Understanding Updated Guidelines for Lung Cancer ScreeningIf you or a loved one has a history of smoking, screening for lung cancer is important for prevention for the disease. Updated guidelines released in 2021 have expanded which patients should be…
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April 26, 2023
Cancer
If you or a loved one has a history of smoking, screening for lung cancer is important for prevention for the disease. Updated guidelines released in 2021 have expanded which patients should be screened. Learn about the new guidelines, explains who should consider getting screened for lung cancer, and outlines what to expect during the screening. |
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Women Are More Likely to Get Lung CancerLung cancer is the leading cause of cancer death in women, killing more women each year than breast, ovarian, and uterine cancer combined. Yet, lung cancer is also the most preventable cancer.…
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The Most Dangerous Cancer for Women Isn’t Breast CancerThe fight against breast cancer understandably has received much attention, but many women would be surprised to discover that lung cancer is a bigger threat to them. Dr. Kirtly Jones spells out the…
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November 20, 2014
Family Health and Wellness
Womens Health Dr. Jones: The number one cause of cancer deaths in women? Most women would say breast cancer, but its lung cancer, and although the rate of lung cancer in men is falling, lung cancer deaths in women is rising. This is Dr. Kirtly Jones from the Department of Obstetrics and Gynecology at University of Utah Health Care and November is Lung Cancer Awareness Month. Lung cancer in women, today on The Scope. Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope. Dr. Jones: The white ribbon. We see pink ribbons everywhere for breast cancer, teal ribbons for ovarian cancer, but where are the white ribbons for lung cancer? The CDC reports that more women die of lung cancer than breast, uterine, and ovarian cancers combined. Twenty-seven percent of all cancer deaths in the US are caused by lung cancer. The five year survival rate for those diagnosed with lung cancer is 16%, which makes it a particularly deadly cancer. Now, the lung cancer rate has fallen 21% among men, but for reasons that remain unclear, the rates have risen 116% among women. Of course, we all know that smoking is the major risk factor. Since 1960, the rate of smoking in men has gone down, but for women, not so much. Lung cancer develops differently in women than men. Women who have never smoked have a greater risk of developing lung cancer than men who've never smoked. Go figure. Worldwide, 53% of women with lung cancer were never smokers. They could have been exposed to more indoor air pollution related to cooking and heating, and that may be the risk factor for women in Asia and in China and somewhat in the United States. Women tend to develop lung cancer at a younger age than men, too. The good news is women are more likely than men to be diagnosed in early stages of lung cancer, because women probably get more health care, and women tend to live longer than men after treatment for lung cancer. So, that's the good news. Well, I'm thrilled to live in Utah where smoking is so uncommon, and where it's against the law to smoke in enclosed public places. However, a notable trend in the increase in lung cancer among healthy non-smokers is known primarily in women. If lung cancers in non-smokers were its own category, it would rank among the top 10 of fatal cancers in the US. Lung cancer can result from factors other than smoking. Genetic mutations, as well as exposure to radon gas, secondhand smoke, air pollution and asbestos, among some other things. In Utah, we have particular geographic risks related to radon and air pollution. So, what to do for this largely preventable, common cancer? If you're a smoker, you should stop smoking. Ten years after quitting, your risk of lung cancer is half of what it would have been if you didn't quit. If you're a heavy smoker over 50, talk to your doctor about the pros and cons of low dose CT scans for screening. If you aren't a smoker, don't start. If you're an adolescent or the parents of one, starting smoking is especially bad, as you're more likely to be addicted to nicotine, and have your developing brain wired for risky behavior, like alcohol. Lowering your risk of secondhand smoke. If someone in your family smokes, no smoking in the house or in the car. Check your home for radon. Now, radon is a naturally occurring radioactive gas that results from the breakdown of uranium and soil and rocks. It cannot be seen, tasted, or smelled, and according to the EPA, radon is the second leading cause of lung cancer in this country, and it's the leading cause among non-smokers. Outdoors, there's so little radon that it's not likely to be dangerous, but indoors, radon can be more concentrated. When it's breathed in, it enters the lungs and exposes them to radiation. Homes in some parts of the US, like Utah, which are built on soil with natural uranium deposits can have high indoor radon levels, especially in basements. My basement is ventilated and has a fan in it specifically for that reason, and I live here in Salt Lake City. If you are concerned about radon exposure, you can use a radon detection kit. State and local offices of the EPA can give you the names of reliable companies who can test your home. So get it checked and get it fixed. Limit your time on the freeway and be an advocate for clean air. Eat your fruits and vegetables. Antioxidants in your diet is associated with lower risk of lung cancer. Vitamin pills won't do the trick. So, ladies and gentlemen, put on your white ribbons this month. Lung cancer is largely a preventable disease. Think about the air you breathe and what's in it. Protect yourself and the people around you. This is Dr. Kirtly Jones and thank you for joining us on The Scope. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |
