Posts Tagged ‘lung cancer’

Lung Cancer Live Chat Takeaways

lung-chat-260x200According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the U.S.  At least 8.6 million Americans qualify as high risk for lung cancer and are recommended to receive annual screening with low-dose CT scans. Lung CT Screening for individuals at high risk has the potential to dramatically improve lung cancer survival rates by finding the disease at an earlier, more treatable stage.  At Winship Cancer Institute of Emory University, a highly coordinated multidisciplinary team provides advanced care and clinical trials option with cutting edge new therapies for lung cancer patients.

We hosted a live chat with Seth D. Force, MD and Suresh Ramalingam, MD of Winship Cancer Institute of Emory University’s lung cancer team on Wednesday, January 11 where we answered your questions about lung cancer risk factors, lung CT screening, symptoms and therapy. We received a lot of great questions that our physicians were able to answer. Below are some highlights from live chat, and you can read the full chat transcript here.

Lung Cancer Live Chat Highlights

Question: Is a chest x-ray the best place to start for screening?

Dr. Force and Dr. Ramalingam: Chest xrays have not been shown to be helpful for lung cancer screening as confirmed by several older clinical trials. For patients at high risk for lung cancer, a chest CT scan is the best screening test.

Question: At what point should a patient seek specialist if diagnosed with nodule

Dr. Force and Dr. Ramalingam:  Any person who is found to have a nodule should seek a specialist. These specialists can include a thoracic surgeon, pulmonologist, or an oncologist specializing in lung cancer. At Winship, our doctors sit down weekly to discuss the specifics cases and use specific guidelines to determine the next step for a patient found to have a lung nodule.

Question:  What are some of lung cancer symptoms that should worry us?

Dr. Force and Dr. Ramalingam: Good question! Most patients who present with early stage lung cancer are asymptomatic. Symptoms that should cause someone to seek medical consultation are persistent cough, chest pain, coughing up blood, difficulty breathing and unexplained weight loss.

 

Thank you to everyone who participated in our lung cancer live chat with Dr. Force and Dr. Ramalingam. Learn more here.

Lung Cancer: Risk Factors, CT Lung Screening, Symptoms & Therapy Live Chat

lung-chat-260x200According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the U.S.  At least 8.6 million Americans qualify as high risk for lung cancer and are recommended to receive annual screening with low-dose CT scans. Lung CT Screening for individuals at high risk has the potential to dramatically improve lung cancer survival rates by finding the disease at an earlier, more treatable stage.  At Winship Cancer Institute of Emory University, a highly coordinated multidisciplinary team provides advanced care and clinical trials option with cutting edge new therapies for lung cancer patients.

Join Seth D. Force, MD and Suresh Ramalingam, MD, with Winship Cancer Institute of Emory University’s lung cancer team, on Wednesday, January 11 at 12 PM for a live chat where we’ll answer your questions about lung cancer risk factors, lung CT screening, symptoms and therapy. All are welcome to attend this online open-forum discussion.

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Minimally Invasive Surgery is Changing the Early Detection of Lung Cancer

Minimally invasive surgery is changing the early detection of lung cancer by innovating ways of tracking lung nodules when lung cancer is suspected.How is minimally invasive surgery changing the early detection of lung cancer?

The majority of lung cancer surgeries are now performed using minimally invasive approaches. Above 80 percent at Emory. This presents advantages to the patient: less muscle is cut and recovery is quicker. Traditionally surgeons would need to touch the nodule to find it, and accessing the lung via smaller incisions prevents that hands on touch.

When it comes to lung cancer early detection, we have to remember that the lung tissue is normally filled with air, sort of like a puffy sleeping bag. When someone gets a CT scan and a nodule is detected, the air is present. During surgery, the tissue collapses, causing the nodule to shift away from where it was.

At Winship, cardiothoracic surgeons Manu Sancheti, Seth Force and colleagues have been developing a technique of using gold markers. It’s called fiducials and it keeps track of small nodules when lung cancer is suspected. The minimally invasive surgeons published their findings in 2014 in the Annals of Thoracic Surgery.

