Quality of Life Parallels Length of Lung Cancer Survival

A new study indicates The way lung cancer patients feel around the time they're diagnosed may be related to how long they survive -- even after taking into account objective measures of the disease.

Researchers found that newly-diagnosed lung cancer patients who rated their quality of life higher generally lived longer with the disease: typically surviving nearly six years, versus less than two years among patients who'd reported a poor quality of life.
And objective measures -- like age, the stage and aggressiveness of the cancer and other health conditions -- did not fully explain the connection.
Quality of life is a "complex construct" that includes a person's feelings of physical, mental and emotional well-being, said Jeff A. Sloan, a professor of oncology and biostatistics at the Mayo Clinic in Rochester, Minnesota, who led the new study.

Blood work and other lab tests are one way of seeing how a patient is doing, according to Sloan. But, he said, doctors have long been aware that two patients can look the same as far as objective cancer-related measures go, yet fare differently.
A number of studies have now shown that quality of life seems to affect the long-term picture for cancer patients, Sloan said.
So doctors at Mayo have begun routinely assessing cancer patients' quality of life, and some other cancer centers are starting to do the same, he added.
The current study, published in the Journal of Clinical Oncology, included 2,442 patients treated for lung cancer at Mayo over 11 years.
Around the time of their diagnoses, patients rated their overall quality of life on a standard scale of zero to 100. The researchers found that 21 percent had a "deficit" in quality of life -- or a score of 50 or lower.
Those patients survived for substantially less time: 1.6 years, on average, versus 5.6 years in the group with a higher quality of life around the time of diagnosis.
There were other differences between the two groups, too. Patients with a poorer quality of life were more likely to be men, current smokers and have more-advanced cancer, for example.
But even when Sloan's team factored in those differences, quality of life was still a predictor of survival time. Overall, the death rate during the study period was 55 percent higher among patients who gave low ratings to their quality of life.
So what can be done when cancer patients have quality-of-life issues? That depends on what seems to be underlying the problem, according to Sloan.

Read more: http://www.foxnews.com/health/2012/03/29/quality-life-tied-to-lung-cancer-survival/#ixzz1qW7U8Gm2

Smoking Or Second Hand Smoke Is Cause of Deadly Small Cell Lung Cancer

Small cell lung cancer has the characteristic of the most aggressive type of the three classifications which is small cell, large cell and carcinoid lung cancer.  Within the category of small cell lung cancer there are two types.
These two types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope.  They are small cell carcinoma (oat cell) or combined small cell cancer.

                                                             Small cell lung cancer scan

                                                  Small cell lung cancer under the microscope




Diagnosing small cell lung cancer involves several procedures.

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

General Information About Small Cell Lung Cancer

Key Points for This Section

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung. There are two types of small cell lung cancer. Smoking tobacco is the major risk factor for developing small cell lung cancer. Possible signs of small cell lung cancer include coughing, chest pain, and shortness of breath. Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer. Certain factors affect prognosis (chance of recovery) and treatment options. For most patients with small cell lung cancer, current treatments do not cure the cancer.

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
The lungs are a pair of cone-shaped breathing organs that are found within the chest. The lungs bring oxygen into the body when breathing in and take out carbon dioxide when breathing out. Each lung has sections called lobes. The left lung has two lobes. The right lung, which is slightly larger, has three. A thin membrane called the pleura surrounds the lungs. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.

Enlarge

Anatomy of the respiratory system, showing the trachea and both lungs and their lobes and airways. Lymph nodes and the diaphragm are also shown. Oxygen is inhaled into the lungs and passes through the thin membranes of the alveoli and into the bloodstream (see inset).

Risk factors for small cell lung cancer include:

• Smoking cigarettes, cigars, or pipes now or in the past.
• Being exposed to secondhand smoke.
• Being exposed to asbestos or radon.

Possible signs of small cell lung cancer include coughing, chest pain, and shortness of breath.
These and other symptoms may be caused by small cell lung cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A cough that doesn’t go away.
• Shortness of breath.
• Chest pain that doesn’t go away.
• Wheezing.
• Coughing up blood.
• Hoarseness.
• Swelling of the face and neck.
• Loss of appetite.
• Weight loss for no known reason.
• Unusual tiredness.

Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer.
The following tests and procedures may be used:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

  Enlarge

  X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film.

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

  Enlarge

  PET (positron emission tomography) scan. The patient lies on a table that slides through the PET machine. The head rest and white strap help the patient lie still. A small amount of radioactive glucose (sugar) is injected into the patient's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.

• Sputum cytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).
• Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. 

Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.

Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

 Unfortunately, the prognosis for small cell lung cancer is not positive.

Approximately 65-70% of patients with small cell lung cancer have disseminated or extensive disease at presentation. Extensive-stage small cell lung cancers are incurable, and patients with extensive disease have a median survival duration of 6 weeks. Patients presenting with localized disease (ie, limited stage) have a median survival duration of about 12 weeks. These survival figures are for untreated patients.
The median survival of patients with small cell lung cancer who are treated with multiple-agent chemotherapy and multimodality therapy are as follows:

• For limited disease, 20 months, with a 2-year survival rate of 45%^[21] and a 5-year survival rate of 20%
• For extensive disease, 12 months (In 1973, the 2-year survival rate was 1.5%; in 2000, the 2-year survival rate was 4.6%.)

Indicators of poor prognosis include relapsed disease, weight loss, and performance status. Patients who ambulate less than 50% of their waking hours and those with weight loss of more than 10% in 6 months have a worse prognosis.  For more information:

http://emedicine.medscape.com/article/280104-overview  or

http://www.cancer.gov/cancertopics

Pathwork Tissue Origin Test Helps Prolongs Life Of Lung Cancer Patients

The Pathwork Tissue of Origin Test is the only FDA-cleared, Medicare-covered molecular diagnostic for identifying tissue of origin. It uses a tumor’s own genomic information to help pathologists and oncologists diagnose challenging cancer cases such as those that are metastatic or that have a complex clinical history.
“The Tissue of Origin Test significantly altered clinical practice patterns for treating metastatic cancer,” explained John Hornberger, M.D., M.S., CEO/President of Cedar Associates LLC and Principal Investigator of the study. “We saw an increase in overall survival and quality-adjusted life years, resulting in an expected cost per QALY of less than $50,000 per patient, which is within the generally accepted threshold of <$100,000 for cost-effectiveness in the United States.”^1,2

The Pathwork Tissue of Origin Test, available through the Pathwork Diagnostics Laboratory, measures gene expression levels of 2,000 genes and uses proprietary algorithms to compare the tumor’s gene expression pattern to that of 15 tumor types, representing 58 morphologies and 90% of all solid tumors. The test provides objective genomic information to help the physician diagnose what type of cancer the patient has. An accurate diagnosis allows oncologists to match therapy to the cancer.
The Pathwork Tissue of Origin Test has been extensively evaluated in multiple independent studies involving more than 1,100 patient specimens, including large validation studies published in the Journal of Clinical Oncology and the Journal of Molecular Diagnostics.
A retrospective study of 111 cases from 66 academic and community oncology practices illustrates the use of the test in management of cancer patients. Over two thirds of the cases reviewed showed cancer management changed after the Pathwork Tissue of Origin Test result was received. The majority of the oncologists identified the Tissue of Origin Test results as influencing the decision to make a change in therapy.

For more information:  
http://www.genengnews.com/industry-updates/pathwork-tissue-of-origin-test-cost-effective-for-increasing-cancer-patient-survival/139175622/