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A New Tool to Confront Lung CancerOnly 15% of patients with lung squamous cell cancer – the second most common lung cancer – survive five years past diagnosis. Trudy Oliver, Ph.D., Huntsman Cancer Institute investigator…
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June 19, 2014
Cancer
Health Sciences Announcer: Examining the latest research and telling you about the latest breakthroughs. The Science and Research Show is on the Scope. Host: Only 15% of patients with squamous cell lung cancer survive to five years past their diagnosis. It is a difficult cancer to treat. My guest, Dr. Trudy Oliver has developed a new tool for understanding the disease and developing targeted therapies. Dr. Oliver, you've developed a mouse model for lung squamous cell carcinoma. Why is this important? Dr. Trudy Oliver: This is really important because, up until now, we've known very little about this disease. Most patients with squamous cell carcinoma are treated with chemotherapy and when that doesn't work, patients really don't have any second line treatments. Whereas for other lung tumor types, over the past 10 or 20 years, there've been tremendous advancements in developing targeted therapies and we really lack these targeted therapies for squamous cell carcinoma of the lung and one of the reasons why our understanding of this disease has lagged behind is because we don't have good model systems. Host: And in the process of making this model for lung squamous cell carcinoma you've made some important discoveries about what triggers formations of these tumors. Dr. Trudy Oliver: That's right. So in 2011 a group called the Cancer Genome Atlas sequenced about 200 human squamous tumors and in that process they discovered the genes that are most frequently altered in the disease, one of which is called SOX2 . So SOX2 is frequently overexpressed or highly expressed in the human squamous tumors and so we took a unique approach to use viruses to deliver genes to the mouse lung that we think are important drivers of the disease. And so we put SOX2 in viruses and delivered them to the mouse lung by having the mice inhale the viruses and the viruses then allow the expression of SOX2 in the mouse lung. This in combination with other - specific other hits in the lung that we engineered - led to the exclusive development of squamous lung tumors. Host: When you tested these in mice, I mean, did you think it would work or did you think it would work as well as it did? I mean I don't know. It seems kind of amazing to me actually. Dr. Trudy Oliver: It definitely felt like... and that's probably why it was so exciting is it definitely felt like this is a longshot and part of the reason why it was a longshot was our approach. So we knew that these genes were important and we knew that if we made genetically engineered mice, that costs thousands and thousands of dollars and take years to develop, we believed we'd ultimately have a model but we didn't know what combination to use. Host: Oh, I see. Dr. Trudy Oliver: So realistically, to test every important combination would take millions of dollars and five, ten years and I knew that I couldn't afford to do that. So the longshot was we said, let's take advantage of these viruses that will allow us to develop - to deliver many genes in a short amount of time with a lot less money but, technically, to deliver these genes is not an easy thing. So we infected a lot of mice with a lot of genes in different combinations and then we monitored the mice by micro-CT imaging. Host: Yeah. Dr. Trudy Oliver: The whole lab was excited and screaming and running around high-fiving each other. Just to see this blob in the lung. And once we started seeing the second tumor and the third tumor, we knew we were on to something. Host: So how similar are these tumors in the mice to what humans get? Dr. Trudy Oliver: They are remarkably similar. In fact, I would say that a pathologist, looking under the microscope at our tumors, would not know it's from the mouse. They would think they're looking at the human disease. So they visually look like human tumors and then when we stain them for biomarkers of the human disease, which are used to diagnose that this is a human squamous tumor, our mouse tumors light up for those markers. Host: In your model you actually combined two changes to gene expression, right? So there was the SOX2 change and then one of another gene... Dr. Trudy Oliver: That's right. Host: Lkb1. Dr. Trudy Oliver: So SOX2 expression alone in the mouse lung doesn't really do anything in terms of cancer. But what we found is that when we combine that with loss of this gene called Lkb1, which is