During a CT scan the radiologist will mark a nodule by inserting a fiducial, which is then visible during the operation via fluoroscopy. This allows the surgeon to precisely cut out the appropriate lung tissue containing the nodule.

“Some nodules are small enough that it’s difficult to feel them at all,” Force says. “Rather than take as many as 45 minutes to hunt around for a nodule during surgery, gold markers are an attractive and accurate alternative.”

Sometimes, cancer can be diagnosed and removed in one day. Some nodules are located deeper, so that it’s harder to access them by needle biopsy first.

A sample from a nodule can be removed during minimally invasive surgery, sent to the pathology lab, and within 30 minutes, the surgeon can have an answer to the question: is it cancer?

Lung cancer remains the number one cancer killer in the U.S. It takes the lives of more people than breast, prostate and colon cancers combined. Lung screenings help lung cancer patients with early diagnosis and increased survival rates through options such as gold markers and minimally invasive surgery. Emory Healthcare’s low-radiation-dose lung screening is available for patients with a significant smoking history. Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

Lung Cancer Screening Guidelines You Need To Know

Current guidelines state that screening for lung cancer is recommended when all of the following lung cancer screening guidelines are met. Learn more.Did you know that not everyone can actually qualify for lung cancer screening? Current guidelines state that screening for lung cancer is recommended when all of the following lung cancer screening guidelines are met:

  • Age 55-77 years
  • Asymptomatic (no signs or symptoms of lung cancer) no lung infection (pneumonia, bronchitis) within the past 12 weeks
  • Current or former smoker (if former smoker, it is recommended that it has been less than 15 years since quitting)
  • History of cigarette smoking with pack-years greater than or equal to 30
  • You have not had a CT of the chest within the last 12 months

How to Calculate “Pack-years”

VIEW ONLINE CALCULATOR

20 cigarettes = 1 Pack

To translate smoking history into ‘pack years,’ simply multiply the number of cigarette packs smoked per day by the number of years smoked.

(# packs per day x # total years smoked = pack-years)
For example: 1½ packs a day smoked over a 30-year period = 45 pack years. If an individual has less than a pack per day smoking history calculate pack-years using the formula below.

(# total years smoked x # cigarettes per day) / 20 = pack-years
For example: 40 year smoking history 15 cigarettes per day = 30 pack years

Please note: a physician’s order is required for the Lung CT Scan. If you do not have this information, please make an appointment with your primary care doctor first. If you do not have a primary care doctor, please call 404-778-7777 and a representative will be happy to match you with an Emory provider.

Do you have any questions? Please comment below.

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What Is Lung CT Scan & How Does It Work?

Lung CT scan provides more detailed information than conventional X-rays making it possible to diagnose & manage lung cancer earlier & more effectively.A lung CT (computed tomography) scan creates detailed pictures of the structures in your chest, such as your lungs. A lung CT scan provides more detailed information than conventional X-rays making it possible to diagnose & manage lung cancer earlier & more effectively. This blog explains what lung CT is and answers some common questions you may be asking as well. If you have more questions, please post them in the comments below and we will respond gladly.

Computed Tomography, commonly known as CT or CAT scanning, is a non-invasive diagnostic tool. CT uses a specialized form of X-ray, coupled with computer technology, to produce cross-sectional images (slices) of soft tissue, organs, bone and blood vessels in any area of the body. CT lung cancer screening has revolutionized medical imaging by providing more detailed information than conventional X-rays and, ultimately, offering better care for patients.

Imaging methods to examine the lungs include chest X-ray, low-radiation-dose chest Computed Tomography (CT) and standard-radiation-dose chest CT. Low-radiation-dose CT is appropriate for cancer screening because it has been demonstrated to be more sensitive than X-ray in detecting cancer, with less radiation exposure than standard chest CT.

CT technology is used to detect pulmonary nodules, collections of abnormal tissue in the lungs that may be early manifestations of lung cancer. These nodules are often detectable by CT before physical symptoms of lung cancer develop. Early detection of pulmonary nodules through CT screenings has been shown to improve survival compared with patients not undergoing lung CT scan.

