung cancer, the leading cancer killer in the United States, will likely cause 162,000 deaths in 2008 in men and women combined, according to projections. The National Cancer Institute indicates that cigarette smoking is linked to 87 percent of these deaths.

 Among research groups studying lung cancer susceptibility, many other genetic markers of increased risk have been identified, but the area identified in this study on chromosome 15 is the only genetic region that is consistent across many studies, You says.

 The three other recent studies that identified these specific genetic variations focused on sporadic lung cancer, but the current study established a strong risk factor in this chromosomal region for the kind of lung cancer that is inherited. Sporadic lung cancer occurs in individuals without a family history of lung cancer, while familial lung cancer, as defined for this study, is lung cancer that occurs in three or more direct blood relatives.

 The three recent studies on sporadic lung cancer cited an approximately 30 percent greater risk for individuals with specific genetic variations in this region of chromosome 15, a much lower risk than found in the current study, You notes.

 One of these studies indicated that smoking increases the risk when people have the genetic variations on chromosome 15, but two of the studies indicated that smoking adds no increased risk in such people. The increase in risk identified in the current study also was not dependent on whether a person smoked.

 "If these genetic variations are associated with a five-fold increased risk, regardless of whether you smoke, that's very important information," says You, professor of surgery at the School of Medicine. "It would suggest that specific genes in this region and smoking are independent risk factors for lung cancer, and together they might cause an even greater increase in lung cancer risk."

 The researchers looked at 194 people with familial lung cancer and compared their genetic profiles to 219 people over age 60 with no history of lung cancer. To make their study population as uniform as possible, only Caucasian subjects were included. DNA samples from blood or cheek swabs from each participant were screened for more than 300,000 known human genetic variations, or SNPs (pronounced "snips," these are points on chromosomes where people's DNA commonly differs by just one unit, or nucleotide).

 The research group found several genetic variants, or SNPs, with a strong association to familial lung cancer on chromosomes 1, 3, 6, 9, 12 and 20, but a cluster of SNPs on the long arm of chromosome 15 had the strongest link to the disease. These genetic variants were found much more often in the study subjects with lung cancer. The statistical analysis of the data suggests that people with a family history of lung cancer and the variants on both copies of chromosome 15 have a 5.7- to 7.2-fold higher risk for developing lung cancer compared to the control group.

 The chromosomal region that contains the high-risk-associated variations is the site of several known genes, including three that code for proteins implicated in nicotine addiction. That connection ties the genes to lung cancer associated with smoking, but some evidence also exists that the genes are directly involved in lung cancer development.

 "These genes play roles in cellular proliferation and cell death," You says. "And they are active in lung cancer tumors. More research will be needed to fully delineate the part they play in lung cancer and whether they will be good targets for cancer therapies in the future."


Update: 08.08.2008

Lung cancer - another step in the right direction

 Cancer specialists at the Australia and New Zealand joint scientific meeting for the Medical Oncology Group of Australia and the Faculty of Radiation Oncology, held in Christchurch NZ were today treated to some positive news in the fight against lung cancer.

 There has long been therapeutic nehalism regarding the treatment of lung cancer. Delegates at the conference saw two excellent presentations which highlighted the emerging role of targeted therapies combined with chemotherapy for the treatment of lung cancer.

 The first study by Dr Arlene Chan, medical oncologist at the Mount Hospital Perth presented data from the AVADO trial.

 AVADO recruited 736 patients from 106 sites in 24 countries. Patients were randomized into one of three arms, to receive three times per week either docetaxel 100mg/m2 plus placebo; or docetaxel 100mg/m2 plus 7.5 mg/kg bevacizumab; or docetaxel 100mg/mg2 plus bevacizumab 15mg/kg.

 The primary aim of the study was to investigate lung cancer survival without disease progression. The median (middle) follow up time was 10.2 months.

 Patient's characteristics were evenly balanced in each of the treatment arms. Patients in the bevacizumab arms experienced the common side effects of diarrhoea, rash and hypertension (high blood pressure), but essentially, treatment in each of the arms was well tolerated.

 The patient survival time without disease progression was statistically better in each of the bevacizumab arms. It was 0.79 in the docetaxel 100mg/m2 plus 7.5 mg/kg bevacizumab arm and 0.72 in the docetaxel 100mg/mg2 plus bevacizumab 15mg/kg arm.

 The median survival time without disease progression was 8.0 months for docetaxel alone; 8.7 months for docetaxel 100mg/m2 plus 7.5 mg/kg bevacizumab arm; and 8.8 months for docetaxel 100mg/mg2 plus bevacizumab 15mg/kg. Overall the patient's response rates to treatment was 44%, 55% and 63% respectively. One year survival data so far is 73%, 78% and 83% respectively.

