Lung Cancer COPD ConfusionAugust 31st, 2009 by Sharon O'Hara
Lung cancer is almost entirely caused by smoking…just as in COPD and COPD kills more people per year than lung cancer and breast cancer combined.
A vast difference though is that COPD is a long slow smother without treatment other than inhaled steroids, several other inhalers, lung reduction and lung transplant while physical exercise beyond the shortness of breath and inhalers, is the single most important thing a COPDer can do to help them live a quality life
Lung cancer is usually faster from diagnosis to death since most lung cancer is not diagnosed until a late stage.
Because there is no proven screening process that can find it earlier while early detection is possible for COPDers with the simple Spirometry test …the only problem is finding a doctor willing to give the quick, inexpensive test….and the only opportunity to give the patient, if a smoker, a chance to change behavior knowing what lies ahead.
Keep in mind too, only about 20 % smokers develop COPD while about 80% COPDers were smokers. (Speaking of patient changing behaviors if the consequences and benefits are known…my next post here will challenge me to do what I preach and throw out a challenge)
According to Jennifer Croswell, MD, of the National Institutes of Health…” Low-dose computed tomography — now under study in two large randomized trials — has delivered significantly more false positives than chest X-rays…”
The false positives can lead to “… more invasive diagnostic procedures among patients screened with the low-dose CT, Dr. Croswell said at the annual meeting of the American Society of Clinical Oncology and “”False-positive results may create increased psychological stress in patients and an increased burden on the healthcare system…”
“According to the American Cancer Society, the five-year survival rate for localized lung cancer is 49.5%, but that falls to 20.6% for disease that has spread outside the lung and 2.8% if there are distant metastases.
The authors of the current study “break a little bit of new ground” in that they are looking at a study with a comparison group, according to Peter B. Bach, M.D., of Memorial Sloan-Kettering Cancer Center in New York.
But it has been known for some time that CT screening uncovers a
“very, very high” frequency of lung abnormalities — up to 50% in
one study and usually in the same range found by Dr. Croswell and
Such findings can be nerve-wracking for patients, he said, and can require invasive procedures to pin down the cause of the “abnormal thing in the lung.”
But “only very rarely is that thing a lung cancer,” he said. “
Complicating the issue, Dr. Bach said, is that for physicians,
the results of a CT scan that showed a minor abnormality are rarely
a Yes or No issue. Instead, he said, they may increase suspicion
and lead a doctor to follow a patient more or less closely.
The work of Dr. Croswell and colleagues, he said, adds to the available information, but “nothing really changes here. There is no organization in the world that recommends screening for lung cancer with CT” or any other technique.
“The status of the science is that (screening is) unproven, no one has ever shown it’s beneficial, numerous studies have shown it causes harm, and no one should be doing screening until we have randomized trials that are completed and show a benefit that outweighs all the harms,” he said.
On the other hand, “there is no question that CT screening will detect many lung cancers,” said Martin Edelman, M.D., of the University of Maryland Greenebaum Cancer Center in Baltimore.
The question is whether the approach will reduce the risk of
death and illness, while minimizing harm to patients, said Dr.
Edelman, who is on the independent committee verifying the
endpoints of the National Lung Screening Trial.
So far, there is still a “complete absence of evidence that this approach decreases mortality or morbidity due to lung cancer,” he said.
Advocates for screening “have long claimed that there is little
or no risk of harm, Dr. Edelman said, but Dr. Croswell and
colleagues “demonstrate that there is a small, but real potential
for harm from screening.”
What’s more, he said, “the potential for false positivity is highest in those at greatest risk for lung cancer.” “
More later… Sharon O’Hara
Tags: American Cancer Society, American Society of Clinical Oncology, Baltimore, breast cancer, chest x-rays, COPD, Dr. Croswell, Greenebaum Cancer Centet, Jennifer Croswell, Lung Cancer, lung reduction, lung transplant, Martin Edelman, MD, Memorial Sloan-Kettering Cancer Center, National Institutes of Health, National Lung Screening Trial, New York, Peter B. Bach, smoking, Spirometry test, steroids, University of Maryland