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Newsday,
March 8, 2006
By Jamie Talan
Smoking is the leading risk factor for
lung cancer, but Dana Reeve’s diagnosis and death
are a reminder that only 80 percent of all patients
have such a history.
Scientists are working to understand what the risk factors
are for nonsmokers like Reeve.
Unlike breast and colon cancer detection,
which now relies heavily on screening tools, there is
no early window into diseased airways. Thus, three quarters
of lung cancer patients are diagnosed in advanced stages.
And, at that point surgery is no longer
an option, said Dr. Avi Barbasch, an associate clinical
professor of oncology at Mount Sinai School of Medicine.
Chemotherapy and other treatments are also less effective
then, which is why 162,460 lung cancer patients a year
die. Median survival is 18 to 24 months after detection.
The hope, of course, is to identify a
screening tool. The federal government is funding a
long-term lung cancer study to test the benefits of
a CAT scan of the chest (a chest X-ray has proved ineffective
in picking up early cases.) But even if it works, and
there is scientific reason to believe it does, only
smokers will be targeted for the costly screening, said
Dr. Caroline Chiles, a professor of radiology at Wake
Forest University Medical Center, a study site. The
scans cost about $1,000 apiece.
The 50,000 people in the study are all
smokers between the ages of 55 and 74. Results won’t
be available until 2008.
“At the end of the day, we have
to invest in research into the diagnosis and treatment
so that we can have more survivors and fewer stories
like Dana Reeve,” said Susan Mantel, executive
director of Joan’s Legacy, a foundation started
in honor of Joan Scarangello, a head writer for “NBC
Nightly News” and a nonsmoker who died in 2001
of lung cancer at the age of 47.
Incidence of the disease has steadily
increased among women, a direct result of smoking. Some
studies suggest non-smoking lung cancer patients are
twice as likely to be female, and no one knows why.
Symptoms include coughing up blood or
a change in relentless cough, pain in the chest, weight
loss and headache. In half of the patients diagnosed,
the disease has already spread beyond the lung. The
average age at diagnosis is 68, said Dr. Jeffery Port,
a thoracic surgeon at New York Presbyterian Hospital.
If the disease could be identified earlier,
the cure rate could jump to 70 percent, Barbasch said.
Preventing smoking would also cut prevalence considerably.
The good news for nonsmokers, said Dr. Jeffery Schneider,
director of the lung cancer center at Winthrop-University
Hospital in Mineola, is they seem to fare better with
treatment, and female non-smokers do better than men.
There are two forms of lung cancer - small
cell and non-small cell. Nonsmokers, most often have
non-small cell cancer, like Reeve, and this is more
responsive to the current therapy, Tarceva, which blocks
a cell growth receptor from signaling the tumor to grow.
It is being tried in many lung cancer patients, less
than 2 percent, are “super responders.”
Their tumors may disappear after a few weeks, Schneider
said.
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