Lung Cancer

 
Lung cancer is the No.1 killer among all types of cancer in the United States. It is estimated that lung cancer will account for about 15% of all new cancer cases in 2010, but will cause nearly 30% of all cancer deaths. Over the past three decades, little improvement has been achieved in extending lung cancer patients’ lives. In 1975-1979, 35% of people survived one year or longer after initial diagnosis; 25 years later (2000-2003), this number had only improved to 41%.

But there is hope. NFCR funds outstanding cancer researchers who are committed to finding more effective strategies for preventing, diagnosing and treating lung cancer. Through their dedicated efforts to build risk prediction models, develop chemopreventive agents, design cutting-edge devices for monitoring drug response, and seek new strategies to overcome tumor drug resistance, NFCR scientists are leading the battle against the deadliest cancer.

Building risk prediction models for smoking-related lung cancer
NFCR Fellow Waun Ki Hong, M.D., M.D. Anderson Cancer Center

Dr. Hong’s team has long been studying the role of smoking in lung cancer development. Their research in this area has provided insights into why only a subgroup of smokers is prone to having their DNA damaged by smoking and, consequently, to developing lung cancer. By building risk models to predict the development of smoking-related lung cancer, Dr. Hong hopes that those who are deemed to be at high risk could be identified and encouraged to take proactive measures early on that might prevent or delay lung cancer development.

Dr. Hong’s team has also initiated clinical research on curcumin and celecoxib to determine their potential in lung cancer chemoprevention (using drugs to prevent cancer). Curcumin is a natural Indian curry spice, and celecoxib is an anti-inflammatory drug used for the treatment of arthritis. Dr. Hong’s research on these two agents may confirm their usefulness in cancer chemoprevention.

Developing new drugs to effectively prevent lung cancer
NFCR Project Director Michael Sporn, M.D., Dartmouth Medical School

A leading scientist in the field of cancer chemoprevention and treatment, Dr. Sporn and his team of researchers have synthesized a new class of anti-cancer drugs, synthetic triterpenoids, which demonstrate powerful preventative and treatment effects against lung cancer, in particular in lung cancer cells bearing a mutation in the Kras protein. With NFCR funding, Dr. Sporn continues to explore the molecular mechanisms of synthetic triterpenoids. These novel agents may soon be evaluated in clinical trials to confirm their ability to protect people from lung cancer.

Simple blood testing for real-time monitoring of lung cancer
NFCR Project Director Daniel A. Haber, M.D., Ph.D., Massachusetts General Hospital Cancer Center

The team designed a new cutting-edge microchip-based device called the CTC-chip, which can detect even a minute number of cancer cells that have entered the blood stream from their originating organs such as the lungs. By running a spoonful of blood through the business-card-size CTC-chip, these difficult-to-detect circulating tumor cells (CTCs) can be trapped onto the chip and isolated. Dr. Haber’s research has shown that a lower amount of CTCs in the blood correlates well with treatment effectiveness. Moreover, CTC-chip technology allows continuous monitoring of the genetic makeup of cancer cells, which could change during treatment.

How You Can Help

These research projects hold great promise for yielding more effective therapies for lung cancer. With more funding, however, they could ramp up their efforts and accelerate progress to save more lives! When you donate to NFCR, your dollars help our scientists accomplish many important research goals aimed at developing better cancer treatment and prevention strategies. Click here to learn more.

Lung Cancer
Overview
Lung cancer is characterized by the uncontrolled growth of abnormal cells in one or both of the lungs. The majority of lung cancers begin in the bronchial tubes that conduct air in and out of the lungs. Cancers of the lung are classified by how they appear under a microscope. While there are more than a dozen different kinds of lung cancer, the two main types of lung cancer are non small cell and small cell, which together account for over 90% of all lung cancers. Non small cell lung cancer accounts for approximately 75% of these cancers and consists of squamous cell, adenocarcinoma and large cell types. Small cell lung cancer represents 20-25% of all lung cancers and is also referred to as “oat cell cancer” because of the shape of cells when examined under the microscope.