Many people have pulmonary nodules, but not all are cancerous. In fact, most nodules are caused by scar tissue from a prior lung infection and are not cancerous. Computed Tomography (CT) Screening frequently detects small nodules that are later determined to be non-cancerous. If you have benign nodules, you’ll be asked to return for a CT screening yearly for one or two years to make sure they don’t grow. If a nodule is concerning for cancer, further diagnostic testing will be recommended.

Common Lung CT Screening Questions

Why Is CT Used?

CT scans are used to check the size and structure of an organ or other soft tissue and determine if it’s infected, solid or filled with fluid. The scans are used to diagnose tumors, cancers, spinal injuries, heart disease, vascular conditions, brain disorders and various other abnormalities within the body. CT scans also are used to rapidly diagnose traumatic injuries and to guide a number of minimally invasive procedures such as needle biopsies, catheter placement, fluid drainage and duct and vessel stenting.

How Does CT Work?

CT uses X-rays to detect and record the amount of radiation absorbed by different tissues. During a CT scan, an X-ray tube focuses a precise beam of energy on a section of the body. A computer analyzes the readings from X-rays taken at thousands of different points and converts the information into images radiologists and other doctors use to analyze internal organs and tissue.

Is CT Safe?

Although there’s no conclusive evidence that radiation from diagnostic X-rays causes cancer, some studies of large populations exposed to radiation from other sources have demonstrated slight increases in cancer risk. However, smokers have a much greater risk of developing lung cancer. The chance of developing lung cancer in one’s lifetime is approximately one in 13 for males and one in 16 for females (combined smokers and non-smokers). The risk of developing lung cancer due to a single CT scan of the chest is estimated to be one in 10,000. Because the risk of developing lung cancer is much greater than the added risk from a CT scan, and smoking increases the risk of lung cancer, we feel the benefits of CT screening for lung cancer in patients with a significant history of smoking outweigh the risks of radiation exposure. The radiation dose for CT lung screening is considered “low-dose” because the radiation exposure is less than a CT scan of the chest that’s done for a diagnosed medical problem.

Please note: a physician’s order is required for the Lung CT Scan. If you do not have this information, please make an appointment with your primary care doctor first. If you do not have a primary care doctor, please call 404-778-7777 and a representative will be happy to match you with an Emory provider.

CT Lung Screening Real-life Patient Story

Read this real life patient story about Becky whose life was saved by an Emory doctor who performed a timely CT lung screening.This real-life story about an Emory CT lung screening patient is just one example of how ct screening for lung cancer can save a life.

Becky Huff had been seeing radiologists just to follow up on findings of calcification after a mammogram. A CT scan of her breasts detected nodules in her lungs. Now 67, she quit smoking more than two decades ago. Becky was wondering whether working in a smoke-filled office also contributed to her cancer risk.

For the next two years Emory doctors monitored her lungs with CT lung screening every six months. Pulmonologist Gerald Staton led the group. Then, a change in the appearance of the nodules, along with an inconclusive biopsy, led her to consult an Emory thoracic surgeon Allan Pickens. He recommended a unique type of imaging — a PET scan — to gauge the possibility that cancer had spread.

“To me, that was another safeguard that they knew what they needed to do beforehand,” Becky says.

Using two small incisions on the side of Becky’s body, Dr. Pickens removed the upper lobe of her left lung. Two months later, in a similar procedure, he removed a segment from her right lung. When pathologists examined the removed tissue and samples from her lymph nodes, they detected no signs that the tumors had infiltrated the lymph nodes. That meant she could forgo chemotherapy and radiation.

“This is an example of when we were able to get there early, before the cancer has progressed,” Dr. Pickens said.

Becky’s recovery from the surgeries included some pain. She had trouble finding a comfortable sleeping position and needed to take pain medicine for a couple of weeks. Yet, she had avoided surgeries that would open the chest.

“I did get over the surgery a lot quicker than other people that I’ve seen,” Becky said.

