WALLA WALLA, Wash. —
Rep. Bill Grant has died just one month after he was diagnosed with lung cancer.
Grant, 71, died at a hospital in Walla Walla on Sunday, House Democratic spokeswoman Melinda McCrady said Monday.
Grant, who had served 22 years in the Legislature, was re-elected in November. He represented the 16th District, which covers Walla Walla and Columbia counties, as well as portions of Benton and Franklin Counties.
His seat will be filled by an appointment until a special election can be held in November, McCrady said.
He is survived by his wife, Nancy, four children and 11 grandchildren.
Sunday, March 8, 2009
Lung cancer cells activate inflammation to induce metastasis
A research team from the University of California, San Diego School of Medicine has identified a protein produced by cancerous lung epithelial cells that enhances metastasis by stimulating the activity of inflammatory cells. Their findings, to be published in the January 1 issue of the journal Nature, explain how advanced cancer cells usurp components of the host innate immune system to generate an inflammatory microenvironment hospitable for the metastatic spread of lung cancer. The discovery could lead to a therapy to limit metastasis of this most common lethal form of cancer. The scientists – headed by Michael Karin, Ph.D., UC San Diego Distinguished Professor of Pharmacology and Pathology, who has been investigating the effects of inflammation on cancer development and progression – used a straightforward biochemical approach to identify proteins produced by metastatic cancer cells that are responsible for generation of an inflammatory microenvironment that supports the growth of metastases. Focusing on macrophages, white blood cells that are key players in the immune response to foreign invaders as well as in cancer growth and progression, they screened for factors produced by metastatic cancer cells in mice that could stimulate the activity of this inflammatory cell type.
Among the mouse cell lines screened, a highly metastatic cell line called Lewis lung carcinoma (LLC) showed particularly potent activation of macrophages. Furthermore, macrophage activation was mediated by a secreted protein. Biochemical purification of proteins secreted by LLC cells resulted in identification of an extracellular matrix protein called versican as the major macrophage activator and metastasis enhancing factor. Versican is also found in very low amounts in normal human lung epithelial cells, but is upregulated in human lung cancer, where a very large amount of this protein is found, especially in aggressive tumors.
The scientists found that versican strongly enhances LLC metastatic growth by activating receptors that lead to production of cytokines – signaling proteins that regulate the immune system. One of these receptors, TLR2, and a cytokine, TNFα, were found to be required for LLC metastasis. However, the normal function of TLR2 and TNF is in host defense-innate immunity to microbial infections. According to Karin, these findings are relevant, not just to the mouse model, but also to human lung cancer – the most common cause of cancer-related deaths worldwide. The major cause of lung cancer is tobacco smoking.
"By usurping these elements of the host immune system, versican helps generate an inflammatory environment that spurs the growth and spread of metastatic cancer," said Karin. "If we can find a way to block the production of versican or its binding to TLR2, therapeutic intervention could be used to limit metastasis of lung cancer."
Among the mouse cell lines screened, a highly metastatic cell line called Lewis lung carcinoma (LLC) showed particularly potent activation of macrophages. Furthermore, macrophage activation was mediated by a secreted protein. Biochemical purification of proteins secreted by LLC cells resulted in identification of an extracellular matrix protein called versican as the major macrophage activator and metastasis enhancing factor. Versican is also found in very low amounts in normal human lung epithelial cells, but is upregulated in human lung cancer, where a very large amount of this protein is found, especially in aggressive tumors.
The scientists found that versican strongly enhances LLC metastatic growth by activating receptors that lead to production of cytokines – signaling proteins that regulate the immune system. One of these receptors, TLR2, and a cytokine, TNFα, were found to be required for LLC metastasis. However, the normal function of TLR2 and TNF is in host defense-innate immunity to microbial infections. According to Karin, these findings are relevant, not just to the mouse model, but also to human lung cancer – the most common cause of cancer-related deaths worldwide. The major cause of lung cancer is tobacco smoking.
"By usurping these elements of the host immune system, versican helps generate an inflammatory environment that spurs the growth and spread of metastatic cancer," said Karin. "If we can find a way to block the production of versican or its binding to TLR2, therapeutic intervention could be used to limit metastasis of lung cancer."
Test could offer lung cancer clue
Testing a lung cancer patient's blood could help doctors predict the likely success of chemotherapy treatment.
UK scientists identified a molecule made by a more aggressive form of the disease, the journal Clinical Cancer Research reported.
Patients with this in their blood were less likely to respond to drugs, they said.
Cancer Research UK said the discovery could help doctors choose the right kind of treatment for patients.
Lung cancer kills more than 30,000 people in the UK every year, and survival rates have not improved alongside those for breast or bowel cancer in recent years. There is more than one type of lung cancer, but the variety under investigation by Liverpool-based researchers, small-cell lung cancer, which accounts for between 15% and 20% of cases, is one of the more difficult to treat.
Even small cell lung cancer comes in different forms, with a version called "neuroendocrine" being the least likely to be treated successfully.
