Lung Cancer

November is Lung Cancer Awareness Month – Reduce Your Cancer Risks Today

lung-cancerAccording to the American Cancer Society (ACS), lung cancer accounts for about 13% of all new cancers. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. For smokers, the risk of lung cancer is higher than non-smokers risks so I encourage smokers to make a plan to quit smoking during this lung cancer awareness month.

I would also recommend that you stay away from all tobacco products and byproducts, including second hand smoke. It’s never too late to stop smoking, contact Emory HealthConnection at 404-778-7777 to learn more from a registered nurse about finding a primary physician who can assist you in your health goals.

In addition to not smoking and avoiding second-hand smoke, The Centers for Disease Control and Prevention (CDC) suggests you get your home tested for radon. Radon, a naturally occurring gas that comes from rocks and dirt, is the second leading cause of lung cancer. Radon can have a big impact on indoor air quality if you would like more information on test kits call 1-800-ASK-UGA1 or visit the website www.UGAradon.org.

About Dr. Sancheti

sanchetiLocated at Emory Saint Joseph’s Hospital, Dr. Sancheti specializes in thoracic oncology, minimally invasive thoracic surgery, esophageal surgery, and lung transplantation.

A board certified thoracic surgeon, Manu S. Sancheti, MD, is an Assistant Professor of Surgery in the Division of Cardiothoracic Surgery of the Department of Surgery at Emory University School of Medicine. He joined the Emory faculty in 2014. Dr. Sancheti holds memberships with the American College of Surgeons, the American Medical Association, the American Association of Physicians of Indian Origin, the Southern Thoracic Surgical Association and the Society of Thoracic Surgeons.

Dr. Sancheti received his MD from the University of Alabama School of Medicine in 2006, after which he did a general surgery residency at St. Luke’s-Roosevelt Hospital Center in New York City from 2006-2011. He joined the faculty at Emory University after completing his cardiothoracic surgery residency on a general thoracic track there.

What is High Dose Rate Brachytherapy?

One of the most technically advanced and convenient options for cancer treatment is called high dose rate brachytherapy (HDR). It is a precise type of radiation therapy that is commonly used to treat localized gynecologic, lung, breast and prostate cancers that have not spread to lymph nodes. As opposed to low dose rate (LDR) brachytherapy, where tiny radioactive “seeds” are permanently placed inside or near a tumor, HDR brachytherapy involves temporarily placing high intensity sources of radiation inside the body with a catheter, for example, and then removing them once treatment is complete.

With short treatment and recovery times, HDR brachytherapy can help patients get back to their lives with minimal disruption. At Winship Cancer Institute of Emory University, the therapy is usually performed on an outpatient basis and carried out in two short sessions over one to two weeks. This results in an extremely precise radiation dose and minimal toxicity to the patient. Patients considering HDR brachytherapy may wonder if they will be radioactive following treatment. The answer is no. The radiation flows like the light that shines from a flashlight; it is not present once the treatment session is completed and the device used to deliver the radiation is removed.

HDR brachytherapy is performed at Winship locations by knowledgeable radiation oncologists with special expertise and certification in brachytherapy. The Department of Radiation Oncology at Winship is the only program in Georgia with advanced credentialing recognized by the National Cancer Institute for both LDR and HDR brachytherapy administration and expert usage.

Watch the short video below to learn more about how HDR brachytherapy is used to treat prostate cancer.

Find a Doctor

HDR Brachytherapy is performed at Winship locations by the following physicians:

For more information regarding HDR brachytherapy treatment at Winship Cancer Institute, please visit Emory Radiation Oncology.

In addition to regular treatments, a voluntary research study is being conducted to help men with recurring prostate cancer by using advanced imaging technology called FACBC to guide radiotherapy and determine the best possible course of treatment. Read more>>

About Dr. Rossi

Peter Rossi, MDPeter Rossi, MD, is a board certified radiation oncologist and the Medical Director of Radiation Oncology at Winship at Emory St. Joseph’s Hospital. Dr. Rossi specializes in the treatment of prostate cancer, cervical cancer and ovarian cancer, and his expertise is in the use of external radiation therapy and brachytherapy for treating prostate and gynecologic tumors. Dr. Rossi is on the Quality Assurance Committee of the American Brachytherapy Society. He lectures, proctors and mentors physicians on the use of HDR brachytherapy for the treatment of prostate cancer at Winship and internationally.

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Taking a Stand in Favor of E-Cigarette Regulation

e-cigarette regulationIt has taken us over 50 years of careful regulation with tremendous pushback to strip the tobacco companies of their ability to aggressively and falsely market cigarettes as safe products. The advent and popularity of e-cigarettes could wipe out much of that progress and endanger an entire generation of young people who are attracted to the slickly packaged cartridges, marketed to a youthful generation as a safe alternative to tobacco burning cigarettes.

I firmly believe that the United States Food and Drug Administration should have full authority to regulate e-cigarettes; the same full authority the agency currently has to regulate regular tobacco products. E-cigarettes are not made up of benign compounds. In fact, some of the ingredients such as formaldehyde are known carcinogens. With recent introductions of e-cigarettes from big tobacco companies such as Philip Morris, I believe they will pose some of the same risks as tobacco-burning projects unless they are regulated.