also called a tumor suppressor, what we found is that that led to squamous cell lung tumors. Host: So help me understand how, like, if someone were to develop this kind of cancer, how it might happen. Would they inherit one of those mutations first or you just don't know, sort of, the sequence of events that would lead to those changes and tumor formation? Dr. Trudy Oliver: So we know that in many cases in cancer, having just one genetic change is not sufficient to make a tumor. It usually requires two or three or seven hits, as we call it, to - for cancer to develop. We know a lot of things in our environment that predispose to cancer. Smoking is definitely one of the biggest risk factors for lung cancer but there're other things, like, asbestos exposure, radon exposure, which is common in Utah. Poor diet, lack of exercise, any of these things can lead to cell stress in the body and when we undergo any kind of cell stress, which could be from our environment but could be just the internal workings of our cells, this can lead to mutations. Host: What do you intend to do with this model now? Dr. Trudy Oliver: Well, this model is really the first step now to begin to understand the disease like we've wanted to do and so there are so many exciting things that we can use this model for. One of which is to really understand what is the cell of origin of this tumor. What lung cell type do these hits, SOX2 and Lkb loss, arise in that lead to the development of this specific tumor type? Announcer: Interesting. Informative. And all in the name of better health. This is the Scope Health Sciences Radio. |
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Silent Killer: Radon Is the 2nd Leading Cause of Lung CancerRadon is radioactivity that seeps up from the ground, stays in closed spaces, sits on your lungs’ surfaces and causes lung cancer; it’s a silent killer and most people are unaware of it.…
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January 02, 2014
Cancer Scot: We all know the number one cause of lung cancer but do you know what number two is? That's coming up next on The Scope. Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope. Scot: Smoking is the number one cause of lung cancer but what about number two? Dr. Wallace Akerley from Huntsman Cancer Institute, what is the second cause of lung cancer? Dr. Wallace Akerley: Well radon is the second leading cause of lung cancer in the United States, probably responsible for approximately 20,000 cancer deaths per year. People aren't aware of it. It's a silent killer. Its radioactivity, it seeps up from the ground and it stays in closed spaces. It can sit in your house. If anyone inhales it this radioactive material sits on your lung surfaces and it causes lung cancer. So first off people don't know that it causes lung cancer and secondly they don't know that it's around. Scot: Sure. And here in Utah from what I understand it's quite a bit worse than a lot of other places in the United States. Dr. Wallace Akerley: We've done testing in the state and been able to collect that data and it seems one in three houses in the state of Utah has excessive levels of radon. Scot: So exactly how dangerous is radon? Dr. Wallace Akerley: It's mostly dangerous if you don't know that it exists. One has to test for it and you can find that it's there. I work in a lung cancer clinic and I see patients with lung cancer every day. The majority of the patients I see actually are no longer smokers but we see maybe a third of patients who have never used a cigarette in their life. And people just assume lung cancer and cigarettes go together but in this circumstance radon is a very big cause, maybe 15% of all lung cancers in the United States are due to radon. Scot: If my level of radon is high does that pretty much guarantee me that I'm going to be getting lung cancer? I mean, at the end of the day I see its high, how concerned do I really need to be? Dr. Wallace Akerley: It depends on whether you're a smoker or not a smoker. If you are a non-smoker it gives you a lifetime risk of approximately 1%... Scot: Okay Dr. Wallace Akerley: ...chance of developing lung cancer. On the other hand, if you're a smoker there's terrible synergy unfortunately and your risk goes up about eightfold. Scot: And it sounds like testing is the best first step. Dr. Wallace Akerley: It's the only first step. You have to know that it exists and one can measure it quite easily. In fact, the majority of the states in the US have laws that require testing or at least that people be made aware. The state of Utah has called on all businesses, institutions, physicians, schools, etcetera to go out and have your houses tested. Scot: Is it something I have to hire somebody to do or can I get a testing kit on my own? Dr. Wallace Akerley: Testing kits are easy to obtain and easy to perform. So the Department of Environmental Quality has made arrangements for a test to be provided to residents of the state at a low cost. Radon.utah.gov. At that website one can sign up for a test and the test costs $7. Basically it's a canister, you put it in your basement, keep it two feet from the floor or the ground. Open it up, leave it there 48 hours, send it in. A result will come back to you and it will tell you if your levels are high, normal or excessive and whether you should do something about it or not. Scot: So my levels are high let's