The researchers found that a molecule called SCG3 mRNA was more likely to be found in the blood of people with neuroendocrine small cell cancer.
In theory, if larger studies back this up, it could mean that patients arriving at the clinic could be tested to give doctors an idea of the likely success of therapy - or perhaps to predict when a patient was relapsing before other signs emerged.
No tests
It might also make it easier for scientists, when looking at new chemotherapy treatments in trials, to compare their effectiveness in different groups of small cell lung cancer patients.
Dr Judy Coulson, from the University of Liverpool, said: "There are currently no blood-based markers routinely used to monitor patients with this type of lung cancer.
"We found that SCG3 mRNA is an incredibly sensitive marker of these tumours and could be used to detect circulating tumour cells in patients with this disease."
Lesley Walker, from Cancer Research UK, said: "This discovery is an important step to understanding how to treat lung cancer patients more effectively.
"Lung cancer can be very difficult to treat in its later stages, either because it has spread or because there are too many tumours."
UK scientists identified a molecule made by a more aggressive form of the disease, the journal Clinical Cancer Research reported.
Patients with this in their blood were less likely to respond to drugs, they said.
Cancer Research UK said the discovery could help doctors choose the right kind of treatment for patients.
Lung cancer kills more than 30,000 people in the UK every year, and survival rates have not improved alongside those for breast or bowel cancer in recent years. There is more than one type of lung cancer, but the variety under investigation by Liverpool-based researchers, small-cell lung cancer, which accounts for between 15% and 20% of cases, is one of the more difficult to treat.
Even small cell lung cancer comes in different forms, with a version called "neuroendocrine" being the least likely to be treated successfully.
The researchers found that a molecule called SCG3 mRNA was more likely to be found in the blood of people with neuroendocrine small cell cancer.
In theory, if larger studies back this up, it could mean that patients arriving at the clinic could be tested to give doctors an idea of the likely success of therapy - or perhaps to predict when a patient was relapsing before other signs emerged.
No tests
It might also make it easier for scientists, when looking at new chemotherapy treatments in trials, to compare their effectiveness in different groups of small cell lung cancer patients.
Dr Judy Coulson, from the University of Liverpool, said: "There are currently no blood-based markers routinely used to monitor patients with this type of lung cancer.
"We found that SCG3 mRNA is an incredibly sensitive marker of these tumours and could be used to detect circulating tumour cells in patients with this disease."
Lesley Walker, from Cancer Research UK, said: "This discovery is an important step to understanding how to treat lung cancer patients more effectively.
"Lung cancer can be very difficult to treat in its later stages, either because it has spread or because there are too many tumours."
Family Members Of Critically Ill Patients Want To Discuss Loved Ones' Uncertain Prognoses
Critically ill patients frequently have uncertain prognoses, but their families overwhelmingly wish that physicians would address prognostic uncertainty candidly, according to a new study out of the University of San Francisco Medical Center.
"Our interviews revealed that caregivers appear to believe that some uncertainty is unavoidable, and just the nature of life," said lead author Douglas White, M.D., M.A.S., assistant professor in UCSF's Division of Pulmonary and Critical Care Medicine and the UCSF Program in Medical Ethics. "The vast majority of families of critically ill patients want physicians to openly discuss the prognosis, even when physicians can't be certain that their estimates are correct."
But past research showing that physicians are reluctant to discuss uncertain prognoses reveals a schism between families' wishes and physicians' comfort.
The results were reported in the second issue for January of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Between January 2006 and October 2007, researchers at the University of San Francisco Medical Center conducted face-to-face interviews with 179 surrogate decision-makers for patients in four separate intensive care units (ICUs). The interviews explored surrogates' attitudes about whether physicians should discuss prognoses when they cannot be certain their prognostic estimates are correct.
When asked whether they would prefer to hear physicians' prognoses, 87 percent of caregivers indicated that they would want to be told of all prognostic estimates, even if the estimates were tentative. Most also indicated that they appreciated a physician's candor in discussing uncertain outcomes as honest, rather than seeing it as a source of confusion or anxiety.
"We learned that family members wanted prognostic information in order to know whether they needed to begin to prepare for the chance that their loved one might die, and so begin the bereavement process," Dr. White said. "I think one of the strongest messages that comes from this study is that family members want to have this discussion with the physician, and want to have the opportunity to take care of unfinished personal and familial business before their loved one dies. They need that chance to say their goodbyes, in case the patient does die."
Dr. White also noted that while the majority of family members indicated that they did want physicians to discuss all possible outcomes, a not-insignificant portion - 12 percent - said they did not want to discuss uncertain prognoses, indicating that a "one-size-fits-all" approach is insufficient in critical care situations.
"Our findings suggest that physicians need to develop the skills to understand the unique needs of surrogates, and then tailor their approach to discussing prognosis to meet those needs," he said. "This is an area in need of well-designed quantitative and qualitative studies."
Dr. White and his colleagues are currently involved in a follow-up study to help family members navigate the process of surrogate decision making in the ICU setting.
