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It is now recommended that physicians discuss lung cancer screening with people who meet certain criteria that put them at higher risk for developing lung cancer.

The recommendations are based on the National Lung Screening Trial study, of which Penn Medicine was a part.

About the National Lung Screening Trial

The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer in high-risk smokers: low-dose helical computed tomography (CT) and standard chest X-ray.

The study aimed to find whether it is possible to detect lung cancers at an earlier more treatable stage such that there would be a decrease in cancer deaths.

Drew Torigian, MD, MA, associate professor of radiology at the Perelman School of Medicine at the University of Pennsylvania, served as the site principal investigator at Penn for this national study, which involved more than 53,000 patients in 33 different sites.

The results were encouraging.

CT scanning detected significantly more cancerous and pre-cancerous lesions than chest X-rays. However, finding lesions isn't enough. The study had to demonstrate that early detection actually saved lives. Preliminary results of the study showed 87 more lives were spared by helical CT as compared to chest X-ray screening, which translates into a 20 percent reduction in the death rate.

New Guidelines for Lung Cancer Screening in Heavy Smokers 

The new guidelines recommend doctors discuss lung cancer screening with high risk patients between the ages of 55 to 74 years and who are in fairly good health.

Patients must have a smoking history equivalent to a pack a day for 30 years, and currently smoke or have quit within the past 15 years.

If people decide to be screened, the recommendation specifies that testing should be done with a low dose computed tomography (CT) scan and take place at a facility with experience in lung cancer screening. And it emphasizes that screening is not a substitute for quitting smoking. The most effective way to lower lung cancer risk is to stay away from tobacco.

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are discussing new treatments for lung cancer including proton therapy for lung cancer.

"At Penn, we care about the total patient experience,” says John Kucharczuk, MD. “We know that for most people, the diagnosis of lung cancer is their first experience with this disease. As doctors, we need to recognize what that means to people, understand their anxiety level.”

New Treatments for Lung Cancer at Penn

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 treatments in radiation and proton therapies for lung cancer patients. 


"At Penn, we care about the total patient experience,” says John Kucharczuk, MD. “ We know that for most people, the diagnosis of lung cancer is their first experience with this disease. As doctors, we need to recognize what that means to people, understand their anxiety level.”

Surgery for Lung Cancer

At Penn, the highest quality of surgical care for lung cancer encompasses understanding what it means to have this disease and undergo treatment. Penn has one of the largest divisions of thoracic surgery in the country, one that includes a dedicated surgical unit staffed with nurses who care only for patients who have undergone this kind of surgery.

Surgeons work as a team with experts from other disciplines to assure optimal care for every patient, and are leaders in developing new technologies and approaches that minimize the invasiveness of surgery, while maximizing the therapeutic effect. These include innovative approaches to lung sparing surgery, robotic platforms and the use of photosensitizers to improve local control of tumors.

Skill and technology are critical, but underlying the Penn program is an active commitment to preserving quality of life for patients. To Dr. Kucharczuk and his team, that involves engaging with each patient to understand what quality of life means to that person, and working to tailor the treatment to the individual.

Radiation and Proton Therapy for Lung Cancer

"Lung cancer treatment is a 'team sport.' We see ourselves as a group of physicians who have the privilege of caring for you. Effective treatment is truly a partnership with our patients." Ramesh Rengan, MD.

For many lung cancer patients, radiation therapy is an important part of their treatment. Penn offers a number of options to patients with most kinds and stages of lung cancer. These include:

• Conventional radiation therapy utilizing 3-D imaging and IMRT
• Protons
• Stereotactic body radiation

Charles Simone, MD, emphasized that there are two major components in delivering effective radiation therapy to lung cancer patients.

• Where is the cancer? This means locating the tumor as precisely as possible. Penn is one of the few centers that has integrated PET scanning and metabolic evaluation of tumors into this process.
• How do we target the cancer? This means getting as much of the radiation dose to the tumor while sparing normal tissue.

The exact type of radiation used depends on the patient--the kind and extent of the cancer, and the overall health or other conditions that might exist. Newer options, such as stereotactic body radiation are making it possible to treat older, sicker or more advanced patients.

Proton therapy is another option for patients with locally advanced lung cancers, the most common diagnosis. Penn is one of only eight centers in the United States that offers proton therapy--a technique that allows more precise, targeted delivery of radiation to the tumor. Protons have the potential to reduce side effects from therapy while being equally effective in treating the cancer.

See all the presentations from the Focus On Lung Cancer Conference here. 

Cancer Information From a Reliable Source

Thank you for a fantastic 2012. The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

Kathy Brandt was diagnosed with non-small cell lung cancer in 2011 at her local hospital. After much research, and a recommendation from her brother-in-law, who is a physician, Kathy chose Penn Medicine for her lung cancer treatment, which included proton therapy. Today, Kathy is cancer free. 