say in the test. What do I do then? Dr. Wallace Akerley: It's actually fairly easy to fix. Sometimes something as simple as sealing your basement will help out. More often than not though some sort of a remediation or mitigation test has to be performed. What they do is they put a pipe that goes from below your basement to the roof of the house and it eliminates the radon gas that would seep up to your house, it lets it bypass the house going through the pipe. Scot: Do you know, right now is that part of building code or is that something I have to tell my contractor if I'm getting a new house, "I want this." Dr. Wallace Akerley: You will find some contractors tell you. Scot: Okay. Dr. Wallace Akerley: Because it is something they offer that others don't but it is not part of code. Scot: Okay, all right. Do you have any final thoughts on the topic of radon? Dr. Wallace Akerley: Most important issue is to be aware that it exists. If you know that it exists you can do something about it. The test can be obtained at radon.utah.gov and they are very, very cheap. If you go to the local store it'll be much more expensive. Announcer: We're your daily dose of science. Conversation. Medicine. This is The Scope. University of Utah Health Sciences Radio. |
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Non-Smoking Causes of Lung CancerThe stigma associated with lung cancer is that it’s a smokers’ disease and they’ve brought it on themselves. While it’s true that 90 percent of lung cancer cases are smoking…
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December 02, 2013
Cancer
Family Health and Wellness Host: Did you know even if you're a non-smoker, just because you live in Utah you have an increased chance of getting lung cancer? We're going to talk with Dr. Shamus Carr of Huntsman Cancer Institute about what's causing that coming up next. Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio. Host: Lung cancer, what causes it? I think everybody thinks it's only smoking. Dr. Carr: Well, 90% of patients who get diagnosed with lung cancer, it is related to smoking. However, what's interesting is that there's 10% who do not. More interesting is here in the state of Utah 30% are non-smokers. Host: Really? What's the cause of that? Dr. Carr: There's a lot of things that have been proven to be the cause. Radon, which is a colorless, odorless gas which is in the basement of pretty much everybody's home here in the state of Utah, is a risk factor. Host: Why is it so predominant here? Dr. Carr: It's the geology, so it just comes up through the ground and here it is. Additionally, we make homes so well today, they are air tight. They keep the cold out. In the winter they keep the heat in. In the summertime they keep the heat out and they keep the cool in. If you have a colorless, odorless gas that's coming up through your basement it's not going anywhere. You run your air conditioner all summer, that air doesn't go anywhere. It just keeps recirculating in your house. Host: What about the inversions that we get? Dr. Carr: That's a great topic, and I think we're going to learn a lot more about that here in the coming years, pollution in general. In fact, there was just a recent study that just came out of China where they looked at the incidence of smoking over the last thirty years, and it hasn't changed. They smoke a lot over there, but the amount of smokers hasn't changed by percentage. Host: We talked about radon. We talked about air pollution, not necessarily proven yet, but likely. Dr. Carr: Very likely. Host: What are some other reasons we've got this 30% incidence of lung cancer in non-smokers here in Utah? Dr. Carr: I think there is also, believe it or not, we're going to find that there's going to be a genetic component. I think there are people out there whose bodies are essentially predestined for this. I've met a number of families, non-smokers, dad died of lung cancer and they said, "Oh, well he worked in the mines," so they kind of attributed it to something else. Then all of a sudden there's somebody else who's got lung cancer, then somebody else. We're starting to see that kind of issue. Host: Is there research currently going on looking into this? Dr. Carr: Yes. Host: When do you think we'll see some results? Do you have any idea? Dr. Carr: As soon as the person who's pulling the data gives it to me. We had a meeting just recently about this. The preliminary data is very striking, very striking that there's going to be a genetic component that we can start talking about in lung cancer, but not yet published. Host: You're saying that 30% of people who get lung cancer in the state of Utah are not smokers, so even though I don't smoke I've got an increased chance just because I live here. Is there a stigma attached to people who get lung cancer in general because for so many people it is because of smoking? Dr. Carr: Yeah, you know, I think there is. It's a shame because it's like, "Oh, they did this to themselves. They were bad people. They smoked cigarettes. They weren't healthy." I think that we need to get beyond that. I think this is a multifactorial problem. The incidence of smoking in the United States continues to decrease, in fact, nationally we're under 20% for the second year in a row. Host: We're your daily dose of science, conversation and medicine. This is The Scope, University of Utah Health Sciences Radio. |