 All of the assembled oncologists will await further promising results with bated breath.


Update: 15.07.2008

New clinical trial for patients with asbestos-associated lung cancer

 The Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital and Columbia University Medical Center is now recruiting patients for a clinical research study of a new targeted radiation and chemotherapy protocol for pleural mesothelioma, a cancer of the lung's lining that is almost always caused by previous exposure to asbestos.

 The standard treatment for pleural mesothelioma is currently surgery to remove the patient's lung - a potentially debilitating consequence.

 "Current surgical and chemotherapy treatments of patients with malignant pleural mesothelioma are unsatisfactory, and have not been shown to significantly prolong survival. In this study, we will investigate whether a combination of chemotherapy and radiation targeted directly at the lung's lining can improve outcomes while avoiding surgery," says Dr. Robert Taub, the study's principal investigator, director of the Mesothelioma Center at NewYork-Presbyterian/Columbia and professor of clinical medicine at Columbia University College of Physicians and Surgeons. "In addition, this approach has shown to have minimal toxic side effects compared to systemic chemotherapy."

 "This trial is also significant because our centre is the only one nationwide that is offering this experimental therapy to treat pleural mesothelioma," added Dr. Taub. "We are very focused on offering these patients the best treatment that medical technology can offer while simultaneously working to preserve quality of life."

 Researchers also anticipate that the radiation therapy will kill the cancer cells on surface of the lung while sparing other parts of the lung and surrounding vital tissues.

 "Delivery of radiation therapy directly into the pleural cavity is a strategy that has been employed since 1945. Today, direct injection of radioactive isotope P-32 may prove to be a significant and effective therapeutic approach for selected mesothelioma patients," adds Dr. Rashid Fawwaz, study co-investigator, radiologist at NewYork-Presbyterian/Columbia and professor of clinical radiology at Columbia University College of Physicians and Surgeons.

 "Overall, it is hoped that this study will decrease the need for patients to undergo radical surgery," states Dr. Joshua Sonett, study co-investigator, chief of general thoracic surgery, surgical director of the Lung Transplant Program and surgical director of the High-Risk Lung Assessment Program at NewYork-Presbyterian/Columbia and professor of clinical surgery at Columbia University College of Physicians and Surgeons.

 Participating patients will receive several rounds of targeted chemotherapy using the drugs cisplatin and doxorubicin via surgically implanted catheters. Some patients will be randomly selected to receive additional systemic (intravenous) chemotherapy using the drugs cisplatin and pemetrexed. All patients will receive targeted radiotherapy using the P-32 radioisotope. Patients may elect to receive additional surgical treatment, including removal of the affected lung lining or lung. Subsequently, patients will be offered outpatient systemic chemotherapy with cisplatin and pemetrexed.

 The investigators previously led a prospective study that employed a similar protocol for patients with pleural mesothelioma as well as those with the more retractable sarcomatous disease. Completed in 2002, the study reported a median survival of 70 months, and a three-year survival of 67 percent (American Journal of Clinical Oncology).

 (Source: American Journal of Clinical Oncology: New York- Presbyterian Hospital/Columbia University Medical Center: June 2008)


Update: 30.06.2008

'Gender equality' of lung cancer

 The Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital and Columbia University Medical Center is now recruiting patients for a clinical research study of a new targeted radiation and chemotherapy protocol for pleural mesothelioma, a cancer of the lung's lining that is almost always caused by previous exposure to asbestos.

 The standard treatment for pleural mesothelioma is currently surgery to remove the patient's lung -- a potentially debilitating consequence.

 "Current surgical and chemotherapy treatments of patients with malignant pleural mesothelioma are unsatisfactory, and have not been shown to significantly prolong survival. In this study, we will investigate whether a combination of chemotherapy and radiation targeted directly at the lung's lining can improve outcomes while avoiding surgery," says Dr. Robert Taub, the study's principal investigator, director of the Mesothelioma Center at NewYork-Presbyterian/Columbia and professor of clinical medicine at Columbia University College of Physicians and Surgeons. "In addition, this approach has shown to have minimal toxic side effects compared to systemic chemotherapy."

 "This trial is also significant because our center is the only one nationwide that is offering this experimental therapy to treat pleural mesothelioma," added Dr. Taub. "We are very focused on offering these patients the best treatment that medical technology can offer while simultaneously working to preserve quality of life."

 Researchers also anticipate that the radiation therapy will kill the cancer cells on surface of the lung while sparing other parts of the lung and surrounding vital tissues.