John Heffner, M.D., past president of the ATS, emphasized that the results of this study parallel previous investigations that examined patient and family preferences in discussing do-not-resuscitate orders and end-of-life care. "In almost all studies, patients and families express a desire for clear information to inform their decisions. Although physicians often wish to shelter their patients and patient families from what might seem to be harsh realities, the human spirit is resilient. Patients and families access to information from their doctors."
"Our interviews revealed that caregivers appear to believe that some uncertainty is unavoidable, and just the nature of life," said lead author Douglas White, M.D., M.A.S., assistant professor in UCSF's Division of Pulmonary and Critical Care Medicine and the UCSF Program in Medical Ethics. "The vast majority of families of critically ill patients want physicians to openly discuss the prognosis, even when physicians can't be certain that their estimates are correct."
But past research showing that physicians are reluctant to discuss uncertain prognoses reveals a schism between families' wishes and physicians' comfort.
The results were reported in the second issue for January of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Between January 2006 and October 2007, researchers at the University of San Francisco Medical Center conducted face-to-face interviews with 179 surrogate decision-makers for patients in four separate intensive care units (ICUs). The interviews explored surrogates' attitudes about whether physicians should discuss prognoses when they cannot be certain their prognostic estimates are correct.
When asked whether they would prefer to hear physicians' prognoses, 87 percent of caregivers indicated that they would want to be told of all prognostic estimates, even if the estimates were tentative. Most also indicated that they appreciated a physician's candor in discussing uncertain outcomes as honest, rather than seeing it as a source of confusion or anxiety.
"We learned that family members wanted prognostic information in order to know whether they needed to begin to prepare for the chance that their loved one might die, and so begin the bereavement process," Dr. White said. "I think one of the strongest messages that comes from this study is that family members want to have this discussion with the physician, and want to have the opportunity to take care of unfinished personal and familial business before their loved one dies. They need that chance to say their goodbyes, in case the patient does die."
Dr. White also noted that while the majority of family members indicated that they did want physicians to discuss all possible outcomes, a not-insignificant portion - 12 percent - said they did not want to discuss uncertain prognoses, indicating that a "one-size-fits-all" approach is insufficient in critical care situations.
"Our findings suggest that physicians need to develop the skills to understand the unique needs of surrogates, and then tailor their approach to discussing prognosis to meet those needs," he said. "This is an area in need of well-designed quantitative and qualitative studies."
Dr. White and his colleagues are currently involved in a follow-up study to help family members navigate the process of surrogate decision making in the ICU setting.
John Heffner, M.D., past president of the ATS, emphasized that the results of this study parallel previous investigations that examined patient and family preferences in discussing do-not-resuscitate orders and end-of-life care. "In almost all studies, patients and families express a desire for clear information to inform their decisions. Although physicians often wish to shelter their patients and patient families from what might seem to be harsh realities, the human spirit is resilient. Patients and families access to information from their doctors."
Saturday, March 7, 2009
Lung cancer to overtake breast cancer
LUNG cancer will soon kill more females than breast cancer as women lag behind men in getting the anti-smoking message, according to the latest snapshot on Australian cancer rates.
Today's report by the Australian Institute of Health and Welfare reveals that women who took up smoking in the 1970s and 1980s are now paying the price, as lung cancer outstrips breast cancer as a cause of death for the first time.
The report, Cancer In Australia: An Overview 2008, predicts that lung cancer rates in women are expected to grow by 0.4 per cent a year until 2010 but will fall by 1.1 per cent for men.
"It's tragic because there is not a lot you can do to prevent breast cancer but there is no reason for having so many people diagnosed with lung cancer when it stems from smoking," the chief executive of the Cancer Council of Australia, Ian Olver, said yesterday.
He called for a price rise on cigarettes and continued graphic advertising campaigns outlining the broad range of smoking's side effects, such as cardiovascular and gum disease.
"One in five people are smokers, so the advertising campaigns are graphic, but they need to remain as intense as they are now to make sure people get the message," he said.
"The Government needs to step up its efforts in reducing smoking-related deaths, and that really means price control and social marketing or advertising campaigns."
More than 100,000 new cases of cancer were diagnosed in 2005, and that number is expected to grow by more than 3000 extra cases each year to 2010, as the population ages.
The most common cancer is still prostate, with 16,349 new cases diagnosed, followed by colorectal (7181), melanoma (6044), lung (5738) and lymphoma (2373).
Testicular cancer had the highest survival rate, with 97 per cent of sufferers still alive five years after diagnosis, followed by thyroid cancer (93 per cent) and skin cancer (92 per cent). Pancreatic cancer had the lowest survival rate, with 4.6 per cent of sufferers alive five years after diagnosis.
Today's report by the Australian Institute of Health and Welfare reveals that women who took up smoking in the 1970s and 1980s are now paying the price, as lung cancer outstrips breast cancer as a cause of death for the first time.
The report, Cancer In Australia: An Overview 2008, predicts that lung cancer rates in women are expected to grow by 0.4 per cent a year until 2010 but will fall by 1.1 per cent for men.
