Posts Tagged ‘lung cancer’

Cancer Risk Dramatically Reduced Since Landmark Smoking Report Issued 50 years Ago

Dr. Fadlo KhuriFifty years ago this month, Dr. Luther Terry, Surgeon General of the United States, issued the landmark 1964 Surgeon General’s Report providing the first definitive proof that cigarette smoking causes both lung and laryngeal cancer. This announcement came after a committee of experts had worked for 18 months, reviewing more than 7,000 published papers and engaging 150 consultants.

The importance of this report and its findings cannot be overstated. Fifty years ago, we did not know that smoking definitely causes lung cancer and other diseases, only that smoking was associated with a higher risk of these diseases. Recognizing that the impact of tobacco on our national and, indeed, the world’s health was the major public health issue of the day, Dr. Terry assembled an unimpeachable panel of distinguished physicians and scientists. He chose individuals for the panel who were not only among the giants of medicine and science, but were also objective and could ensure the integrity of the report.

The report was based on what ranked as the largest and most careful review of the medical literature yet undertaken. Most importantly, the report was clear, evidence based and unequivocal. It showed beyond a shadow of a doubt that smoking caused both lung cancer and larynx cancer. The report concluded that cigarette smoking is 1) a cause of lung cancer and laryngeal cancer in men; 2) a probable cause of lung cancer in women; and 3) the most important cause of chronic bronchitis.

The impact of the report on public perception was astonishing. In 1958, only 44% of Americans believed that smoking seriously impacted health, according to a Gallup Poll. Ten years later, and four years after the report’s release, that number had climbed to 78%. The report also galvanized the anti-tobacco movement. Its findings have lent enormous credence to smoking cessation efforts over the last 50 years. In 1964, 52% of adult men and 35% of adult women smoked cigarettes. This had fallen to 21.6% of adult men and 16.5% of adult women by 2011.

Today, we are certain that tobacco causes some of the most widespread and devastating diseases in the world, including cancers of the lung, larynx (voice box), esophagus, mouth, throat and bladder, which together account for about 30% of the world’s cancer-related deaths. Tobacco is also a major cause of heart disease, emphysema and other diseases of the lungs and heart.

There have been several subsequent reports issued by the Surgeons General, the latest an eye-opening look at smoking behavior among the younger generation. This, like all prior reports, builds on that first landmark report from a great physician leader and his matchless panel of experts. The impact of their efforts on smoking in the US and the world is unquestionable. The debt that the world owes these 12 brave scientists has never been greater.

Author: Fadlo R. Khuri, MD, deputy director, Winship Cancer Institute

Want to learn more about the impact of the 1964 Surgeon General’s Report on smoking? View this video as Dr. Khuri further discusses the effect the report has had on the medical community.

About Dr. Fadlo Khuri
Fadlo 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.

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Genomic Testing for Lung Cancer: What Does it Mean for You?

Lung Cancer Awareness MonthYou may be surprised to learn that lung cancer is the leading cause of cancer deaths in both men and women in the United States.  However, in the past few years, tremendous progress has been made leading to improved outcomes for patients with lung cancer.  According to the Centers for Disease Control and Prevention, genomics is “the study of all the genes in a person, as well as the interactions of those genes with each other and a person’s environment.”  While 99.9% of everyone’s genetic makeup is identical, the difference in the remaining 0.1% helps inform researchers about disease. For patients with certain subtypes of lung cancer, we have now made genomic testing of tumors a routine part of care.  Understanding that each person has a unique genetic makeup allows for individualized treatment for patients with specific mutations in their tumor tissues.

Lung cancer is broadly divided into two types: non-small cell lung cancer and small cell lung cancer.  Approximately 85% of lung cancers are of the non-small cell lung cancer category, which consists of three major subtypes: adenocarcinoma, squamous cell carcinoma and large cell carcinoma.

Adenocarcinoma accounts for nearly 50% of all non-small cell lung cancers and has had an increasing rate of incidence in the United States over the past few years. During the same time, we have learned a lot about the biology of lung cancer overall. As a result, sophisticated tests are now available to identify specific mutations in tumors of patients with adenocarcinoma of the lung.  For example:

  1. A gene called epidermal growth factor receptor (EGFR) is mutated in nearly 15% of patients with adenocarcinoma.  After years of research, we now know that treatment for these patients involves an orally administered targeted drug, versus combination chemotherapy. These novel treatments result in significant improvement of symptoms, disease control and survival.
  2. Through other research, we now know that another group of patients with adenocarcinoma carries a mutation in a gene called ALK.  For these patients, an FDA-approved treatment option named crizotinib is used, which has been found to provide great benefits to these patients.