 "Delivery of radiation therapy directly into the pleural cavity is a strategy that has been employed since 1945. Today, direct injection of radioactive isotope P-32 may prove to be a significant and effective therapeutic approach for selected mesothelioma patients," adds Dr. Rashid Fawwaz, study co-investigator, radiologist at NewYork-Presbyterian/Columbia and professor of clinical radiology at Columbia University College of Physicians and Surgeons.

 "Overall, it is hoped that this study will decrease the need for patients to undergo radical surgery," states Dr. Joshua Sonett, study co-investigator, chief of general thoracic surgery, surgical director of the Lung Transplant Program and surgical director of the High-Risk Lung Assessment Program at NewYork-Presbyterian/Columbia and professor of clinical surgery at Columbia University College of Physicians and Surgeons.

 Participating patients will receive several rounds of targeted chemotherapy using the drugs cisplatin and doxorubicin via surgically implanted catheters. Some patients will be randomly selected to receive additional systemic (intravenous) chemotherapy using the drugs cisplatin and pemetrexed. All patients will receive targeted radiotherapy using the P-32 radioisotope. Patients may elect to receive additional surgical treatment, including removal of the affected lung lining or lung. Subsequently, patients will be offered outpatient systemic chemotherapy with cisplatin and pemetrexed.

 The investigators previously led a prospective study that employed a similar protocol for patients with pleural mesothelioma as well as those with the more retractable sarcomatous disease. Completed in 2002, the study reported a median survival of 70 months, and a three-year survival of 67 percent (American Journal of Clinical Oncology, February 2008).

 Patients aged 18 and older that have not had recent radiation therapy or chemotherapy, and have not received prior Alimta chemotherapy, may be eligible for the current study. Those interested in enrolling should contact Dr. Robert Taub, Dr. Joshua Sonett or study coordinator Lilian Batista at (212) 305-6837.

 The study is being conducted at the Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital and Columbia University Medical Center.

 Drs. Taub, Fawwaz and Sonett are joined by co-investigators Drs. Mark Ginsberg and Lyall Gorenstein -- both of NewYork-Presbyterian Hospital and Columbia University Medical Center.

 From 1940 through 1979, approximately 28 million U.S. workers were exposed to asbestos at work. An estimated 3,000 people died of mesothelioma in the late 1990s. It is unknown how asbestos causes the disease.


Update: 11.06.2008

Inhalable form of gene-therapy takes aim at lung cancer and inflammatory lung disease

 A new inhalable form of gene therapy - based on technology recognized in the 2006 Nobel medicine prize, shows increasing promise for treating lung cancer, infectious diseases and inflammatory lung disease, scientists have concluded after an exhaustive review of worldwide research on the topic. Their report is scheduled for the June 2 issue of ACS' Molecular Pharmaceutics, a bi-monthly journal.

 In the article, Sally-Ann Cryan, Niamh Durcan, and Charlotte Murphy focus on research efforts to develop an inhalable form of RNA interference (RNAi), a gene-therapy technique that interferes with or "silences" genes that make disease-causing proteins. The authors explain that RNAi has advantages over other gene therapies. It is potent, very specific, and appears to have a low risk of side effects.

 They cite encouraging results with RNAi in laboratory studies in cells and animals with a range of lung diseases, including lung cancer, certain respiratory infections and inflammatory lung disease. Keys to successful therapy in humans include careful design of the gene-silencing agents, determining the most effective doses, and developing better ways of delivering RNAi agents to the lungs, the scientists say. - MTS



 Lung Cancer, malignancy of the lungs that is the leading cause of cancer deaths for both men and women in the United States and Canada. About 90 percent of all lung cancer occurs in current or former smokers. The American Cancer Society estimates that 164,000 new cases of lung cancer are diagnosed annually in the United States and an estimated 157,000 people die from the disease each year. According to the Canadian Cancer Society, 20,600 new cases of lung disease are diagnosed in Canada annually, and the disease causes 17,700 deaths a year.

 There are four main types of lung cancer, which tend to arise in different parts of the lung and differ in characteristics and behavior. Squamous cell carcinoma accounts for 20 percent of all lung cancer. It frequently begins toward the central part of the lung in the bronchial tubes, which are the major airways that lead into the lungs. About 40 percent of lung cancers are adenocarcinomas, cancers that originate on the outer edges of the lungs and under the lining of the bronchial tubes. Small-cell carcinoma spreads more rapidly than any other type of lung cancer. It is characterized by small cells that may be shaped like either oat grains or rods and makes up about 20 percent of lung cancer cases. Ten percent of all cases are large-cell carcinomas, cancers characterized by large, abnormal cells that usually begin along the outer edges of the lung.