Watch Kathy Brandt, a patient alum, tell her story about proton therapy for lung cancer. 

You hear the words cancer and it's truly terrifying.

It was basically just a checkup with my pulmonologist because I have emphysema. He sent me for a chest X-ray and that is when they found the tumor in my lung.

It was a terrifying time and thankfully I had strong family surrounding me - strong family helping me make decisions about what kind of treatment I should have.

After that initial diagnosis, when you feel like you have been hit with a ton of bricks, then the decision needs to be made where you are going to seek treatment. My brother-in-law, who is a physician, along with my pulmonologist suggested I go to Penn Medicine for treatment.

Penn Medicine was a wonderful choice for us. They used a team approach. I saw an oncologist, I saw a surgeon, and the radiologist is all located at Penn Medicine. It was very comforting to know that all these people are just working to take care of you and to make you better.

I was diagnosed with non-small cell lung cancer at the end of June. My surgery was the beginning of August and chemo started in September. It was finished in November. I started proton therapy for lung cancer in December, which lasted for 4 weeks.

Deciding to Have Proton Therapy for Non-Small Cell Lung Cancer

I decided to go with the proton radiation because of the cancer’s proximity to my heart and spine. I chose proton therapy because I knew it would be more precise and would have less side effects and that was very important to me.

The Proton Therapy Experience

Every day, I would leave work, come home, and my husband would take me to Penn for proton therapy. After the treatment, we’d go home and I’d spend time with my grandchildren and their parents, who were living with us at the time. My granddaughter was about 3 months old at the time. And I would take her, feed her, and just spend time with the people that meant the most to me.

I really felt wonderful. I continued to work the whole time I had proton therapy – I never missed a day of work, actually. I was a bit more tired than usual, but that was really the only side effect I felt.

When I completed proton therapy, I rang the bell. Everybody in the waiting room clapped, and we went home and I think I had a very big glass of wine after treatment was finished.

After Proton Therapy

Today, I don’t sweat the small stuff.

I would tell anyone to feel very comfortable going to Penn Medicine, and I would tell anyone to also feel very comfortable in choosing proton therapy simply because of the fewer side effects and its extreme precision. I would recommend Penn Medicine wholeheartedly. I cannot say enough good things about my experience.

Learn More About Proton Therapy for Non-Small Cell Lung Cancer at Penn Medicine

Proton therapy is a non-invasive, incredibly precise cancer treatment that uses a beam of protons moving at very high speeds to destroy the DNA of cancer cells killing them and preventing them from multiplying.

Unlike conventional radiation that can affect surrounding healthy tissue as it enters the body and targets the tumor, proton therapy’s precise, high dose of radiation is extremely targeted. This targeted precision causes less damage to healthy, surrounding tissue.

Learn more about proton therapy, or schedule a consultation with a radiation oncologist at Penn Medicine.

Watch the full video of Kathy's experience here. 

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 ways in which lung cancer tumors are being used to create new treatments for lung cancer.

Demystifying the Immune System

"Lung cancer is a formidable foe with many ways of eluding the immune system--but we are developing multiple approaches to using immunotherapy as a treatment option." Gregory Beatty, MD, PhD

Our immune systems are sophisticated, highly evolved and multi-dimensional. They look for and attack invaders. They fight infections, heal wounds and maintain our body health. But do they recognize and fight cancer? And if not, why not?

The answer is complicated. The immune system does, at least in some instances, recognize and attack cancer cells, including lung cancer cells--but in many cases, it fails to eradicate these cells. New research indicates that cancer cells actually develop ways of co-opting the immune system, teaching it to help the cancer grow and spread. This says Dr. Beatty is "bad education," and the goal of immunotherapy research is to re-educate the immune system to attack cancer cells.

At Penn, researchers are using a number of approaches. These include:

• Cancer cells have the ability to produce STOP signals that prevent the immune system from recognizing them. One approach to immunotherapy is to develop specific antibodies that go after these STOP signals and block them. One example is the PD-1 blocking antibody.
• CAR-T or chimeric antigen receptors use specially engineered killer T-cells to attack cancer cells. These T-cells are harvested from the patients, go through an amazing process by which they are "re-programmed" to attack the patient's tumor, and then re-injected. The results for several cancers have been promising--with trials scheduled to begin for non small cell lung cancers.

Right now, there are no immunotherapy agents approved by the FDA to treat lung cancer, but clinical trials are underway in patients with advanced disease, and are planned as adjuvant therapy for patients who undergo potentially curative surgery as a means of reducing the risk if recurrence.