Since it has been identified that a person’s genetic makeup plays a significant role in not only understanding their overall health and disease occurrence, but also the ideal treatment method(s) they should receive, nowadays, almost every patient diagnosed with lung adenocarcinoma is genetically tested for specific mutations. The good thing about this test is that it can usually be performed from already collected specimens used to diagnose lung cancer, therefore eliminating the need for additional invasive procedures.

Highlights of this post

At the Winship Cancer Institute of Emory University, we have implemented a standardized molecular testing protocol for every patient diagnosed with lung adenocarcinoma.  As a result, in most circumstances, when an oncologist sees a patient for the first time, detailed molecular information is available on the tumor tissue, which helps inform treatment decisions.

Unfortunately, for certain mutations, there are currently no FDA-approved treatment options. Yet, as Georgia’s first and only National Cancer Institute –designated cancer center, Winship offers a number of innovative clinical trials for such patients, with the aim of identifying treatment options that provide the best likelihood of success.

Through research and clinical trials, investigators and physicians have discovered that understanding the genetic makeup of lung cancer patients is key. This knowledge allows for optimal, individualized treatment options that lead to overall improved outcomes for our patients.

Suresh Ramalingam MDAbout Dr. Ramalingam
Suresh Ramalingam, MD, is Associate Professor of Hematology and Medical Oncology and Director of the Translational Thoracic Malignancies Program for the Emory Winship Cancer Institute. He is a Georgia Cancer Coalition Distinguished Cancer Clinician and Scientist.

Prior to joining Emory, Dr. Ramalingam was at the University of Pittsburgh Cancer Institute. He specializes in lung cancer, esophageal cancer and other thoracic cancers and is actively involved in the scientific development of novel anti-cancer treatment agents.

Dr. Ramalingam serves as the principal investigator on several early phase clinical trials in lung cancers, many of which are sponsored by the NCI.  He is widely published in peer-reviewed scientific journals and serves as a reviewer for a number of medical journals.  Dr. Ramalingam is a member of the Thoracic Core Committee of the Eastern Cooperative Oncology Group and serves on the editorial board of the journal Clinical Lung Cancer.

He earned his medical degree at the University of Madras in India, and served as chief medical resident in Internal Medicine at Wayne State University in Detroit.  He later conducted his fellowship in hematology and oncology at the University of Pittsburgh Cancer Institute.

Dr. Ramalingam is a recipient of the prestigious “Clinical Research Career Development Award,” which is presented by the American Society of Clinical Oncology. He has been selected as one of “The Best Doctors in America” and has received numerous awards of excellence such as The University of Pittsburgh Leadership Award for Excellence in Clinical Trials Program Development.

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“TOTAL” Care for Lung Cancer – One Team, One Place, One Goal

Winship Cancer Institute of Emory UniversityEspecially in their later stages, lung cancer and other pulmonary diseases can be very complex to treat. The treatment of lung cancer can involve pulmonary surgeons, medical oncologists, radiation oncologists, pulmonary medicine specialists, interventional pulmonologists, pathologists, researches, nurses and supportive care team members. Because the treatment of pulmonary diseases like lung cancer requires a multifaceted and comprehensive team approach, the Winship Cancer Institute of Emory University has established the “TOTAL” Lung Clinic at Emory University Hospital Midtown.

The Winship Thoracic Oncology Treatment and Long Term Care Lung (TOTAL) Clinic at Emory University Hospital Midtown is designed to make it easier for patients with lung cancer and other pulmonary diseases to seek all of their treatment in one place, with one team who are working together to coordinate the care of each and every patient. Patients of the TOTAL Clinic are able to see up to four lung cancer specialists in one setting and one trip: thoracic surgeon; interventional pulmonologist; medical oncologist; and radiation oncologist. In addition, patients may consult with supportive services, including dietitians and social services, at the same visit and setting.

The TOTAL Clinic was started by the Winship Cancer Institute of Emory University approximately a year ago to make the journey through lung cancer treatment and survival an easier one on our patients. Below, hear from two of the patients of the Thoracic Oncology Treatment and Long Term Care Lung Clinic  what comprehensive treatment and care means to them:

The team/clinic approach has worked well for me and continues to do so. Initially, I was referred to cardiac/thoracic department by neurology. It was here that I became acquainted with Dr. Berkowitz, Dr. Pickens, and Dr. Kono. I was diagnosed, given a plan of action, and started on this plan within days due to their cooperation and effort.