We know that nicotine is highly addictive, whether it is delivered from an e-cigarette, a regular cigarette or a patch. There is some data that nicotine may promote certain cancer signaling networks. There is also some very good evidence in young people that nicotine can cause the rewiring of the brain circuitry. Of greatest concern is recent data obtained from careful studies conducted by the Centers for Disease Control (CDC) that show that people who use e-cigarettes are twice as likely to consider smoking tobacco burning products. In my view, this makes e-cigarettes a Trojan Horse that allows tobacco products into the lives of young people without the proper FDA regulation.

The full range of health risks posed by e-cigarettes is unclear because they have not been fully studied. Just because we don’t have all the scientific evidence does not mean that e-cigarettes should get a free or easy ride. They should be held to the full high bar, especially because we don’t currently understand all of the dangers they pose.

My biggest concern about e-cigarettes is that they are easily marketed to teens and young adults. The campaigns seem to be working since e-cigarette use has almost tripled in the last three years. Only 19% of Americans are active cigarette smokers, but that’s still far too high in my book. We should be concerned as a society that smoking rates will increase as a result if e-cigarettes continue to be sold without any regulation. E-cigarettes are a step backward in our goals to move towards a tobacco free society.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University and Professor and Chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, and executive associate dean for research of Emory University, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.

Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.

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Lung Cancer Progress Made, But We’re Not There Yet

Lung Cancer (This blog was originally posted on September 29, 2014 on the American Association for Cancer Research website)

Luther Terry, the ninth Surgeon General of the United States, released his now seminal Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States on Jan. 11, 1964. The report, assembled by a brave and committed panel of independent physicians and scientists, definitively concluded that lung cancer and chronic bronchitis are causally related to cigarette smoking.

Fifty years later, genomic discovery and the rapidly accelerating fields of epigenetics, proteomics, metabolomics, and drug discovery have presented an armada of new options for patients with lung cancer. Computed tomography (CT) screening of high-risk individuals, particularly smokers, helps detect the disease in its early, more-curable stages more than 80 percent of the time. Breakthroughs in cancer immunology have led to the accelerated development of PD-1 and PD-L1 inhibitors, demonstrating remarkable and durable benefits in early clinical trials of lung cancer patients with advanced disease. But in 2014, five-year survival remains under 20 percent for patients diagnosed with lung cancer and more than 1.5 million people worldwide will die of lung cancer. Moreover, smoking rates, while down to 19 percent in the U.S., remain well over 30 percent in much of the rest of the world.

Despite the armada of new targeted medicines, cure remains elusive for the vast majority of patients diagnosed with this dreaded illness, and a significant number of never-smokers seem to contract this disease without any known risk factors. So why are we optimistic that major progress made in science can meaningfully impact lung cancer?

2014 has seen major strides in lung cancer research and treatment. Smoking cessation efforts have accelerated with the Food and Drug Administration’s (FDA) increased abilities to enforce regulations on tobacco products. Our understanding of lung cancer biology grows exponentially by the day. A number of exciting trials have been launched this year to test targeted agents in the adjuvant, postoperative setting, as well for therapy of patients with advanced stage disease. Exciting clinical trials have led to the approval of second- and third-generation agents targeting oncogene-driven tumors. A major initiative has been launched to target RAS, the most frequently mutated oncogene in all cancer, and a major driver of outcomes in lung cancer.

Substantial progress has been achieved this year in targeted therapy, stereotactic radiation, and immunotherapy of lung cancer. Collaborative work demonstrated that patients with metastatic lung cancer who were treated successfully by targeting their oncogenic drivers do better than individuals who were treated with standard approaches across several centers of excellence, and that work needs to be successfully translated in the community for all patients with lung cancer in the coming years. While emergence of resistance, triggered through enhanced survival signaling circuits, is inevitable in these highly complex tumors, our understanding of these escape circuits is accelerating rapidly. We are learning to combine improved imaging methods with superior technology to detect circulating tumor cells in order to identify and treat patients with disease earlier than ever before.

However, we have yet to show we can successfully intervene in lung carcinogenesis. In a large trial that we performed in the ECOG-ACRIN Cancer Research Group, we found that natural compounds are incapable of reversing the damage caused by ongoing tobacco smoke. We must ally smoking cessation and early detection, and enhance our understanding of the cause of disease in never-smokers. We need to develop potent but tolerable compounds that can reverse premalignant lesions in former smokers.

While the 2009 Tobacco Control Act has enhanced the FDA’s ability to regulate tobacco products in some key areas, such as marketing to minors, major obstacles regarding the regulation of cigars, water pipes, menthol, and particularly e-cigarettes have limited the FDA’s ability to more effectively regulate the menace of Big Tobacco. Indeed, the booming electronic cigarettes industry threatens to enable a whole new generation of smokers. Unless we act decisively to carefully regulate the use of e-cigarettes, the steady progress made in lung cancer research and therapy over the past few decades could be eroded. It is only when we effectively reduce smoking by enforcing the FDA’s control of all products and implementing tobacco control programs with real teeth while simultaneously unraveling and preventing the causes of lung cancer in never-smokers that we will truly start to make an impact, fulfilling Surgeon General Terry’s and, most importantly, our patients’ goals to make lung cancer a disease of prior generations, and a scourge no more.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University and Professor and Chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.

Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.