Evidence of the Impact of Environmental Tobacco Smoke in Never-Smokers: Correlations with EGFR Mutations


It seems obvious: environmental tobacco smoke (ETS)/passive smoke exposure from being around smokers, can be harmful and may cause cancer in never-smokers. A new paper in the Journal of Clinical Oncology by Lee and colleagues from Korea actually offers some evidence that highlights this, showing that never-smokers in Korea were less likely to have an EGFR mutation if they were exposed to ETS.

Get ready to throw out your Premarin (again): Thoughts on hormones and lung cancer


The role of hormones in the development and progression of lung cancer in women has generated much interest. Unfortunately, a lot of the data to date has been observational, which doesn't establish a "cause and effect" relationship. The Nurses Health Study (more on this below) is a good example: a large cohort of women was observed over time. The women completed questionaires on all sorts of exposures (diet, hormone replacement therapy, tobacco, etc), and they were followed over time.

An Important Piece of the Puzzle: Why Some Smokers Get Lung Cancer and Others Don’t


Admit it. You have probably wondered why you or your loved one was unlucky enough to get lung cancer while that obnoxious neighbor or coworker has smoked 2 packs a day for 50 years and doesn’t even have a cough. In fact, only about 15% of male smokers and 10% of female smokers eventually develop lung cancer. The field at large has been searching for why some smokers get lung cancer and others don’t for many years, and while progress has been made the answer has been elusive.

Surgery for T4 Tumors: The Importance of Local vs. Distant Failure Risk


People who have been following my comments know that I am often questioning the wisdom of surgery in patients who don't fit the usual criteria for resection, which is most commonly pursued in stage I and II NSCLC and is often considered an option for some patients with stage IIIA NSCLC. To provide a very quick review of NSCLC staging, it's a combination of three factors:

1) Tumor (T) stage -- from 1 to 4, going from smallest and easiest to remove to hardest or largest to remove

2) Node (N) stage -- from 0 to 3, going from none to further distances from the main tumor

Lung Nodule Growth Rate: An Important Factor in Assessing Risk of Cancer


A cancer has to grow faster than the tissue around it to become a tumor. Progressive growth is therefore a central feature of a cancer and a critical factor in distinguishing cancerous nodules from benign ones. There is a characteristic "volume doubling time" (VDT), the interval it takes for a nodule to double in volume. It's worth keeping in mind that because a nodule is generally spherical, an increase in the diameter by just 28% (such as a 2 mm increase from 7 to 9 mm) actually represents a doubling of the volume of a nodule.

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