Reference
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Lung CancerLung cancer, a largely incurable disease, remains the leading cause of cancer deaths among women each year in the United States, exceeding annual breast cancer mortality in women and accounting for 12% of all new female cancer cases (Table 1). Although lung cancer has always been and continues to be more prevalent in men than in women, lung cancer mortality patterns now reveal that the rate of rise of such cancer deaths among men has slowed and begun to decline since 1990, whereas in women it has continued to rise. Several studies suggest that women are more susceptible than men to lung cancer and to conditions, like chronic obstructive pulmonary disease, that predispose to this cancer; hence the question has been raised as to whether lung cancer is a different disease in women than in men.
Overall smoking remains the most important risk factor for the development of lung cancer in both women and men, and the smoking trends have changed in women over the years to parallel an increase in the number of female lung cancer cases. “Although there has been a large decline from the peak female smoking rate of 34.2% seen in 1965, smoking among teenage girls has increased dramatically over the past decade. Among high school students, cigarette use (defined as at least one cigarette in the past 30 days) has increased from 21% in the 1980s to about 35% of both boys and girls in 1997” (Siegfried, 2001). In 2001, the U.S. Surgeon General issued a new report, Women and Smoking, in which the 600% increase since 1950 in female lung cancer death rate was described as “a fullblown epidemic,” wherein smoking is now the leading cause of preventable death and disease in women.
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Online Resources
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American Cancer Society lung cancer screening guidelinesAnswer questions and earn CME/CNE Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high‐risk groups can be reduced by annual screening with low‐dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high‐volume, high‐quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30–pack‐year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision‐making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low‐dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation.
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Five-year lung cancer survival: Which advanced stage nonsmall cell lung cancer patients attain long-term survival?The core strategy of American College of Chest Physicians lung cancer guidelines is identification of the earliest symptoms of lung cancer and the immediate initiation of diagnosis and treatment. In the absence of screening, most symptomatic lung cancer is discovered at advanced stages, with the goal of long-term survival entirely dependent on effective treatment of stage III and IV lung cancer. In a retrospective review, all patients diagnosed with stage IIIA, IIIB, and IV nonsmall cell lung cancer (NSCLC) between the years 1986 and 2001 at City of Hope National Medical Center who survived 5 years or longer were analyzed to identify parameters that might predict long-term survival. Of 846 patients presenting with stage III or IV disease, 56 (6.6%) survived 5 years or longer. Sixteen patients died of primary tumor progression beyond 5 years. Two 5-year survivors died of second tobacco-caused neoplasms, and 16 died from medical conditions potentially related to prior treatment. A substantial majority of survivors were from specific pathologic subsets including: 1) resectable N2 disease (n = 17, 30.4%), 2) multiple lung tumors (n = 7, 12.5%), 3) T3N0 (n = 5, 8.1%), and 4) single site distant metastasis (n = 8, 14.2%). Despite aggressive multimodality therapy, 5-year survival in patients with advanced stage NSCLC was very poor and limited to small pathological subsets. Patients with advanced stage NSCLC who did not belong to 1 of these subsets had a small chance of long-term survival.
Streaming Media
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Lung Ablation: New Hope for Lung CancerCombining the latest image-guided radiological and surgical techniques, radiofrequency ablation, or RFA, makes use of a thin wire probe, inserted directly into tumors, to heat and kill cancer cells with electrical current. Employed successfully for years in liver, kidney, and bone cancers, RFA has only recently been tested in lung cancer cases, with positive results. This fascinating program features Dr. Damian Dupuy, who has pioneered the use of ablation to treat lung cancer in the United States.
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Non-Small Cell Lung CancerThe leading cause of cancer death among men and women alike is non-small cell lung cancer, or NSCLC. Accounting for 87 percent of all lung cancers, it also claims more lives than breast, colon, and prostate cancer combined. Because lung cancer tends to metastasize before it is discovered, the survival rates for patients are quite poor. But, as this program points out, new therapies and advances in imaging studies that could lead to earlier detection are serving as beacons of hope for patients and their families.
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Quit to Live: Fighting Lung CancerABC News’ World News Tonight partnered with the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Quitline Consortium to provide viewers with a comprehensive look at the leading cause of preventable death in America: lung cancer. This compilation of WNT segments reports on issues ranging from tobacco-related public health policy, to the latest medical advances in lung cancer treatment and prevention, to the efforts of smokers trying to kick the habit during National Lung Cancer Awareness Month. The 16 segments are The Power of Tobacco, What’s in a Cigarette, Smokeless Tobacco, Marketing to Kids, Teen Smoking, Women at Risk, Lung Cancer, Detecting Lung Cancer, Addiction, The Quitting Drug, Smoking Bans, Settlement Spending, and Smokers’ Video Diary, Parts 1 through 4.
Perspectives
Primary Liver Cancer
Primary Liver Cancer: Surveillance, Diagnosis and Treatment focuses on the many therapies rapidly evolving to assist with controlling hepatocellular carcinoma as well as emerging technologies to assist in early diagnosis as well as prevention. All chapters are written by experts in their fields and include the most up to date information for diagnosis, treatment, surveillance, epidemiology, staging, recurrence and prevention. This volume will serve as a useful resource for clinical gastroenterologists, hepatologists, oncologists, pathologists, and physicians who treat patients with chronic liver disease and hepatocellular carcinoma.
Primary Liver Cancer
"Primary Liver Cancer: Challenges and Perspectives" presents the recent progress in basic and clinical research in Primary Liver Cancer (PLC) in China and around the world. PLC patients in China make up more than 50% of the total patients worldwide. By contributing to the book, the leading experts in the field of liver cancer in China as well as in the US share with readers their new concepts, practices, and experiences from bench to bed, from population study to individual survey, from molecular search to clinical practice, and from early diagnosis to treatment. The book is intended for researchers in the fields of epidemiology, molecular genetics, cell biology, immunology of HCC and other cancers, and clinical oncology in primary liver cancer. Jianren Gu is a Professor of molecular oncology at the Shanghai Cancer Institute, Shanghai Jiao Tong University School of Medicine and Academician of Chinese Academy of Engineering.
Liver Cancer: Methods of Cancer Diagnosis, Therapy, and Prognosis
This volume presents a detailed survey of imaging, multidetector-row computed t- various methodologies related to diagno- ography, helical computed tomography, sis, therapy, and prognosis of liver cancer, ultrasonography, and power Doppler ult- including colorectal liver metastases and sound, for the prognosis and assessment of biliary tract carcinomas, while the already liver cancer treatment (including HCC) and published Volumes 1, 2, 3, and 4 detail liver metastases from colorectal cancer are similar aspects of breast, lung, prostate, discussed in detail, as is the use of radiof- gastrointestinal, and colorectal cancer, quency ablation in hepatic tumors. respectively. Approximately 50% of colorectal cancer Surgical resection is the standard therapy (CRC) patients develop liver metastases for resectable liver disease, resulting in during the course of their disease, and 5-year overall survival rates of 20-40%. more than 50% of patients who die of CRC One the other hand, the median overall have liver metastases at autopsy. Regional survival of patients with unresectable liver lymph node (RLN) involvement in patients metastases does not exceed 18-20 months, with colorectal liver metastases is one with a 5-year survival rate approaching of the worst prognostic factors. Recent zero. In other words, there is virtually no studies indicate that for these patients, long-term survival. Both resectable and combined liver resection and pedicular unresectable liver cancers are discussed lymphadenectomy can be recommended, in this volume. The method of selecting when RLN metastases respond to p- patients for resection of hepatic colorectal operative chemotherapy.