Lung Cancer

May 232013
 
New lung cancer prediction tool promises better use of screening CT

New Prediction Model Selects Best Lung Cancer Screening Candidates In the National Lung Screening Trial (NLST), screening for lung cancer with low-dose chest CT scans resulted in a 20% reduction in death from lung cancer. The consumer-serving American Lung Association recommended outright that older people with heavy smoking histories should get lung cancer screening; leading [… read more]

Apr 172013
 
How dangerous are ground glass nodules over time?

image: Radiology Assistant Ground-Glass Nodules: If Growing, Assume Cancer Blair Westerly, MD The more CT scans that are performed, the more ground-glass opacities (GGO’s) are seen and what to do with these abnormalities can be difficult to ascertain for clinicians. With the National Lung Cancer Screening Trial showing a mortality benefit from low dose CT [… read more]

Mar 212013
 
Big Tobacco win: Feds to take breather in fight for scary cigarette labeling

Feds to Big Tobacco on Cigarette Labeling Fight: “Uncle!” The feds are admitting defeat for now in their fight for graphic, negative imagery to be displayed on all cigarette packaging and advertisements. Attorney General Eric Holder announced yesterday that the Justice Department will not ask the Supreme Court to reverse their loss in a federal [… read more]

Jan 022013
 
PET scans often inaccurate; may deny curative surgery for lung cancer

The use of positron emission tomography — better known as PET scans — has grown dramatically over the past 15 years, thanks to their seemingly magical ability to identify foci of undetected metastatic cancer. But PET scans’ perceived high accuracy in diagnosing metastatic non-small cell lung cancer (NSCLC) — a published 94% sensitivity and 83% [… read more]

Dec 302012
 
Bad news for IP guys? Incidental mediastinal lymphadenopathy may not need routine biopsy

(image: Wikipedia) With increasing use of chest CT, incidental mediastinal lymphadenopathy seems to be frequently discovered and subsequently biopsied using EBUS. The “if it’s enlarged, stick a needle in it” mantra is challenged by a paper by Stigt et al. 83 people (age ~59) with at least one incidentally discovered mediastinal lymph node > 1 [… read more]

Dec 282012
 
ACCP, ATS only weakly recommend lung cancer CT screening, warn of harms

The American College of Chest Physicians (ACCP) has issued its long-awaited recommendations on lung cancer screening with chest CT — and far from a ringing endorsement of screening, they are conservative and subdued, emphasizing the potential risks of an uncontrolled approach to lung cancer screening in the general population. The American Society of Clinical Oncology [… read more]

Dec 282012
 
American Lung Association recommends CT screening for lung cancer

The American Lung Association has become the largest advisory body to recommend lung cancer screening for high-risk people, advising nearly all people aged 55-74 with a 30+ pack-year smoking history (the entry criteria for the National Lung Screening Trial, or NLST) to undergo low-dose CT scanning to detect early lung cancer. The National Comprehensive Cancer Network, [… read more]

Dec 262012
 
Pleural catheters equal to pleurodesis for dyspnea relief from malignant effusions (TIME2)

(image: Wikipedia) In the TIME2 randomized trial published in the June 13 2012 JAMA, indwelling pleural catheters and talc pleurodesis were equivalent at reducing dyspnea over the 6 weeks following the procedure among 106 patients with malignant pleural effusions. Most patients receiving pleural catheters required no hospital stays, and overall had fewer repeat procedures than those [… read more]

Dec 242012
 
Let's be honest: quitting smoking usually does make you fatter

There’s no use in sugar-coating the truth: Nicotine is an appetite suppressant, and smoking prevents weight gain. Not wanting to gain weight is a common reason why body-obsessed teenage girls say they smoke–and as far as we know, they’re “right:” teens who smoke gain slightly less weight than teens who don’t. It’s also long been believed [… read more]

Dec 212012
 
Moderate pot smokers' lung function better than nonsmokers

Smoking marijuana moderately over years is strongly associated with small improvements in lung function, even compared to people who have never smoked cigarettes or marijuana, according to a study in JAMA. But the popular news media and the study authors downplayed that finding of the study, apparently to avoid sending a pro-marijuana message. Mark Pletcher, [… read more]