To learn more about immunotherapy clinical trials at Penn, call Abramson Cancer Center Clinical Trials Service Toll Free: 1-855-216-0098, Local: 1-646-354-4221 Monday through Friday, 8:30 am to 5:30 pm or email ACCStudies@emergingmed.com

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 treatments in radiation and proton therapies for lung cancer patients. 


"At Penn, we care about the total patient experience,” says John Kucharczuk, MD. “ We know that for most people, the diagnosis of lung cancer is their first experience with this disease. As doctors, we need to recognize what that means to people, understand their anxiety level.”

Surgery for Lung Cancer

At Penn, the highest quality of surgical care for lung cancer encompasses understanding what it means to have this disease and undergo treatment. Penn has one of the largest divisions of thoracic surgery in the country, one that includes a dedicated surgical unit staffed with nurses who care only for patients who have undergone this kind of surgery.

Surgeons work as a team with experts from other disciplines to assure optimal care for every patient, and are leaders in developing new technologies and approaches that minimize the invasiveness of surgery, while maximizing the therapeutic effect. These include innovative approaches to lung sparing surgery, robotic platforms and the use of photosensitizers to improve local control of tumors.

Skill and technology are critical, but underlying the Penn program is an active commitment to preserving quality of life for patients. To Dr. Kucharczuk and his team, that involves engaging with each patient to understand what quality of life means to that person, and working to tailor the treatment to the individual.

Radiation and Proton Therapy for Lung Cancer

"Lung cancer treatment is a 'team sport.' We see ourselves as a group of physicians who have the privilege of caring for you. Effective treatment is truly a partnership with our patients." Ramesh Rengan, MD.

For many lung cancer patients, radiation therapy is an important part of their treatment. Penn offers a number of options to patients with most kinds and stages of lung cancer. These include:

• Conventional radiation therapy utilizing 3-D imaging and IMRT
• Protons
• Stereotactic body radiation

Charles Simone, MD, emphasized that there are two major components in delivering effective radiation therapy to lung cancer patients.

• Where is the cancer? This means locating the tumor as precisely as possible. Penn is one of the few centers that has integrated PET scanning and metabolic evaluation of tumors into this process.
• How do we target the cancer? This means getting as much of the radiation dose to the tumor while sparing normal tissue.

The exact type of radiation used depends on the patient--the kind and extent of the cancer, and the overall health or other conditions that might exist. Newer options, such as stereotactic body radiation are making it possible to treat older, sicker or more advanced patients.

Proton therapy is another option for patients with locally advanced lung cancers, the most common diagnosis. Penn is one of only eight centers in the United States that offers proton therapy--a technique that allows more precise, targeted delivery of radiation to the tumor. Protons have the potential to reduce side effects from therapy while being equally effective in treating the cancer.

See all the presentations from the Focus On Lung Cancer Conference here. 

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.

Learn more about CT scans to detect lung cancer.

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. 

Carly Roop RD, CSO, is a registered dietitian at the Joan Karnell Cancer Center (JKCC). She provides nutrition education and support to patients while addressing nutrition-related side effects from chemotherapy and radiation. Dietitians at JKCC provide educational nutrition programs that are open to patients as well as the community.

The American Institute of Cancer Research found compelling evidence that a diet high in fruit can lower lung cancer risk as much as 36% of those U.S. lung cancer cases not caused by tobacco. The AICR recommends eating at least 5 servings of a variety of fruits and vegetables every day!

This may seem hard to do, but the AICR makes it easy by suggesting you rethink your plate.

As a dietitian, my mantra is food first; there is convincing evidence that high-dose supplements of beta-carotene can actually increase lung cancer risk. Therefore, it is better to get your beta-carotene from vegetables such as carrots, pumpkin, and sweet potato.

In the food form, the phytochemical beta-carotene neutralizes free radicals, which may damage cells. The anti-cancer compounds found in cabbage and kale such as indole-3-carbinoles and isothiocyanates have also been linked to a lower incidence of lung cancer.

Sauerkraut anyone?

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses how basic science research can bring about new treatments for lung cancer.

"The answer lies in our DNA--the blueprint for life." Steven Abeida, MD

Basic science research is complex, but very important because it teaches researchers about how cancer cells grow and respond to treatment.

One way findings from basic science is translating into treatments for lung cancer is through personalized medicine. By studying the way cells act and interact within the body, researchers can explore more personalized approaches to lung cancer treatment.

Cancer occurs when cells grow and divide in an uncontrolled way. That sounds like a relatively simple statement, but the processes that control normal, and abnormal cell growth, turn out to be very complex. In fact, the more researchers learn about how cells behave, the more complex it becomes.