Diagnosing Lung Cancer
When lung cancer is diagnosed, the doctor must determine the type (small cell or non small cell) and the extent of spread or stage of the cancer in order to determine the best treatment. Lung cancer may grow locally in the lungs or spread distantly (metastasize) to other sites in the body, including lymph nodes, bones, and the brain. Determining the presence of a lung cancer and the type of lung cancer requires examination of tissues from the lung. A biopsy is the removal of a small piece of tissue for examination under a microscope and can be obtained using one or more of the following procedures.

Bronchoscopy: During a bronchoscopy, a surgeon inserts a bronchoscope (thin, lighted tube) through the nose or mouth into the trachea (windpipe) and bronchi (air passages that lead to the lung). Through this tube, the surgeon can examine the inside of the trachea, bronchi and lung and collect cells or small tissue samples.

Fine Needle Aspiration: During this procedure, a surgeon inserts a needle through the chest into the cancer to remove a tissue sample for examination under the microscope.

Thoracentesis: During a thoracentesis, a surgeon uses a needle to remove a sample of the fluid that surrounds the lungs in order to check for the presence of cancer cells.

Thoracotomy: A thoracotomy is a major operation, which involves opening the chest in order to diagnose lung cancer.

Sputum Cytology: Sputum cytology is a procedure used to examine mucus that is coughed up from the lungs or breathing tubes. The mucus is examined under a microscope in order to detect cancer cells.

Staging
When a diagnosis of lung cancer is confirmed, determining the stage or extent of spread of the cancer is essential in order to understand treatment options or interpret published cancer treatment information. Determining the stage of lung cancer may require many tests, which often include the following:

Mediastinoscopy: A mediastinoscopy is a procedure that can indicate whether the cancer has spread to the lymph nodes in the chest. During a mediastinoscopy, a surgeon inserts a mediastinoscope (lighted tube) through a small incision in the neck while a patient is under general anesthesia. This mediastinoscope allows the surgeon to examine the center of the chest (mediastinum) and nearby lymph nodes, as well as remove a tissue sample.

Computed Topography or CT Scan: A CT scan is a technique for imaging body tissues and organs, during which X-ray transmissions are converted to detailed images, using a computer to synthesize X-ray data. A CT scan is conducted with a large machine positioned outside the body that can rotate to capture detailed images of the organs and tissues inside the body. This method is more sensitive and precise than the chest x-ray.

Magnetic Resonance Imagery or MRI: During MRI, a powerful magnet linked to a computer makes detailed pictures of areas inside the body.

Positron emission tomography (PET): Positron emission tomography (PET) scanning has been used to improve the detection of cancer in lymph nodes. One characteristic of living tissue is the metabolism of sugar. Prior to a PET scan, a substance containing a type of sugar attached to a radioactive isotope (a molecule that spontaneously emits radiation) is injected into the patient’s vein. The cancer cells “take up” the sugar and attached isotope, which emits positively charged, low energy radiation (positrons). The positrons react with electrons in the cancer cells, which creates the production of gamma rays. The gamma rays are then detected by the PET machine, which transforms the information into a picture. If no gamma rays are detected in the scanned area, it is unlikely that the mass in question contains living cancer cells. In one clinical study, PET scanning detected 85% of lymph nodes involved with cancer, which was significantly better than the detection rate with CT scanning.

Bone Scan: A bone scan is used to determine whether cancer has spread to the bones. Prior to a bone scan, a surgeon injects a small amount of radioactive substance into a vein. This substance travels through the bloodstream and collects in areas of abnormal bone growth. An instrument called a scanner measures the radioactivity levels in these areas and records them on x-ray film.

All new treatment information is categorized according to whether patients have small cell or non-small cell lung cancer and according to the stage of disease. To learn more about the general treatment of lung cancer and current results achieved with new treatments, select small cell or non-small cell lung cancer.

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