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Lung cancer ranks among deadliest, most neglected cancers


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Treatment advances

What price prevention?


ATLANTA, Georgia (CNN) -- Three years ago, when Glenn Davis, 49, was diagnosed with lung cancer, the doctors told him he could die -- soon.

A spot on his lung was misdiagnosed as pneumonia, but later turned out to be a cancerous tumor. It had even spread to his brain.

"I'd quit smoking for about two years and I had headaches," remembered Davis, who writes, produces and films videos for corporations in El Cerrito, a suburb of Oakland, in northern California. After his diagnosis, though, two trips to the surgical table were in order.

Experts are studying ways to help people quit smoking
Get some tips for kicking your smoking habit from Ron Todd, director of tobacco control for the American Cancer Society

Afterward, with the brain tumor mostly killed and his right lung removed, Davis struggled to regain a normal life while getting support from his wife and two daughters.

He's still happy to be alive and now takes the time to talk to others about treating lung cancer while he pushes for greater recognition. He's even made public service announcements for organizations helping people deal with lung cancer.

"You got to kill it, it's ferocious," Davis said of lung cancer. "Smoking cessation is a small part of stopping it."

Despite Davis and others' efforts to focus more attention on lung cancer care, doctors say that successful stop-smoking campaigns could wipe out some 90 percent of lung cancer cases.

In fact, quitting smoking will cut a person's risk of getting lung cancer -- after a period of 15 years -- to only twice that of a nonsmoker. The normal risk to smokers for lung cancer is 10 times more than nonsmokers.

To that end, Thursday, November 16, marks the American Cancer Society's Great American Smokeout -- a nationwide push to get people to stamp out their butts.

"Cigarettes cause lung cancer. It's as simple as that," said Dr. Dan Sullivan, a radiologist for the National Cancer Institute. Sullivan is part of an institute-led group that recruited 3,000 current and former smokers for the Lung Cancer Screening study to see if a new diagnostic tool, called a spiral CT scan, can become a part of physicians' cancer care.

Physicians already know that spiral CT scans can detect small lung cancers, often at the edges of the lungs. However, it still remains to be proven if the scans, which cost about $300 per patient and are not covered by insurance, can actually save lives. Conventional chest X-rays are still a very common diagnostic tool for lung cancer, even though about half of U.S. hospitals own spiral CT machines.

The Lung Cancer Screening will not seek to track the spiral CT survival advantage, Sullivan said, but will serve to guide researchers who may consider doing a larger, more in-depth study. The overall survival rate is only 14 percent, but when the tumors are detected while they're still small and confined to the lung, nearly 50 percent of sufferers can be cured.

Non-small cell lung cancer, the most common form of the disease, is difficult to track.

Doctors meeting in Chicago in October for the annual clinical congress of the American College of Surgeons reported they had found a potential chemical marker in bone marrow that may help them screen out lung cancer victims at an early stage and help them determine what kind of treatment to use. But the bone marrow marker may not be as useful, experts said, as a hoped-for marker researchers are looking for in a simple blood test.

The benefits of early screening are already one of the cornerstones of Lung Cancer Awareness Week, which began November 13 and was started by Cancer Care Inc., a nonprofit organization devoted to helping lung cancer patients and their families understand the disease.

The group is quick to point out that lung cancer research gets short shrift compared the funding dollars spent on other diseases, like breast and prostate cancer. The disproportionate funding happens, said Cancer Care's Diane Blum, despite the fact that it's the nation's leading killer among cancers -- even after you combine the number of deaths from breast, ovarian and prostate cancers.

"The heavy toll of lung cancer can only be reduced if we combine public awareness with public research dollars," Blum said.

Treatment advances

Treatments for lung cancers have come long way: Radiation therapy can be more precisely focused to minimize damage to healthy lung tissue; and chemotherapy regimens are now available that have fewer side effects and are easier on the body.

Long-term survival for lung cancer has nearly doubled in 30 years, according to the recent book "Lung Cancer: A Guide to Diagnosis and Treatment", by Dr. Walter Scott.

Still, experts point out the cure rate for cancer has a long way to go before it reaches the 70 percent cure rate associated with breast cancer.

Some researchers at Duke University Medical Center in Durham, North Carolina, have decided to deal with lung cancer by focusing on ways to measure and improve quality of life for its sufferers -- it other words, do away with the 'doom and gloom' of the disease.

Dr. Jennifer Garst, an oncologist at the Duke Comprehensive Cancer Center, is among those measuring pain, shortness of breath, fatigue, appetite and other life aspects to understand how small changes can make a difference in how well lung cancer patients feel.

One example includes a Duke study to measure taste changes in older lung, breast and colon cancer patients and to improve flavors with cancer center-developed flavor-enhancers. If a patient's sense of salty and sweet are damaged during chemotherapy treatment, then food can taste very bitter -- or worse, food can have little taste at all. Researchers hope to change that by adding concentrated-like essences of some flavors.

"I don't think people understand how depressing it is to not be able to taste food," Garst said. "If we can take care of pain, taste, appetite and other problems, we should be able to increase the patient's ability to take care of themselves" and improve survival.

What price prevention?

For now, events like Thursday's 'smokeout' and the lung cancer awareness week are battling a shocking trend among U.S. smokers -- about the same number teenagers as adults light up.

And more girls than boys are smoking, which concerns experts, considering that lung cancer is increasingly a women's disease. Female deaths from lung cancer have risen 150 percent between 1974 and 1994, compared to just a 20 percent increase among men during the same period, according to Cancer Care.

Doctors don't know for sure why smoking does such a number on females, but a recent study points to women's generally smaller lungs. Lung cancer also appears to strike blacks more than other populations.

Attempts to persuade people not to smoke have crept along -- spurring many, like Davis, to clamor for creative methods to get the word out on just how dangerous lung cancer really is.

"I tell people 'man, they don't have anything to cure this'," Davis said. "Don't get this disease."

American College of Surgeons' Commission on Cancer
Alliance for Lung Cancer
Memorial Sloan-Kettering Cancer Center
Cancer Care events

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