 Lung cancer often spreads, or metastasizes, through the bloodstream or lymphatic system to other tissues. More than 50 percent of people newly diagnosed for lung cancer already show signs of cancer elsewhere in the body. Conversely, some cancers detected in the lung are actually cancers that have metastasized from other parts of the body to the lungs. These are not considered lung cancers. For example, if breast cancer spreads to the lung, it is still considered breast cancer. It does not look or behave like a cancer that starts in the lung.

Early Symptom Lung Cancer


 The symptoms of lung cancer are not usually apparent during early stages of the disease. The first symptoms to appear are often similar to those of other, nonmalignant respiratory ailments. The patient may develop a persistent cough, or find that a chronic smoker’s cough is worsening. Other symptoms include chest pain, shortness of breath, hoarseness, bloody sputum (fluid coughed up from the respiratory tract), and frequent bouts of bronchitis or pneumonia. Sometimes, the first symptoms of lung cancer are bone pain, headaches, dizziness, or other signs that the disease has metastasized.

 A physician who suspects lung cancer may use a chest X ray to view the lungs and locate any tumors. Computed tomography, a series of X-ray images combined by a computer, may be used to pinpoint the tumor’s approximate size and location. To further evaluate cancerous cells, the physician must examine them under a microscope. In a procedure known as a biopsy, the physician removes a small tissue sample from the tumor. Sometimes a microscopic analysis of cells contained in the sputum will also help confirm a diagnosis.

 A diagnostic technique called bronchoscopy enables the physician to visually examine the patient’s bronchial tubes. In this procedure, the physician feeds a bronchoscope, a thin, fiber optic tool equipped with a light and magnifying device, through the patient’s mouth and down into the trachea and bronchial tubes to view the lungs. The bronchoscope can be fitted with a tiny cutting tool, enabling the physician to obtain samples of cells for later microscopic examination.

Early Symptom Lung Cancer - Sign Symptom Lung Cancer - Lung Cancer Symptoms and Treatment

This dissection of human lung tissue shows light-colored cancerous tissue in the center of the photograph. At bottom center lies the heart. While normal lung tissue is light pink in color, the tissue surrounding the cancer is black and airless, the result of a tarlike residue left by cigarette smoke. Most lung cancer begins in the cells lining the main air passages, or bronchi. In their cancerous state, these cells lack the cilia that normally catch and eliminate foreign particles inhaled into the lung. Mucous ordinarily cleared by bronchial cilia becomes trapped, blocking air passages. Lung cancer accounts for the largest percentage of cancer deaths in the United States, and cigarette smoking is directly responsible for the majority of these cases.

RISK FACTORS


 Cigarette smoking is the single greatest cause of lung cancer. Up to 90 percent of lung cancer patients are smokers, and most of the remainder have been exposed to secondhand smoke. The great majority of lung cancer cases could be prevented and thousands of lives could be saved each year if people quit smoking.

 Other environmental factors linked to a higher incidence of lung cancer include prolonged exposure to certain workplace substances, such as arsenic, asbestos, and high doses of ionizing radiation, such as that emitted by uranium (see Radiation Effects, Biological). Long-term exposure to air pollution, which is largely composed of the remains of burned petroleum and coal, may also increase the risk of lung cancer. One constituent of indoor air pollution, naturally occurring radon gas, a colorless, odorless gas that silently seeps from the earth in some regions, poses a special danger to cigarette smokers.

 Not all heavy smokers develop lung cancer, suggesting that heredity may also play a role in lung cancer development. Some people seem to inherit an inability to break down certain types of cancer-causing chemicals, making them more susceptible to disease. Exposure to tobacco smoke, for example, may cause key cancer prevention genes to malfunction in these people. For instance, a tumor suppressor gene called FHIT prevents the growth and spread of tumors. Many people with lung cancer inherit a mutated form of this gene that fails to perform this job. The tumor suppressor gene p53 also prevents tumor growth, and researchers have learned that a mutated form of the p53 gene fails to block the growth of cancerous tumors.

 Some studies indicate that women are twice as likely as men to develop lung cancer. Researchers have found a gene called GRPR that causes abnormal cell growth in people exposed to cigarette smoke. The gene is more active in women than in men and it may explain why females are more susceptible to lung cancer.

