Scans - PET-CT, etc.

The much-anticipated manuscript from the NCI-sponsored National Lung Screening Trial (NLST) was just published on line in the New England Journal of Medicine, with an editorial by Dr. Harold Sox.

For years and years, lung cancer advocates have often aggressively championed screening for lung cancer, while many in the medical "establishment" and policy-makers expressed reservations that, while there were encouraging indicators of benefit, there was not evidence that lung cancer screening saves lives, so we really couldn't make a blanket statement encouraging lung cancer screening.

Over three and a half years ago, I wrote a post about about early work looking at the possibility that a PET scan done anywhere from three days to a month out from the start of a new systemic therapy (chemo or EGFR inhibitor) for advanced NSCLC could be predictive of a good outcome or not.

Here is the second case in my expert round table discussion on locally advanced NSCLC with medical oncologist Dr. George Blumenschein froMD Anderson Cancer Center and radiation oncologist Dr. Walter Curran from Emory University.

A radiologist, the person who specializes in reviewing imaging studies in medicine, is often someone you notice if they're unusually bad or unusually good. They perform a service and you presume that they're good at it, but a few are so sharp that the other doctors they work with notice it at every tumor board discussion or one on one exchange.

On March 24, 2009, Dr. West wrote,

This is the first of the presentations by guest speakers at our NSCLC Patient Education Forum back in September. Dr. Gerard Silvestri is a pulmonologist, a lung disease specialist (not only cancer), and he is also one of the most important leaders in lung cancer within the field of pulmonology, as both a writer of some very important work and as a great speaker.

Over the lasat decade, PET scans have become commonplace in the staging of NSCLC. There's an older post that reviews the concept of PET scans in providing metabolic imaging, as well as a podcast that provides a more complete discussion of PET scanning in oncology, with a focus on lung cancer.

There is nothing more disheartening to the patient, and quite frankly for the treating oncologist, than have to hear (or say) the words “I’m afraid the treatment isn’t working”. The scientific term is “disease progression”, but the reality is that the cancer is growing despite the treatment and it doesn’t take an expert to know that isn’t good news.

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.