Around the time of her surgeries in the spring of 2011, Becky had begun taking piano lessons. While raising five children, she had always wanted to learn to play. Now, five years after her surgeries and a reassuring PET scan this year, she continues to learn piano and stays active with frequent walks on her family’s wooded property in Talbot County, Georgia.

A physician’s order is required for CT lung screening. If you don’t currently have a care provider; you may meet with one of Emory team members to determine if CT lung screening is right for you.

Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

6+ Reasons to Quit Smoking on November 17th

acspc-048514More than 40 million Americans smoke cigarettes, despite the fact that tobacco use is the single largest preventable cause of death in the U.S. To help lower this number and the heightened risk for disease caused by cigarette smoking, the American Cancer Society’s Great American Smokeout is Thursday, November 17. The event is held each year to encourage smokers to set a quit date with a community of peers and support.

Along with the Great American Smokeout event, November is Lung Cancer Awareness Month, meaning there are multiple opportunities to make a change and choose to quit smoking today. If the momentum and support created through these events and efforts aren’t enough, there is plenty of data to prove the benefits of quitting smoking today.

According to the American Cancer Society:

  • Within 20 minutes of quitting, your blood pressure and heart rate are reduced to almost normal.
  • Within 12 hours of quitting, the carbon monoxide level in your blood drops to normal.
  • Within 2 week to 2 months, your circulation improves, and your lung function increases.
  • Within 10 years of quitting smoking, the risk of dying from lung cancer is about half of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decrease
  • Smoking can reduce your good cholesterol (HDL) and your lung capacity, making it difficult to get the physical activity you need to stay healthy.
  • Quitting smoking today will lower your risk for heart disease, aneurysms, blood clots, stroke and peripheral artery disease (PAD). More details.

For more information on the Great American Smokeout, check out the American Cancer Society’s website on the event.

Lung Cancer Screening – How It Can Save Your Life

Early lung cancer screening detects cancer & helps catch a tumor before it spreads. Medicare & private insurance companies cover screening for lung cancer.Did you know that lung cancer screening can save your life or that of your loved one? Better screening and minimally invasive surgery are changing the prognosis for patients with early-stage lung cancer.

We breathe in and out, every minute of every day. Our lungs are critical for life. Yet if a group of cells in someone’s lungs starts growing into a tumor, that person usually can’t see it or feel it. Until it becomes large enough to be dangerous.

The lungs are encased in the ribs, with few nerve endings. So a tumor has to grow quite large. Only then it starts to take away enough lung capacity to cause discomfort or make someone cough. Even below that threshold, as a tumor becomes larger, it is more likely for some cells to separate off and metastasize.

Early detection of lung cancer by CT (computed tomography) lung cancer screening offers an opportunity to catch a tumor before it grows and spreads. In 2011, the National Lung Screening Trial with over 50,000 participants established the life-saving value of lung cancer screening by lowdose CT for people with a history of heavy smoking. In the last two years, both Medicare and private insurance began to cover the screening for lung cancer procedure.

“Better lung cancer screening is changing the outcomes for lung cancer patients by allowing us to find these tumors earlier,” says Allan Pickens, a Winship thoracic surgeon and director of minimally invasive thoracic surgery and thoracic oncology at Emory University Hospital Midtown. “When we find these tumors earlier, they are generally of a smaller size and have not had the chance to spread to other parts of the body, lymph nodes or other organs.”

Because of increased numbers of lung cancer screenings, doctors now discover lung cancer when it’s small. Often, less than two centimeters wide. Clinical studies show this is a point when it may be possible to treat the cancer by surgery alone. Surgeons also have been shifting to minimally invasive approaches known as video-assisted thoracic surgery.

Lung cancer remains the number one cancer killer in the U.S. It takes the lives of more people than breast, prostate and colon cancers combined. Lung screening may help with the early diagnosis and increased survival rates for lung cancer patients. Emory Healthcare’s low-radiation-dose lung screening is available for patients with a significant smoking history.
Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

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.

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.