Increasing Trend of NSCLC Among Never-Smokers Prompts New Research Efforts

“Twenty percent of lung cancer cases in the United States are diagnosed in people who never smoked.

“This translates to between16,000 and 24,000 Americans annually, according to the American Cancer Society.  The majority of these cases are non–small cell lung cancer.

“Although the exact cause for increased proportion of lung cancer cases among never-smokers has not been established, researchers suggest environmental factors may to be blame.

“However, they emphasize more data are needed to identify the factors that are driving the increase ― and determine the most appropriate treatment options for never-smokers ― before changing practice.”


For Breast Cancer Patients, Never Too Late to Quit Smoking

“Documenting that it’s never too late to quit smoking, a large study of breast cancer survivors has found that those who quit smoking after their diagnosis had a 33 percent lower risk of death as a result of breast cancer than those who continued to smoke.

“The study involved more than 20,600  with breast cancer, and is one of the largest studies of survival outcomes according to  habits in women with a history of breast cancer, and the first study to assess smoking habits both before and after diagnosis.

“The paper was published in the Journal of Clinical Oncology on January 25, 2016.”


NSCLC Emerging as a Growing Problem Among Never-Smokers

“Lung cancers account for more than one-quarter of cancer deaths in the United States, and the disease is expected to kill nearly 160,000 Americans in 2016 alone. Early detection, which occurs in just 15% of cases, remains the best avenue to longterm survival; about half of patients found to have an early-stage lung cancer are alive 5 years after diagnosis, compared with fewer than 5% of patients whose cancers are detected after metastasis.

“The National Lung Screening Trial studied more than 53,000 patients and demonstrated that low-dose helical computed tomography (CT) is more effective at lung cancer early detection than standard chest X-rays, yielding—over an observation period of about 7 years—a 20% lower risk of dying from the disease. The trial enrolled only symptomless current or former smokers ages 55 to 74 who had a smoking history of 30 packyears (that is, a pack a day for 30 years, or 2 packs a day for 15 years) and who had been smokers within the prior 15 years.”


COPD Heightens Deadly Lung Cancer Risk in Smokers

“Smokers who have chronic obstructive pulmonary disorder (COPD) may face nearly twice the risk of getting small cell lung cancer (SCLC)—the deadliest form of lung cancer—than smokers who don’t have COPD, according to a large worldwide study led by researchers at the Harvard T.H. Chan School of Public Health.

“The study was published online September 24, 2015 in EBioMedicine.

“The new study—the largest-ever epidemiologic study of SCLC—is the first to look at how much COPD, a progressive disease that makes it hard to breathe, increases smokers‘ risk of getting SCLC. Although it’s long been known that smoking is a major risk factor for lung cancer, the new study estimates the risk more precisely than before.”


Lung NETs and Their Treatment


Cancers that arise in the lung are mostly of the type known as NSCLC (non-small cell lung carcinoma). A much smaller proportion of lung tumors arise from neuroendocrine cells in the lungs. These cells (which are also found in most other organs) secrete a variety of hormones that are necessary for normal organ function, as well as for healing after injury or infection. Like other lung cells, neuroendocrine cells may transform to become cancers. Lung cancers that arise from neuroendocrine cells are called pulmonary neuroendocrine tumors (NETs), or lung NETs. Continue reading…


Super Patient: Chris Newman Seeks a Second Opinion—and Survives Lung Cancer


In late 2009, Chris Newman thought she was just another busy person who kept feeling run down. “I had profound fatigue for a year and two bouts of bronchitis,” recalls Chris, who was a lawyer at the time.

Then a bad case of pneumonia took her to the emergency room, where an X-ray revealed a large mass—nearly three inches across—and several small ones in her lungs. A biopsy showed she had non-small cell lung cancer, a PET scan for sugar uptake showed it was extremely aggressive, and genetic testing showed there was no targeted treatment for it. Continue reading…


Smokers at Twice Risk of Prostate Cancer Recurring after Surgery

“Current smokers, and those who have quit smoking less than 10 years previously, have twice the risk of a recurrence of prostate cancer after surgery, according to new research presented at the European Association of Urology conference in Madrid.