I applaud Emory for their approach to healing and their remarkable professionals.

-Elizabeth Ross

When I was diagnosed with lung cancer, there was no question as to where I would begin my treatment.Emory’s top-notch reputation has lived up to all my expectations.

Through the entire process I have felt the doctor’s, nurses, and staff genuinely care about my well-being. That is one less concern for me as I battle to defeat this disease.

-Belinda Conley

For more information on the TOTAL Clinic, the Winship Cancer Institute of Emory University, or lung cancer treatment programs available at Emory Healthcare, please use the “Related Resources” links below.

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Join Us for a Live Web Chat: Lung Cancer

Lung cancer is the deadliest form of cancer among both men and women. It’s responsible for more deaths each year than breast, colon, and prostate cancers combined. Older adults are at a greater risk for lung cancer; it’s less common in adults under the age of 45. There are several other factors that can increase a person’s risk for lung cancer, but evidence undeniably shows that smokers are at the greatest risk. Studies show the earlier a person starts smoking and the more cigarettes smoked on a per-day basis, the greater the risk for lung cancer.

To learn more about other risk factors for lung cancer, and to get information including screening recommendations, lung cancer prevention tips, and information on survivorship resources, join us for an online chat!

On November 27 at noon (ET) we’re hosting a free online web chat with lung cancer expert Dr. Suresh Ramalingam, MD, Associate Professor, Hematology & Medical Oncology from Winship Cancer Institute of Emory University, Georgia’s only National Cancer Institute-designated cancer center.

Chat Transcript HERE

How to Support Your Loved Ones in their Efforts to Quit Smoking

If you want a loved one to stop smoking and you feel tempted to nag him or her, you may want to try to curb your impulse. You might be doing more harm than good, a Winship Cancer Institute expert says. Reinforce positively and try not to nag, advises Carla Berg, Ph.D., a member of the Cancer Prevention and Control department of Winship and also a professor in the Rollins School of Public Health.

Help Your Loved Ones Quit SmokingWith Heart Month upon us and roughly 17-18%  of adults in the United States continuing to smoke, this is important. Smoking is not only is the major cause of lung cancer, the nation’s number one cancer killer, but it’s also responsible for as many as 30% of all coronary heart disease deaths in the United States each year. Smoking is a major risk factor for more than two dozen other cancers, including head and neck cancer, bladder cancer and stomach cancer.

Berg says an important component can be providing support to someone who is trying to quit. The initiation, maintenance and cessation of smoking is strongly influenced by other family members, Berg says. Smokers are more likely to marry smokers, to smoke the same number of cigarettes as their spouse, and to quit at the same time. Smokers who are married to nonsmokers or ex-smokers are more likely to quit and remain abstinent. In addition, married smokers have higher quit rates than those who are divorced, widowed or have never married. Research shows that support from the spouse and from other family members and friends is highly predictive of successful smoking cessation. In particular, supportive behaviors involving cooperative behaviors, such as talking the smoker out of smoking the cigarette, and reinforcement, such as expressing pleasure at the smoker’s efforts to quit, predict successful quitting. Negative behaviors, such as nagging the smoker and complaining about smoking, are predictive of relapse. In fact, supportive behaviors have been associated with initial smoking cessation, while negative or critical behaviors have been associated with earlier relapse.

In addition, encouraging the establishment of smoke-free homes reduces exposure to secondhand smoke among all people living with smokers. Because secondhand smoke exposure has been found to have detrimental effects on the cardiovascular health of people living with smokers, particularly children in homes where smoking occurs, promoting smoke-free homes is critical. Research also has shown that creating smoke-free homes also encourages attempts to quit smoking and reduced cigarette consumption among smokers.

Do:

  • Talk the smoker out of smoking the cigarette
  • Express pleasure at the smoker’s efforts to quit
  • Encourage smoke-free home policies
  • Support attempts to quit

Don’t:

  • Nag the smoker
  • Complain about smoking
  • Shun the smoker
  • Shame or guilt the smoker

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Lung Cancer MD Chat Follow-up Questions Answered

Dr. Taofeek Owonikoko

Dr. Taofeek Owonikoko

Dr. Kristin Higgins

Dr. Kristin Higgins

Doctors Kristin Higgins and Taofeek Owonikoko held a live web chat on the topic of lung cancer this month. From that chat, there were several unanswered questions that we wanted to circle back with the answers for. You’ll find them below in a Q&A format. If you’re interested in checking out the rest of the conversation from the chat, check out the lung cancer chat transcript.