"It's tragic because there is not a lot you can do to prevent breast cancer but there is no reason for having so many people diagnosed with lung cancer when it stems from smoking," the chief executive of the Cancer Council of Australia, Ian Olver, said yesterday.
He called for a price rise on cigarettes and continued graphic advertising campaigns outlining the broad range of smoking's side effects, such as cardiovascular and gum disease.
"One in five people are smokers, so the advertising campaigns are graphic, but they need to remain as intense as they are now to make sure people get the message," he said.
"The Government needs to step up its efforts in reducing smoking-related deaths, and that really means price control and social marketing or advertising campaigns."
More than 100,000 new cases of cancer were diagnosed in 2005, and that number is expected to grow by more than 3000 extra cases each year to 2010, as the population ages.
The most common cancer is still prostate, with 16,349 new cases diagnosed, followed by colorectal (7181), melanoma (6044), lung (5738) and lymphoma (2373).
Testicular cancer had the highest survival rate, with 97 per cent of sufferers still alive five years after diagnosis, followed by thyroid cancer (93 per cent) and skin cancer (92 per cent). Pancreatic cancer had the lowest survival rate, with 4.6 per cent of sufferers alive five years after diagnosis.
Non-Surgical Procedure To Blast Lung Cancer
If you made a New Year's resolution to quit smoking, here's more incentive to stick with it: More than 150,000 Americans will likely die of lung cancer this year.
Quitting can greatly reduce your chance of getting sick, but cancer isn't completely preventable. The good news is tumors are having a harder time hiding these days with a new, non-surgical procedure.
Ceil Hall cherishes memories galore; this Wisconsin farm girl who married the love of her life Charlie, 58 years ago. Her decades of photos show children and grandchildren.
Although some more recent images document some uninvited guests. A cancerous tumor was found in each of Hall's lungs. It was metastatic cancer, meaning it had spread, first to a chest muscle.
"Three months later there was another one, and that was on my spine. That was also treated with CyberKnife. And three months after that there was another one on the adrenal gland," said Hall.
She was immediately scheduled for surgery and was offered chemotherapy as follow-up care.
Instead she opted to attack each tumor with CyberKnife. It basically delivers pinpoint, targeted radiation to tissue at two to three times the saturation of conventional radiation in a fraction of the time.
"Each beam is pretty weak," said Dr. Andrew Fink, HealthEast Medical Director of Surgery. "But then rotates slightly, and shoots another beam. Rotates slightly, shoots another beam. Does that 150 to 200 times."
The advantage is greater precision to blast the tumor with every beam, while healthy surrounding tissues are mostly spared.
"You can see how close it is to the kidney ... the bowel, the spinal cord, the aorta. These are all what we call critical structures," said Fink.
Fink said CyberKnife is often a good option for those whose medical complications would make standard surgery too risky. A study currently underway comparing it to surgery for early stage lung cancers shows it to be quite promising.
"We're able to kill that cancer at least 80 percent of the time, which is comparable to surgery," Fink said.
Hall has had no new growths in six months. She also was spared the down time from surgery and the side-effects of chemo, and she is amazed by the technology.
"A robotic machine can deliver radiation. And as you're lying on the table breathing, the machine breathes with you," recalled Hall.
Hall is a former smoker, but she quit nearly 30 years ago. For those of you who'd like a little free help quitting and for a virtual tour of how the CyberKnife works, click on the links below.
Free Help To Quit Smoking
CyberKnife Virtual Tour
Quitting can greatly reduce your chance of getting sick, but cancer isn't completely preventable. The good news is tumors are having a harder time hiding these days with a new, non-surgical procedure.
Ceil Hall cherishes memories galore; this Wisconsin farm girl who married the love of her life Charlie, 58 years ago. Her decades of photos show children and grandchildren.
Although some more recent images document some uninvited guests. A cancerous tumor was found in each of Hall's lungs. It was metastatic cancer, meaning it had spread, first to a chest muscle.
"Three months later there was another one, and that was on my spine. That was also treated with CyberKnife. And three months after that there was another one on the adrenal gland," said Hall.
She was immediately scheduled for surgery and was offered chemotherapy as follow-up care.
Instead she opted to attack each tumor with CyberKnife. It basically delivers pinpoint, targeted radiation to tissue at two to three times the saturation of conventional radiation in a fraction of the time.
"Each beam is pretty weak," said Dr. Andrew Fink, HealthEast Medical Director of Surgery. "But then rotates slightly, and shoots another beam. Rotates slightly, shoots another beam. Does that 150 to 200 times."
The advantage is greater precision to blast the tumor with every beam, while healthy surrounding tissues are mostly spared.
"You can see how close it is to the kidney ... the bowel, the spinal cord, the aorta. These are all what we call critical structures," said Fink.
Fink said CyberKnife is often a good option for those whose medical complications would make standard surgery too risky. A study currently underway comparing it to surgery for early stage lung cancers shows it to be quite promising.
"We're able to kill that cancer at least 80 percent of the time, which is comparable to surgery," Fink said.
