Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new imaging and diagnostic advances for lung cancer.
Defining Risk, Reducing Deaths from Lung Cancer
The National Lung Screening Trial (NLST) demonstrated that regular, low dose CT screening for people at high risk of developing lung cancer reduces the death rate by 20 to 25%.That trial, the largest screening trial in history, also raised a number of questions.
- Who is at high risk? The NLST included people over the age of 55 with a 30 pack year history of smoking. Should that definition be broadened to include younger people, or those with less of a smoking history?
- What are the appropriate protocols for evaluating various types of lung lesions discovered on these CT scans? In some instances, the lesion is clearly a lung cancer--or clearly not one, but if you do CT scans of people's lungs, you discover a lot of lesions that are not as clear cut. Following those lesions can mean additional studies, or even invasive procedures such as biopsies. It is important to have low dose CT scans done in a center that has the expertise to evaluate and follow any findings.
- What is the appropriate amount of time after treatment to switch to low dose CT for follow up? Lung cancer survivors are also at higher risk of developing a recurrence of their tumors, or even a second cancer. Penn currently recommends making that change at the five-year mark.
Imaging for Lung Cancer is Critical
"It takes a village to care for a lung cancer patient." Andrew Haas, MD, PhD
Until they are diagnosed with a potentially serious disease such as lung cancer, few people realize what a critical role diagnostic radiology plays in the treatment process. The ability to "see" the tumor is essential to accurate diagnosis and staging, which is, in turn, essential to optimal treatment planning.
For lung cancer patients, the ability to both see and reach the tumor--and biopsy it in the least invasive way possible is also important. In order to do molecular profiling, now standard for lung cancer patients, it is necessary to have tissue for the pathologist to analyze. New imaging techniques and technologies are improving that process, allowing interventional radiologists to reach deep into previously inaccessible airways to visualize smaller and smaller tumors, and extract the needed tissue. The instruments they use are increasingly smaller and more flexible, often employing robotic technology and navigational aids much like the ones we use in our GPS systems.
The line between diagnostic radiology and treatment has all but disappeared. Today, Penn interventional radiologists treat common side effects of lung cancer and its treatment such as pleural effusion and airway blockages.
On the horizon....new imaging technologies that will make it possible to deliver therapies directly to the tumor.
View all the presentations from the 2012 Focus On Lung Cancer Conference here.