Rhonda asked: Is there any lung cancer treatment program for people without health insurance?

Dr. Owonikoko: Depending on where this person resides, the state may have a program for indigent cancer patients. Also, the American Cancer Society has some patient support programs for indigent patients to support cancer care. Here is the webpage to the support options on the ACS website.

Marjorie asked: My sister has been treated this year for non-small cell lung cancer in the RUL, that was inoperable. she underwent 6 months of radiation and chemotherapy, and has been told that she is now in remission. what are the odds that she will remain in remission for 5 years or more?

Dr. Owonikoko: This is not a medical advice; best to discuss with the treating oncologist. However, depending on the exact stage of the cancer, 20-30% of patients treated with chemoradiation will survive past 5 years.

Marjorie asked: Also, can you comment on outcomes from radiation induced pneumonitis?

Dr. Higgins: Radiation pneumonitis arises in about 20-25% of patients that are treated with radiation and chemotherapy.  It typically resolves with a course of steroids but sometimes requires hospitilization for more intensive monitoring and supplemental oxygen.

Hank asked: There seems to be some controversy about the use of radiation therapy for lung cancer depending on the stege. What are the pro’s and con’s?

Dr. Owonikoko: There is not much controversy about the benefit of radiation for patient with locally advanced lung cancer. The discussion is more about the best way to give the radiation and how much. Radiation is generally not needed for patients with stage I lung cancer of the non small cell subtype but may be useful for symptom palliation in patients with stage IV non small lung cancer.

Dr. Higgins can provide additional insight on the radiation questions.

Dr. Higgins: A form of local therapy is needed to cure lung cancer that has not yet spread to distant sites, whether it be radiation or surgery.  Surgery is the best option for early stage lung cancer.  New techniques of radiation, particularly SBRT, have been used in patients with early stage lung cancer that are not medically fit for surgery. Outcomes have been very good with SBRT, however surgery and SBRT have not been directly compared and surgery remains the standard of care.  There are trials underway that are directly comparing SBRT vs. surgery.
Again I want to stress that surgery remains the standard of care for early stage lung cancer, but pros to SBRT include minimal recovery time and a less invasive procedure.

Do you have other questions for us related to lung cancer? Leave them in the comments below & we’ll be sure to post responses here.

7+ Reasons to Quit Smoking on November 17th

Great American Smokeout American Cancer Society

Image source: American Cancer Society

More than 46 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:

  • Within 20 minutes of quitting, your blood pressure and heart rate are reduced to almost normal.
  • Within 48 hours of quitting, damaged nerve endings begin to repair themselves, and sense of taste and smell begin to return to normal as a result.
  • Within 2-12 weeks of quitting, your heart attack risk is lowered.
  • According to a 2005 study by the National Institute of Health, within 10 years of quitting smoking, your risk of being diagnosed with lung cancer is between 30-50% of that for the smoker who didn’t quit.
  • Smoking can reduce your good cholesterol (HDL) and your lung capacity, making it difficult to get the physical activity you need to stay healthy.
  • If you smoke one pack of cigarettes per day, at roughly $5 per pack, you’ll save $1825 over the next year alone by quitting today.
  • Quitting smoking today will lower your risk for heart disease, aneurysms, blood clots, stroke and peripheral artery disease (PAD). More details.

According to the American Cancer Society, smoking cigarettes kills more Americans every year than alcohol, car accidents, suicide, AIDS, homicide and illegal drugs combined. It is also responsible for 9 out of 10 lung cancer deaths, a disease that is extremely hard to treat, but that could be prevented.

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

If you’re interested in discussing lung cancer, including diagnosis and treatment options, in more detail with us, we’re holding a lung cancer web chat this week on the same day as the Great American Smokeout, November 17th. This one-hour web chat is a free event for our community to get your lung cancer questions answered. If you want to participate, fill out this short form to receive your link to join Thursday’s chat.

2 Ways to Lower Your Lung Cancer Risk Today

Lung Cancer Awareness Month
More people in the U.S. die from lung cancer than any other type of cancer. Lung cancer is responsible for approximately 30% of cancer deaths in the United States. In fact, it’s actually the cause of more deaths than breast cancer, colon cancer and prostate cancer combined. November is Lung Cancer Awareness Month and we’d like to share with you some important information and tips for how you can lower your lung cancer risk.