Hall has had no new growths in six months. She also was spared the down time from surgery and the side-effects of chemo, and she is amazed by the technology.
"A robotic machine can deliver radiation. And as you're lying on the table breathing, the machine breathes with you," recalled Hall.
Hall is a former smoker, but she quit nearly 30 years ago. For those of you who'd like a little free help quitting and for a virtual tour of how the CyberKnife works, click on the links below.
Free Help To Quit Smoking
CyberKnife Virtual Tour
Study examines racial disparities in survival among patients diagnosed with lung cancer
Disparities in survival among black patients diagnosed with early-stage lung cancer are not seen when patients are recommended appropriate treatment, according to a report in the January issue of Archives of Surgery, one of the JAMA/Archives journals.
Lung cancer causes more deaths in the United States than any other cancer, according to background information in the article. Pulmonary resection—or surgery to remove a portion of the lung—provides the best chance for patients with early-stage disease to be cured. "Black patients with early-stage lung cancer have lower five-year survival rates than white patients, and this difference in outcome has been attributed to lower rates of resection among black patients," the authors write. "Several potential factors underlying racial differences in the receipt of surgical therapy include differences in pulmonary function, access to care, refusal of surgery, beliefs about tumor spread on air exposure at the time of operation and the possibility of cure without surgery, distrust of the health care system and physicians, suboptimal patterns of patient and physician communication and health care system and provider biases." Of these, access to care is often considered the most important of factors underlying racial disparities.
Farhood Farjah, M.D., M.P.H., of the University of Washington, Seattle, and colleagues designed a study to address whether differences in survival persist when evaluating only patients who had been recommended to receive optimal therapy, in this case lung resection. Patients recommended for therapy were considered likely to have "cleared" at least one major hurdle of access to care. The investigators analyzed data from 17,739 patients who were diagnosed with lung cancer between 1992 and 2002 (average age 75, 89 percent white and 6 percent black) and who were recommended to receive surgical therapy. They tracked whether or not the patients underwent surgery, and their overall survival, through 2005.
While black patients recommended to surgery had lung resections less frequently than white patients (69 percent vs. 83 percent, the authors write. After adjustment, there was no significant association between race and death.
Several possible explanations exist for the differences in rates of surgery, the authors note, and these may be important for understanding patient decision-making and improving care delivery systems. Black patients may be more likely to refuse surgery than white patients, or may have more limited access to recommended care.
"Although these findings do not refute the likely roles of health care system and provider biases and patient characteristics as important causal factors underlying health disparities, the findings do suggest that other factors (i.e., distrust, perceptions and beliefs about lung cancer and its treatment and limited access to subspecialty care) may have a more dominant role in causing disparities than previously recognized. The implication of these findings is that interventions designed to narrow gaps in health care should target structural aspects of care, providers and patients and communities at risk for lung cancer and suboptimal care." The study findings suggest that referral of all patients with potentially curable lung cancer for consideration of lung resection may be a helpful tool in mitigating previously identified racial differences in survival.
###
(Arch Surg. 2009;144[1]:14-18. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: Dr. Farjah was supported by a Cancer Epidemiology and Biostatistics Training Grant and a Ruth L. Kirschstein National Research Service Award from the National Cancer Institute. Additional resources were available through the Department of Surgery and the Surgical Outcomes Research Center, University of Washington and the generosity of the Schilling family. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Lung cancer causes more deaths in the United States than any other cancer, according to background information in the article. Pulmonary resection—or surgery to remove a portion of the lung—provides the best chance for patients with early-stage disease to be cured. "Black patients with early-stage lung cancer have lower five-year survival rates than white patients, and this difference in outcome has been attributed to lower rates of resection among black patients," the authors write. "Several potential factors underlying racial differences in the receipt of surgical therapy include differences in pulmonary function, access to care, refusal of surgery, beliefs about tumor spread on air exposure at the time of operation and the possibility of cure without surgery, distrust of the health care system and physicians, suboptimal patterns of patient and physician communication and health care system and provider biases." Of these, access to care is often considered the most important of factors underlying racial disparities.
Farhood Farjah, M.D., M.P.H., of the University of Washington, Seattle, and colleagues designed a study to address whether differences in survival persist when evaluating only patients who had been recommended to receive optimal therapy, in this case lung resection. Patients recommended for therapy were considered likely to have "cleared" at least one major hurdle of access to care. The investigators analyzed data from 17,739 patients who were diagnosed with lung cancer between 1992 and 2002 (average age 75, 89 percent white and 6 percent black) and who were recommended to receive surgical therapy. They tracked whether or not the patients underwent surgery, and their overall survival, through 2005.
While black patients recommended to surgery had lung resections less frequently than white patients (69 percent vs. 83 percent, the authors write. After adjustment, there was no significant association between race and death.
Several possible explanations exist for the differences in rates of surgery, the authors note, and these may be important for understanding patient decision-making and improving care delivery systems. Black patients may be more likely to refuse surgery than white patients, or may have more limited access to recommended care.
