A new screening method may offer a better way to monitor recurrence after lung cancer surgery. Recurrence is common, but traditional screening methods, including chest x-rays and computed tomography (CT) scans, have significant drawbacks. A new minimal dose CT (MnDCT) scan reduces radiation exposure to no more than that of standard x-rays, but it maintains superior sensitivity. In a recent study, MnDCT detected 94% of cancer recurrences in patients who had received surgery to remove stage I or II lung cancer; x-rays caught only 21%. However, MnDCT has a high rate of false positives (ie, detecting lung cancer when none is actually present), which is of concern because recurrence may call for invasive and potentially dangerous follow-up procedures.
“Men ages 55 to 69 who are considering prostate cancer screening should talk with their doctors about the benefits and harms of testing and proceed based on their personal values and preferences, according to a new clinical practice guideline released today by the American Urological Association (AUA)…”
“Prostate cancer is the most common type of cancer in men and the second leading cause of cancer death in men in the United States. The recent surge of high-throughput sequencing of cancer genomes has supported an expanding molecular classification of prostate cancer. Translation of these basic science studies into clinically valuable biomarkers for diagnosis and prognosis and biomarkers that are predictive for therapy is critical to the development of precision medicine in prostate cancer. We review potential applications aimed at improving screening specificity in prostate cancer and differentiating aggressive versus indolent prostate cancers…”
Some patients who undergo surgery for suspected lung cancer turn out not to have the disease. Such a misdiagnosis is known as a “false positive.” A recent analysis found that the rates of lung cancer false positives vary widely from state to state, ranging from 1.3% of lung cancer diagnoses in Vermont to 25% in Hawaii, with no clear pattern across states. Possible reasons for the variation include local differences in how quickly clinicians move from a suspicious finding during lung cancer screening to surgery. Other potential factors involve conditions like chronic fungal infections, which are more common in certain regions and can be mistaken for lung cancer. The findings underline the need for caution in the interpretation of lung cancer screens, especially considering that 2.1% of the patients in the study who had received a false positive diagnosis died after surgery.
“Performance of prostate biopsy is uncommon in older men with abnormal screening PSA levels and decreases with advancing age and worsening comorbidity. However, once cancer is detected on biopsy, most men undergo immediate treatment regardless of advancing age, worsening comorbidity, or low-risk cancer. Understanding downstream outcomes in clinical practice should better inform individualized decisions among older men considering PSA screening…”
“ACP recommends that clinicians inform men between the age of 50 and 69 years about the limited potential benefits and substantial harms of screening for prostate cancer. ACP recommends that clinicians base the decision to screen for prostate cancer using the prostate-specific antigen test on the risk for prostate cancer, a discussion of the benefits and harms of screening, the patient’s general health and life expectancy, and patient preferences…”
An ongoing collaboration of more than 50 research groups around the world has identified 23 new genes or genomic regions that may contribute to the development of prostate cancer. These findings allow for a more accurate assessment of a person’s risk of developing prostate cancer. The results were published in the April, 2013, issue of Nature Genetics (doi:10.1038/ng.2560).
Including the 23 new prostate cancer susceptibility genetic loci, there are now a total of 77 known loci linked to prostate cancer. This accounts for about 30% of all familial risk for prostate cancer—the other factors for familial risk for prostate cancer are not yet defined. Continue reading…
“New research from NewYork-Presbyterian Hospital/Columbia University Medical Center suggests that men who are considering their treatment options for low-risk prostate cancer may benefit from additional biopsy testing before making a decision. Based on this research, doctors at the medical center are modifying their practices to more accurately distinguish early and low-risk prostate cancers from more aggressive disease.”