Quit Smoking

Obviously, if you smoke, the most important step you can take to lower your risk for lung cancer is to quit smoking. Quitting smoking:

  • Lowers your blood pressure and your heart rate – Within 20 minutes of quitting, your blood pressure and heart rate are reduced to almost normal.
  • Repairs damaged nerve endings – Within 48 hours of quitting, damaged nerve endings begin to repair themselves, and sense of taste and smell begin to return to normal as a result.
  • Lowers your risk for heart attack – Within 2-12 weeks of quitting, your heart attack risk is lowered.
  • Lowers your risk for lung cancer – According to a 2005 study by the National Institute of Health, within 10 years of quitting smoking, your risk of being diagnosed with lung cancer is between 30-50% of that for the smoker who didn’t quit.

Smoking accounts for ~90% of lung cancer cases. If you smoke, this is the critical first step in lowering your lung cancer risk. If you have a history of smoking and are between the ages of 55-75, you may be a candidate for a Lung CT Scan.

Eat a Wider Variety and More Fruits & Veggies

In November 2007,  the American Institute for Cancer Research (AICR) and the World Cancer Research Fund published Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective, the most comprehensive report on diet and cancer ever completed. The study found evidence linking diets high in fruit and their ability to lower lung cancer risk to be probable. This is one of the core reasons that the AICR recommends consuming at least five portions a day of fruits and vegetables. After evaluating approximately 500,000 people in 10 countries in Europe, another study demonstrated intaking a variety of produce may also help lower lung cancer risk, so make sure to vary the color on your plate!

Chat Online with Dr. Suresh Ramalingam

Lung Cancer Web ChatIf you have specific questions about lung cancer, whether they’re related to prevention, risk factors, symptoms, diagnosis, treatment, support, or otherwise, Dr. Ramalingam is hosting a free 1-hour online web chat about Lung Cancer on Thursday, November 17th. Dr. Ramalingam will also be fielding questions on the topic of Lung CT scanning, a lung cancer screening mechanism that studies have shown may help lower the risk of lung cancer mortality.

You can ask as many questions as you’d like in the chat, or feel free to sign up to check out Dr. Ramalingam’s answers to other participant questions. We hope to see you there! UPDATE: Lung Cancer Chat Transcript

Lung Cancer Risk Reduction via Lung CT Scans Continue to Gain Momentum

Lung CT Screening

Did you know that only 15% of lung cancer patients survive more than 5 years after their cancer has been identified? As Vicki Griffin of the Atlanta Journal Constitution puts it in a recent AJC article on lung cancer, “The bleak bottom line is that lung cancer overwhelmingly terminates lives within months of the initial diagnosis.” But as Dr. Curran of the Winship Cancer Institute reported weeks ago in a lung cancer blog post, this number could be improved. How, you ask? Through low-dose Lung CT scanning.

A recent 5 year study sponsored by the National Cancer Institute (NCI), which is the same organization that has designated the Winship Cancer Institute as one of only 65 NCI designated cancer centers in the United States, shows that when lung adenocarcinomas are caught in earlier, more treatable stages, lung cancer death rates for those at high risk are reduced by 20%. Based on our knowledge that 157,000 people died at the hands of lung cancer in the U.S. in 2010 alone, this means last year, over 31,000 lives could have been saved.

The study evaluated over 53,000 participants at high risk for lung cancer in 25 states, including Georgia. As part of the evaluation of the effectiveness of low-dose Lung CT scans, the study compared the ability for Lung CT screenings and the currently standard chest X-ray technology to identify lung cancer early on.

Emory was a participant in the NCI sponsored study, and we conducted trials across the state of Georgia. As a result of the study’s significant findings, our teams at the Emory Clinic and Emory University Hospital Midtown are now offering current and former smokers with a significant smoking history high risk for lung cancer an opportunity to get a Lung CT scan at very reasonable rates.

Lung cancer remains the number one cancer killer in the U.S., claiming more lives than the next three most common cancer killers — prostate, breast and colorectal cancers – combined. But Lung CT screening may help with the early diagnosis and ultimately, increased survival rates, for lung cancer patients.

For more information on Lung CT scanning, or to find out if you are a candidate for screening, please visit our newly launched website dedicated to educating our community on Lung CT screening and its benefits. You can also call us for more information at 404-778-7777.