"Although these findings do not refute the likely roles of health care system and provider biases and patient characteristics as important causal factors underlying health disparities, the findings do suggest that other factors (i.e., distrust, perceptions and beliefs about lung cancer and its treatment and limited access to subspecialty care) may have a more dominant role in causing disparities than previously recognized. The implication of these findings is that interventions designed to narrow gaps in health care should target structural aspects of care, providers and patients and communities at risk for lung cancer and suboptimal care." The study findings suggest that referral of all patients with potentially curable lung cancer for consideration of lung resection may be a helpful tool in mitigating previously identified racial differences in survival.
###
(Arch Surg. 2009;144[1]:14-18. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: Dr. Farjah was supported by a Cancer Epidemiology and Biostatistics Training Grant and a Ruth L. Kirschstein National Research Service Award from the National Cancer Institute. Additional resources were available through the Department of Surgery and the Surgical Outcomes Research Center, University of Washington and the generosity of the Schilling family. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
National Lung Cancer Partnership And LUNGevity Foundation Announce 2009 Grant Recipients
The 2009 winners of the National Lung Cancer Partnership/LUNGevity Foundation Research Grants are Prasad Adusumilli, M.D. and Lee Goodglick, Ph.D. The $100,000 grants will fund the scientist's research on visceral pleural invasion and the role of estrogen in lung cancer tumors, respectively.
Dr. Adusumilli, a general thoracic surgeon specializing in lung cancer at Memorial Sloan-Kettering Cancer Center in New York, was awarded the grant focused on basic research for his proposed study of Visceral Pleural Invasion, a condition that affects one in four early stage lung cancer patients in which their cancer spreads to the membrane covering the lungs surface and is associated with poorer treatment outcomes.
Using a mouse model, Dr. Adusumilli's will use genetic engineering to program immune cells to target and suppress tumor cells on the lung membrane.
Dr. Goodglick of the David Geffen School of Medicine at the University of California, Los Angeles was awarded the grant for research in the area of sex differences in lung cancer. His research will focus on estrogen, which many lung cancers either make or are responsive to, similarly to breast cancer. Aromatase-inhibitors, drugs which turn off the enzyme aromatase which can cause some cancers to grow and have long been used in breast cancer treatment, will be studied in a pre-clinical trial to determine their effectiveness in treating lung cancer. Additional research will use new technology to address other ways that estrogen may affect lung cancer in order to identify future therapies.
"Only by continuing to fund this type of lung cancer research can we keep the momentum towards better treatments for patients," Dr. Joan Schiller, president of the National Lung Cancer Partnership and chief of hematology/oncology of the University of Texas Southwestern Medical Center said. "Supporting the work of scientists like Drs. Adusumilli and Goodglick is critical to our continued battle against the world's number 1 cancer killer."
----------------------------
Article adapted by Medical News Today from original press release.
----------------------------
National Lung Cancer Partnership is a 501(c)(3) non-profit organization dedicated to decreasing deaths due to lung cancer, and helping patients live longer and better, through research, awareness and advocacy.
The LUNGevity Foundation is the only organization in the U.S. dedicated exclusively to funding lung cancer research. The 501(c) (3) organization was founded in 2000 by seven Chicago-area lung cancer survivors to increase funding for lung cancer research.
Source: Colleen O'Donnell
Dr. Adusumilli, a general thoracic surgeon specializing in lung cancer at Memorial Sloan-Kettering Cancer Center in New York, was awarded the grant focused on basic research for his proposed study of Visceral Pleural Invasion, a condition that affects one in four early stage lung cancer patients in which their cancer spreads to the membrane covering the lungs surface and is associated with poorer treatment outcomes.
Using a mouse model, Dr. Adusumilli's will use genetic engineering to program immune cells to target and suppress tumor cells on the lung membrane.
Dr. Goodglick of the David Geffen School of Medicine at the University of California, Los Angeles was awarded the grant for research in the area of sex differences in lung cancer. His research will focus on estrogen, which many lung cancers either make or are responsive to, similarly to breast cancer. Aromatase-inhibitors, drugs which turn off the enzyme aromatase which can cause some cancers to grow and have long been used in breast cancer treatment, will be studied in a pre-clinical trial to determine their effectiveness in treating lung cancer. Additional research will use new technology to address other ways that estrogen may affect lung cancer in order to identify future therapies.
"Only by continuing to fund this type of lung cancer research can we keep the momentum towards better treatments for patients," Dr. Joan Schiller, president of the National Lung Cancer Partnership and chief of hematology/oncology of the University of Texas Southwestern Medical Center said. "Supporting the work of scientists like Drs. Adusumilli and Goodglick is critical to our continued battle against the world's number 1 cancer killer."
----------------------------
Article adapted by Medical News Today from original press release.
----------------------------
National Lung Cancer Partnership is a 501(c)(3) non-profit organization dedicated to decreasing deaths due to lung cancer, and helping patients live longer and better, through research, awareness and advocacy.
The LUNGevity Foundation is the only organization in the U.S. dedicated exclusively to funding lung cancer research. The 501(c) (3) organization was founded in 2000 by seven Chicago-area lung cancer survivors to increase funding for lung cancer research.
