ILLUSTRATIONS: RAFAEL LOPEZ
Homing in on a deadly cancer
Today’s most lethal cancer does not arise in the breast, nor in the prostate. The leading cancer killer is lung cancer, but physicians in City of Hope’s Lung Cancer and Thoracic Oncology Program believe certain technological tools already available today can make it a little less deadly.
Using spiral computed tomography, or CT, to routinely screen people at high risk for lung cancer can detect the disease early and increase the chance of cure, according to a study in the New England Journal of Medicine that included City of Hope researchers.
Grannis and Rotter are part of the International Early Lung Cancer Action Program, or I-ELCAP, which published the findings in October 2006.
Today, most lung cancers are found when they are advanced and are more difficult to treat successfully, physicians say. Grannis, Rotter and their I-ELCAP colleagues want to find a reliable way to detect more lung cancers at an early stage to offer patients a better chance at beating the disease.
I-ELCAP comprises researchers at 40 institutions in the United States, Europe and Asia who are studying the potential of CT for early lung cancer detection. City of Hope is the only I-ELCAP participating institution in the Los Angeles area.
In the study, researchers screened more than 31,500 asymptomatic people who smoked, people who had stopped smoking, those who were exposed to significant secondhand smoke or were exposed to carcinogens, such as radon, in their work. They conducted screenings from 1993 to 2005, and conducted nearly 27,500 repeat screenings between seven and 18 months later.
Among participants, 13 percent who underwent a baseline CT and 5 percent of those who had a follow-up CT had a positive result requiring further investigation.
Screenings and subsequent biopsies detected lung cancer in 484 participants. Among these patients, 85 percent had stage 1 lung cancer (412 of 484). Researchers estimate that 88 percent of these stage 1 patients will survive 10 years.
Moreover, the researchers estimated the survival rate to be even higher — 92 percent — for stage 1 patients who had surgery within a month of diagnosis. However, researchers still must follow the patients to determine the true 10-year survival rate.
MARKIE RAMIREZPhysicians Frederic W. Grannis Jr., (foreground) and Arnold Rotter, seek out lung cancers while they are still in an early stage through their participation in the International Early Lung Cancer Action Program.
Another recent, unrelated study of CT to detect lung cancer among current and former smokers found that CT did not appear to increase patients’ survival. But I-ELCAP investigators believe the body of research must be evaluated further to determine the true value of screening tools.
“Annual CT screening is a viable way to find lung cancers in people at high risk while the cancers are still curable,” said Grannis, clinical associate professor of surgery and a member of City of Hope’s Lung Cancer and Thoracic Oncology Program. “Aside from saving lives, we also believe it’s cost-effective. Low-cost CT screening costs less than $350, and treatment for early stage lung cancers usually costs much less than that for late-stage lung cancers.”
In the U.S., more than 213,000 people are diagnosed annually with lung cancer and more than 160,000 die of the disease each year, according to the American Cancer Society.
Information about City of Hope’s program is available at http://www.cityofhope.org/lungscreen.