Dec 212012
 
Bioengineered tracheas successfully transplanted in two men

New Trachea Grown, Transplanted In Two Men Paolo Macchiarini, Philipp Jungebluth et al report in Lancet their successful bioprosthetic trachea creation and transplantation in a 36-year old man in Sweden after a distal tracheal resection for recurrent primary tracheal cancer. The same group transplanted a bioengineered trachea into a 30-year old Baltimore man, who is [… read more]

Nov 202012
 
New pleural mesothelioma biomarker can speed diagnosis

(image: Wikipedia) Pleural Mesothelioma Biomarker Fibulin-3: Could It Improve Care? Pleural mesothelioma (malignant mesothelioma) has a dismally sad prognosis of about a year after diagnosis. Earlier detection of this lethal pleural cancer could conceivably result in earlier treatment and some improvement in life expectancy. Researchers report in the October 11, 2012 New England Journal of [… read more]

Aug 172012
 
Advanced bronchoscopy yields are 70% in meta-analysis (Review)

(image: Wikipedia) As one after another specialty society endorses routine lung cancer screening with chest CT scans, we all know a Nodule Storm is coming to a pulmonology clinic near you. Thankfully, smart people are asking how we can systematically and successfully handle this soon-to-be-common outpatient clinical problem. Most of these many thousands of nodules [… read more]

Aug 032012
 
Non-small cell lung cancer (NSCLC): Advances in Diagnosis and Treatment (Update/Review)

Advances in Diagnosis and Treatment of Non-Small Cell Lung Cancer (NSCLC) This review document is periodically updated and reposted as new information is published. Please comment below with your suggestions for inclusion in upcoming updates of this review. (More PulmCCM topic reviews) The diagnosis and treatment of non-small cell lung cancer (NSCLC) is rapidly evolving, [… read more]

Jul 202012
 
Should pleurodesis or PleurX drain be 1st-line Rx for malignant pleural effusion?

(image: Wikipedia) There are an estimated 200,000 pleural effusions due to malignancy each year in the U.S. alone, and these represent an important cause of suffering and limitation in functional ability for people living with advanced cancer. Pleurodesis (using talc or other sclerosants) and placement of indwelling pleural catheters are both accepted, reasonable approaches to the [… read more]

Jul 152012
 
Superior Vena Cava Syndrome Review

Superior Vena Cava Syndrome: A Cancer-Related Medical Emergency (More PulmCCM Topic Updates) Multiple cancers are expected to rise in prevalence in the U.S. over the coming decades, and so is the risk for cancer-related medical emergencies. For a few, superior vena cava syndrome (SVC syndrome) will be the first manifestation of their cancer. It’s important [… read more]

Jul 122012
 
New molecular test predicts lung cancer survival better than staging

Non-small cell lung cancer (NSCLC) unfortunately recurs even more often than other cancers, even when early stage and apparently completely resected. The explanation, of course, is it wasn’t completely resected: there was residual metastatic disease hiding out somewhere, but in such microscopic quantities as to be undetectable by our improving but still crude techniques (i.e., [… read more]

Jul 082012
 
Cancer-Related Medical Emergencies: Tumor Lysis Syndrome

Cancer-Related Medical Emergencies: Acute Tumor Lysis Syndrome (More PulmCCM Topic Updates) The prevalence of multiple cancers are expected to rise in the United States over the coming decades. Despite improved survival with some cancers, some people with malignancy will develop cancer related emergencies; for a few, this will be the first manifestation of their cancer. [… read more]

Jul 062012
 
NSCLC: Anti-PD-L1 immunotherapy breaks ground, buys time for some

Immunotherapy — creating antibodies to tumor markers, then activating the immune system to selectively kill cancer cells — is the newest and most-hyped frontier of oncology. And with some justification: the mechanism is cleaner and kinder than chemotherapy, and being a whole new treatment modality, can complement and augment traditional therapies. Results of immunotherapy in [… read more]