Source: Colleen O'Donnell
National Lung Cancer Partnership’s Scientific Executive Committee Member Receives Honor
The National Lung Cancer Partnership congratulates Dr. Everett Vokes M.D. on his election to the Board of Directors of the American Society of Clinical Oncology (ASCO).
A nationally recognized expert in lung cancer, Dr. Vokes is the John Ultmann Professor in the Departments of Medicine and Radiation Oncology and serves as Director of the section of hematology/oncology and Co-Deputy Director of the cancer center at the University of Chicago.
Dr. Vokes is a member of National Lung Cancer Partnership’s Scientific Executive Committee, where he served as the Chair of the Partnership’s 2008 Research Grant Review Committee.
“Dr. Vokes is a respected clinician and researcher and a valuable member of the Partnership’s Scientific Executive Committee. His contribution towards advancing lung cancer research continues to enhance the field,” said Regina Vidaver, executive director of the National Lung Cancer Partnership said. “We are excited for Dr. Vokes and know that he will be a great addition to ASCO’s Board of Directors.”
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More Information:
The National Lung Cancer Partnership
A nationally recognized expert in lung cancer, Dr. Vokes is the John Ultmann Professor in the Departments of Medicine and Radiation Oncology and serves as Director of the section of hematology/oncology and Co-Deputy Director of the cancer center at the University of Chicago.
Dr. Vokes is a member of National Lung Cancer Partnership’s Scientific Executive Committee, where he served as the Chair of the Partnership’s 2008 Research Grant Review Committee.
“Dr. Vokes is a respected clinician and researcher and a valuable member of the Partnership’s Scientific Executive Committee. His contribution towards advancing lung cancer research continues to enhance the field,” said Regina Vidaver, executive director of the National Lung Cancer Partnership said. “We are excited for Dr. Vokes and know that he will be a great addition to ASCO’s Board of Directors.”
# # #
More Information:
The National Lung Cancer Partnership
Study: Do more to help patients quit smoking
FAIRMONT — A survey of cancer patients being treated at the Mary Babb Randolph Cancer Center indicates that many of the smokers did not quit the habit in light of their diagnosis and some of them were not even advised to do so by their doctors.
“It absolutely benefits patients to quit,” said Dr. Jame Abraham, chief of oncology at WVU Hospitals and the medical director of the Mary Babb Randolph Cancer Center in Morgantown. “No. 1, we know that smoking can potentially alter the effectiveness of chemotherapy.
“No. 2, smoking can cause many other conditions, including lung cancer and COPD (chronic obstructive pulmonary disease), and smoking can increase the chance of getting pneumonia and lung disease, which can complicate the ability to take the treatment.”
The study was the idea of Lola Burke, now a second-year medical student who performed much of the survey work, Abraham said.
Burke sent surveys to 1,000 cancer patients, and 200 of them responded. Of the 200 who responded, 52 percent had a history of smoking, but only 20 percent had been actively smoking at the time of the diagnosis, Abraham said.
Of the active smokers, 44 percent quit while 56 percent did not, Abraham said.
“Another thing we found was that 40 percent were not told by the doctors to quit,” he added. “They didn’t even hear this from their doctors or their health-care provider.”
Bruce Adkins, director of the Division of Tobacco Prevention for the West Virginia Bureau for Public Health, has teamed up with Marshall University’s Joan C. Edwards School of Medicine in an effort to offer training to physicians who would teach them how to counsel patients to quit smoking.
“We started doing some provider training about two and a half year ago,” he said. “It’s a tough addiction to break. You have to keep reinforcing it. People don’t usually quit smoking the first time they attempt to quit. The average number of times it takes someone to quit using tobacco is eight to 10 times.”
Staff members from Marshall’s School of Medicine travel throughout the state offering a three-hour course to physicians, covering topics such as cessation counseling, spit tobacco, smoking and pregnancy, and the pharmacotherapy of tobacco cessation, Adkins said.
In 2007, the Centers for Disease Control and Prevention (CDC) reported that West Virginia had the second-highest rate of adult smokers in the United States at 25.7 percent, second to Kentucky at a rate of 28.6 percent.
The findings of the study at the Mary Babb Randolph Cancer Center, which have been released in this month’s edition of Journal of Oncology, published by the American Society of Clinic Oncology, illustrate that more must be done in order to help cancer patients quit, Abraham said.
“Many times, that person has been smoking for a long time,” he said. “That addictiveness is so high, so you can’t just walk away from this in one day.”
The news came during the same week that the CDC released a report in its Morbidity and Mortality Weekly Report stating that Kentucky and West Virginia have the highest death rates from smoking.
It also comes during the same month that actor Patrick Swayze, undergoing treatment for pancreatic cancer, admitted that he still smokes.
“We do see similar behavior all the time,” Abraham said of Swayze’s admission. “But I’m not going to blame the patient. Last week, I was talking to a patient who, because of her cancer treatment has lost her hair, and she said, ‘I know it looks ridiculous to smoke.’ She knows that, but she’s still smoking. It’s more complicated than that.”