TREATMENT - Innovative Lung Cancer Therapies


 The course of treatment depends on the type of lung cancer, the size and location of the tumor, the stage of disease, and the age and general health of the patient. If there is no evidence that the disease has spread beyond the lung, the tumor can be removed using one of several surgical procedures. In a resection, only a small part of the lung is removed. The left lung is composed of two lobes, the right lung of three; the removal of an entire lobe is called a lobectomy. Removal of an entire lung is called a pneumonectomy. Following surgery, radiation treatment and chemotherapy (anticancer drugs) may be used to ensure that the entire tumor is eliminated. Unfortunately, fewer than 50 percent of lung cancer patients are candidates for surgery because their cancer has spread to other parts of the body. In these cases, patients may receive chemotherapy or radiation treatment or a combination of both, depending on the severity of the illness.

 Lung cancer patients must be monitored regularly following treatment, even if no signs of cancer persist. Second lung cancers develop in a significant number of survivors.

 Gene therapy—the use of genes to replace defective genes or supersede their actions—is an emerging treatment for lung cancer and other diseases with genetic components. Preliminary results from experiments using gene therapy for lung cancer, first reported in 1996, have found that replacing defective p53 tumor suppressor genes with normal p53 genes shrank or stopped the growth of some lung tumors.

Alternative and Complementary Lung Cancer Treatments


 In each CTCA facility, you’ll find a welcoming staff of practitioners who specialize in alternative and complementary therapies to help you experience a better quality of life during your lung cancer treatment.

 These supportive therapies can: ease the side effects of your conventional treatments; help you maintain your strength; build your immune system; and, improve your overall quality of life.

 Whether you decide to explore the benefits of naturopathic medicine, nutrition, acupuncture, mind-body medicine or spiritual support, our professionals will work with your team of doctors to provide you with the most comprehensive and best possible care.

 Our whole-patient approach to integrative care centers on providing a full range of healing options to help to balance and nurture your body, mind and spirit. Many of these options have been used for thousands of years around the globe to increase energy levels, reduce pain and restore emotional and physical health. Your care team at CTCA will work with you to select the complementary therapies that are most appropriate for your lung cancer treatment and individual needs.

Pain management

 Ninety percent of people who experience pain from cancer treatment are able to find relief from their pain. At CTCA, your doctors and clinicians will help you choose from a wide range of conventional pain-reduction treatments, including surgery, medication and nerve-numbing techniques. They may also suggest complementary options such as acupuncture, acupressure, visualization and meditation.

Chemotherapy for Lung Cancer

 At Cancer Treatment Centers of America (CTCA), we offer innovative methods to deliver chemotherapy that can decrease the side effects of your lung cancer treatment.

 Such chemotherapy delivery breakthroughs include fractionated-dose chemotherapy, in which we are able to administer chemotherapy drugs in smaller, more manageable doses rather than a large, single dose. Fractionated-dose chemotherapy is just one example of the leading chemotherapy practices that we utilize. Our doctors do everything in their power to help make your chemotherapy as tolerable as possible.

 Chemotherapy is the use of anticancer drugs to treat cancer. These drugs are designed to work by interfering with the rapidly dividing cancer cells in your body. Your doctors may suggest chemotherapy as a form of lung cancer treatment before or after surgery. Chemotherapy is usually administered intravenously (through the vein) or orally (in the form of pills). Your doctor may recommend a central port placement to help preserve your vein tissue from chemotherapy-related side effects.

 Chemotherapy is used as a lung cancer treatment in three main ways:
 Neoadjuvant or primary systemic chemotherapy may be used before surgery to destroy cancer cells. It also allows your oncologist to determine the effectiveness of a particular lung cancer treatment regimen on your tumor.
 Adjuvant chemotherapy, used after surgery or radiation, may further target any possible cancer cells that were not removed during lung cancer surgery. It helps prevent the cancer from spreading to other parts of your body. Systemic chemotherapy plays an important role in the treatment of patients with locally advanced or metastatic lung cancer.

 Doctors have a variety of ways to monitor the effects of chemotherapy on your cancer, including physical exams, blood tests, CT scans, MRI scans and X-rays.

 Common side effects of chemotherapy are fatigue, hair loss, nausea and suppression of bone marrow function. Often, side effects can be treated and/or minimized by the conventional and complementary lung cancer treatment options we offer at CTCA. Supportive/complementary therapies that may help improve your quality of life include nutrition, naturopathic medicine, acupuncture and mind-body medicine. These therapies may be helpful before, during and after chemotherapy.

PROGNOSIS


 According to the American Cancer Society, 41 percent of people diagnosed with lung cancer survive one year after diagnosis; only 14 percent survive five years. If the cancer is discovered while still localized, the five-year relative survival rate is about 50 percent, but only 15 percent of lung cancers are discovered at this stage.

Next: Colorectal Cancer

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