The Lung Cancer Alliance (LCA) announced Feb. 25 that statistics recently released by the American Cancer Society (ACS) indicate that lung cancer continues to kill more people each year than all the other major cancers combined.

Beginning in 2003, ACS started using the 2000 census for its age adjusted statistical analysis. Since that time, the incidence rate for lung cancer in men rose from 86 new cases per every 100,000 of population to 89, and incidence rates for women went from 51.4 to 55.2.

The LCA points out that in research dollars per death, lung cancer is receiving a fraction of the amounts given to breast, prostate and colon cancers.

The five-year survival rate for breast cancer now stands at 88 percent, prostate cancer 99 percent and colon cancer 65 percent, while lung cancer remains at 15 percent.

The ACS credits screening as a major component in achieving high survival rates. So, part of the problem, according to an article published in the Baltimore Sun Feb. 27, is that there is not yet any effective way to screen for lung cancer.

Reporter Stephanie Desmon found that neither physicians nor major medical societies advocate lung cancer screening at this time, because no one has proved that it saves lives.

Studies have shown that screenings find more cancer, but also more lesions and nodules that may or may not be cancer, Desmon’s report said. This leads to confusion about how to treat these spots, or whether to treat them at all. There also are concerns that lung screenings may lead to further tests, biopsies and surgeries, some of which may be unnecessary or harmful to a patient. Scans that produce “watch and see” results also lead to fear and anxiety, and emotional cost to the patient.

In 2002, the National Cancer Institute launched the National Lung Screening Trial (NLST), which will compare two ways of detecting lung cancer – spiral computed tomography (CT) and the standard chest X-ray. By Feb. 2004, nearly 50,000 people (smokers or former smokers) had joined NLST at more than 30 study sites across the country.

The trial (now closed to further enrollment) is slated to collect and analyze data for eight years to examine the risks and benefits of each type of screening. The NLST is a randomized, controlled study and is large enough to determine if there is a 20 percent or greater drop in lung cancer mortality from using spiral CT compared to chest X-ray. The trial is scheduled to last until 2009.

Probably one of the most discouraging things about Mesothelioma is the fact that it is hard to diagnose and hard to treat. The diagnosis for most meso patients is bleak. By the time the cancer is diagnosed, it’s often advanced. Most patients only live for a year, maybe two, after being diagnosed.

This is a cancer that has a really long incubation period, with the time between first exposure to asbestos and the development of mesothelioma ranging from 20 and 50 years. Even scarier, the American Cancer Society (ACS ) says that the risk of mesothelioma DOES NOT DROP with time after exposure to asbestos. The risk appears to be lifelong and undiminished.

As a result, most patients diagnosed with mesothelioma are older. The ACS says about three-fourths of people diagnosed are over 65 years old. They may already be weak from symptoms of the disease, or unable to tolerate aggressive therapies.

Of course, it’s now known that exposure to asbestos is the main reason for the development of mesothelioma, and also asbestosis (formation of scar tissue in the lungs) and adenocarcinoma, another form of the asbestos-related cancer. The highest risk group seems to be people who were exposed to asbestos through their work. The ACS estimates that up to 8 million Americans may already have been exposed to asbestos.

As awareness of mesothelioma grows, it is hoped that more people who know they were exposed to asbestos will seek diagnosis early. It has been shown that a chest x-ray often isn’t very effective in diagnosing mesothelioma, so there has been interest in a blood test that measures the levels of certain proteins that is higher in people who have lung damage due to asbestos.

But even with early diagnosis, traditional cancer treatments, like chemotherapy, radiation and surgery, are not very effective against mesothelioma. One problem is that it does not grow as a single mass. Instead it tends to spread along surfaces, nerves, and blood vessels. This makes it hard for one or more types of treatment to get rid of all of the disease. Cancer treatments may ease symptoms, like shortness of breath, pain, bleeding or trouble swallowing, but they are unlikely to provide a longterm cure.

So how do people continue to hope? What keeps them fighting? I’d really like to know. Please share your story with me.

Also, a GREAT site to check out is the Lung Cancer Support Community. Their link is in the blogroll, or type in www.lchelp.org. They have message boards, chats, information and even a place to start your own blog.

As I was browsing some of the online news sites today, I came across an article on msnbc.com that was originally posted Aug. 31, 2007, attributed to The Associated Press. It talks about a new system of classifying tumors in lung cancer cases that can help more people get access to aggressive therapy who might otherwise have been ruled out, and also to help prevent those who aggressive treatment wouldn’t particularly help avoid the stress of ineffective and physically draining treatment.

The new system was developed by the International Association for the Study of Lung Cancer. I’m putting a link to the group in my blogroll, but it’s mainly full of professional development opportunities for doctors. But if you’re interested, it’s there.

Basically, the old system of “staging” a tumor (based on tumor size, how much it has spread, etc.) was developed from examining about 5,000 tumor samples gathered from the University of Texas M.D. Anderson Cancer Center, in Houston, DECADES ago. The new plan is based on 100,000 tumor samples from around the world, including Asia (predicted by ResearchandMarkets.com, particularly Japan, to see increases in cases of Mesothelioma due to the heavy use of asbestos there in the 1970s).

Doctors predict that the expansion of tumors for study and comparison will greatly increase understanding of tumor characteristics and allow them to better identify specific stages of tumor development beyond the four basic groupings (which will remain in place). They estimate that as a result as many as 10,000 patients a year in the United States will be shifted from inoperable to operable classifcations!

Changing some groupings, like creating more sub-stages for tumor size, reclassifying tumors that have spread into the fluid surrounding the lung, recognizing that spread to certain lymph nodes is more dangerous than its spread to others, and additional factors will let patients be classified at an earlier stage, where they can be recommended for more aggressive treatments.

Right now, only about 20 percent of cases are diagnosed in stages 1 or 2.

The article quotes Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, who says that staging for lung and other types of cancer should become even more precise in the near future, as biomarkers and gene tests are developed that will even better sort patients.

Expanding the base of study from 5,000 samples limited to the U.S. - and one cancer center in the U.S. - to a base of 100,000 samples that includes international elements has to be good for the future of treatment. Just think how much more doctors can learn, and how much more variety they will be able to access to help them make a more accurate diagnosis!