The study was filled out by people being treated for a variety of different cancers, not just those that generally have been associated with cigarette smoking, which include cancer of the lungs, head and neck, bladder, stomach and pancreas.
“Many times, some early-stage cancer patients get cured from the primary cancer and then come back with a second cancer,” Abraham said. “We had a stage-one breast cancer patient. I gave her the treatment and I told her, ‘You’re going to be fine. There is a 90 percent chance that it’s not going to come back.’
“But she was an active smoker and two years later, she had a large mass in her lung and died of lung cancer.”
The situation frustrates anti-smoking activist Adkins, who smoked in college and was treated for cancer of the tongue three years ago, about 30 years after he quit his smoking habit.
When he had cancer, Adkins said, radiation treatments were very uncomfortable, and he could not imagine smoking during that time period.
“I could barely swallow. I could barely eat. Nothing tasted good. Everything was yucky,” he said. “Smoking could not have made that better. It could only have made things worse if I was a smoker.”
E-mail Mary Wade Burnside at mwburnside@timeswv.com.
“It absolutely benefits patients to quit,” said Dr. Jame Abraham, chief of oncology at WVU Hospitals and the medical director of the Mary Babb Randolph Cancer Center in Morgantown. “No. 1, we know that smoking can potentially alter the effectiveness of chemotherapy.
“No. 2, smoking can cause many other conditions, including lung cancer and COPD (chronic obstructive pulmonary disease), and smoking can increase the chance of getting pneumonia and lung disease, which can complicate the ability to take the treatment.”
The study was the idea of Lola Burke, now a second-year medical student who performed much of the survey work, Abraham said.
Burke sent surveys to 1,000 cancer patients, and 200 of them responded. Of the 200 who responded, 52 percent had a history of smoking, but only 20 percent had been actively smoking at the time of the diagnosis, Abraham said.
Of the active smokers, 44 percent quit while 56 percent did not, Abraham said.
“Another thing we found was that 40 percent were not told by the doctors to quit,” he added. “They didn’t even hear this from their doctors or their health-care provider.”
Bruce Adkins, director of the Division of Tobacco Prevention for the West Virginia Bureau for Public Health, has teamed up with Marshall University’s Joan C. Edwards School of Medicine in an effort to offer training to physicians who would teach them how to counsel patients to quit smoking.
“We started doing some provider training about two and a half year ago,” he said. “It’s a tough addiction to break. You have to keep reinforcing it. People don’t usually quit smoking the first time they attempt to quit. The average number of times it takes someone to quit using tobacco is eight to 10 times.”
Staff members from Marshall’s School of Medicine travel throughout the state offering a three-hour course to physicians, covering topics such as cessation counseling, spit tobacco, smoking and pregnancy, and the pharmacotherapy of tobacco cessation, Adkins said.
In 2007, the Centers for Disease Control and Prevention (CDC) reported that West Virginia had the second-highest rate of adult smokers in the United States at 25.7 percent, second to Kentucky at a rate of 28.6 percent.
The findings of the study at the Mary Babb Randolph Cancer Center, which have been released in this month’s edition of Journal of Oncology, published by the American Society of Clinic Oncology, illustrate that more must be done in order to help cancer patients quit, Abraham said.
“Many times, that person has been smoking for a long time,” he said. “That addictiveness is so high, so you can’t just walk away from this in one day.”
The news came during the same week that the CDC released a report in its Morbidity and Mortality Weekly Report stating that Kentucky and West Virginia have the highest death rates from smoking.
It also comes during the same month that actor Patrick Swayze, undergoing treatment for pancreatic cancer, admitted that he still smokes.
“We do see similar behavior all the time,” Abraham said of Swayze’s admission. “But I’m not going to blame the patient. Last week, I was talking to a patient who, because of her cancer treatment has lost her hair, and she said, ‘I know it looks ridiculous to smoke.’ She knows that, but she’s still smoking. It’s more complicated than that.”
The study was filled out by people being treated for a variety of different cancers, not just those that generally have been associated with cigarette smoking, which include cancer of the lungs, head and neck, bladder, stomach and pancreas.
“Many times, some early-stage cancer patients get cured from the primary cancer and then come back with a second cancer,” Abraham said. “We had a stage-one breast cancer patient. I gave her the treatment and I told her, ‘You’re going to be fine. There is a 90 percent chance that it’s not going to come back.’
“But she was an active smoker and two years later, she had a large mass in her lung and died of lung cancer.”
The situation frustrates anti-smoking activist Adkins, who smoked in college and was treated for cancer of the tongue three years ago, about 30 years after he quit his smoking habit.
When he had cancer, Adkins said, radiation treatments were very uncomfortable, and he could not imagine smoking during that time period.
“I could barely swallow. I could barely eat. Nothing tasted good. Everything was yucky,” he said. “Smoking could not have made that better. It could only have made things worse if I was a smoker.”
E-mail Mary Wade Burnside at mwburnside@timeswv.com.
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