“Prostate cancer is the third most common male cancer in Europe, accounting for over 92,000 deaths in 2012 (9% of male deaths). Around 30% of all prostate cancer patients treated with radical prostatectomy experience biochemical recurrence (defined by an increase in PSA, prostate specific antigen) within 10 years after surgery

“An international group of scientists and clinicians from the USA and Europe retrospectively looked at biochemical prostate cancer recurrence – in 7191 men who had had their prostate removed by radical prostatectomy. Of these men, roughly a third were never smokers (2513, or 34.9%), a third were former smokers (2269, or 31.6%) and a third were current smokers (3409, or 33.5%). These patients were followed up for an average of 28 months.

“The results showed that after a median of 28 months, current smokers had around double (HR 2.26) the chance of the cancer recurring than did patients who had never smoked (see abstract below for full results). Even those who had quit smoking within the last 10 years still had a significantly higher risk of cancer recurrence, at about the same level (HR 2.03) as that for current smokers. It wasn’t until 10 years after a patient had quit smoking that the risk of cancer recurrence dropped significantly.”


Medicare Will Cover CT Lung Cancer Screening

“Current and former heavy smokers ages 55 to 77 can undergo annual low-dose CT screening for lung cancer paid by Medicare, the Centers for Medicare and Medicaid Services announced Thursday.

“The decision finalizes a preliminary plan the agency released in November with one important difference: a higher upper limit to the age range, which had previously been set at 74.

“As in the draft plan, individuals must still have a 30 pack-year history of smoking to qualify and must either be smoking currently or have quit in the past 15 years.

“Also, beneficiaries must obtain a written order from a physician for the first screening, stipulating that the patient underwent counseling on lung cancer screening and that it involved a shared decision-making process. Subsequent annual screenings will also require similar written orders.

“The counseling sessions must emphasize the importance of continued abstinence for ex-smokers and cessation for current smokers.”


When Fighting Lung Cancer, Every Cancer Is Personal

“Larry Dry’s lung cancer was discovered by accident. The husky, physically active 69-year-old had no cough, no breathing problems, only a little tingling in one hand. When his doctor ordered an X-ray before surgery for a pinched nerve, he wasn’t thinking lung cancer. Dry hadn’t smoked in 40 years and a chest X-ray taken less than a year earlier had been perfectly clear. But the new X-ray contained ghostly images of large nodules. Non-small cell lung cancer. Stage IV, the most advanced kind. Eight months of gut-wrenching chemotherapy shrank the tumors, but they quickly rebounded. A second, less toxic drug didn’t work.

“Kathy Dry, a former CDC employee, asked the doctor if there wasn’t something else for her husband, perhaps something at Emory. And that was how, in July 2013, Dry met Winship Cancer Institute oncologist Suresh Ramalingam, professor and director of Winship’s Lung Cancer Program. Dry quickly entered one of the 20 to 30 ongoing lung cancer clinical trials underway at Winship, thanks to Winship’s status as Georgia’s only National Cancer Institute-designated cancer center. Dr. Ram, as his patients call him, is principal investigator of a multi-institutional Phase II trial testing the efficacy of a new class of immunotherapy cancer drugs, drugs that stimulate the immune system to attack cancer cells while sparing healthy ones.

“Every two weeks, Dry met with Ramalingam and Colleen Lewis, nurse practitioner in Winship’s busy clinical trials unit, and spent an hour in Winship’s infusion center. A huge benefit of the new immunotherapy treatments, says Ramalingam, is how well they are tolerated. Dry’s previous chemotherapy caused constant diarrhea. The new treatment only caused occasional gastrointestinal upset and he was able to regain lost pounds and his trademark energy. His tumors shrank by more than half and stayed that way for 11 months.

“Thanks to their experience at Winship, Kathy Dry encourages people with lung cancer not to give up. There is hope, she says.”