For lung cancer patients, there are several core concepts that can help you understand how unraveling the mysteries of DNA is leading to the new era of personalized medicine.

• Normal cell growth is carefully controlled. Cells only grow and divide when they get a specific signal to do so. Think about wound healing as an example.
• Normal cells are programmed to live for a period of time and then die. Cancer cells are often "immortal," meaning they don't "listen to or receive " the signal to die.
• Cell growth is controlled by genes that turn on and off as needed. Cancer occurs when these genes are damaged and the signaling is disrupted. It is as if you are driving a car and either the accelerator gets stuck in the go position, or the brakes fail.
• These genes don't work by themselves or in isolation. They are all part of pathways--sequences of inter-related reactions that regulate cell growth.
• Researchers have identified a number of "driver mutations” - specific genetic changes that are essential to the growth and survival of the cancer cells. These are the targets of new therapeutic approaches.
• Cancer cells are "smart." They continue to change and evolve, developing new ways of growing and resisting attacks from either standard treatments or newer targeted ones.

What does this mean for lung cancer patients?

Right now, doctors are able to identify several driver mutations in lung cancer and target those with therapies that block the pathways.

• EGFR is a mutation found in about 10% of patients with adenocarcinoma of the lung. It can be targeted with the drug erlotinib.
• ALK-1 is found in about 5% of lung cancer patients. The drug crizotonib is showing real promise in treating people with this mutation.

That' s only 15% of people who have lung cancer though. The goal now is to find more driver mutations, and to develop drugs that target known mutations. KRAS, for example, is found in a higher percentage of lung cancer patients, but there is currently no drug available that targets this mutation.

The real goal for the future is to be able to identify driver mutations in every tumor, and treat that tumor on an individual basis. That means full gene sequencing for every patient.

One obstacle to achieving that goal is the need for tissue, which come only from biopsies. Circulating tumor cells could prove to be another significant advance. This technology allows doctors to find tiny numbers of cancer cells in the blood; cells that can be used to profile tumors, monitor response to treatment and determine the best therapeutic approaches for every patient.

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses how the new treatments for lung cancer come about from research in the lab.

"We have a phenomenal interdisciplinary research program in lung cancer. It's really unique to Penn Medicine. We bring together the experts from every field, and our patients are always the center of everything we do." - Chi Van Dang, MD, PhD, director, Abramson Cancer Center

From the Lab to the Patient

Dr. Van Dang set the tone for the day in his introductory remarks when he stated the current goal of lung cancer research is to "move from remission to cure." The pathway to that progress is through what is known as translational research.

Translational research takes new knowledge from the laboratory and uses it to develop new approaches to cancer treatment.

For lung cancer, and many other cancers, that increasingly means being able to profile individual tumors, identifying specific genetic mutations and changes that provide targets for therapy. Penn Medicine is leading the way with a new Center for Personalized Diagnostics that will not only provide these critical services to patients but expand the research base by identifying new genes and ways to control their behavior.

The other "new tools" in the fight against lung cancer are coming from the field of immunotherapy--using the body's own immune system to recognize and fight cancers. Penn is a national leader in this emerging area of cancer therapy.

Learn more about the Center for Personalized Diagnostics.

Donna-Lee Lista

Donna-Lee Lista is a lung cancer survivor and an advocate for lung cancer research. In this blog, she talks about nutrition and prevention advice… and why sometimes, you just have to take all the advice with a grain of salt. 

Who does all the research about what foods you should and shouldn’t eat to avoid cancer? I’ve often questioned how accurate all this nonsense is. Then again can nonsense be accurate? I really get a kick out of these reports that say you can lesson your chance of cancer by eating this or doing that. Blueberries, for instance, are supposed to lower your risk of cancer. Eat a diet of fruits and vegetables and limit red meat. Make sure to exercise and only drink in moderation (a little helps your heart!).

The list goes on and on and on.

I followed it all! Most of it I did when I wasn’t even aware it was supposed to help prevent cancer. As a kid, I loved blueberries, and detested cigarettes and red meat. I was the one always stuck sitting at the dinner table poking at my steak, because I just couldn’t swallow it. I ate healthy - one of the few kids that loved vegetables when I was young. I played outside all day long, and got plenty of exercise.

As an adult I got all the recommended screenings, EARLY! Had a few wild drinking nights in college, but honestly only a few and as an adult never really drank much, and lately, not at all. There were many years as a teenager that I fried my skin at the beach. I actually wouldn’t have been surprised if I got melanoma, but no, I dodged that bullet. I actually got hit with the bullet that I didn’t even knew could be aimed my way!

So, it means one of three things: God only knows what would have happened to me if I didn’t do those things, my case is a head-scratcher for the scientific community, OR (and this is the one I’m going with) no one knows for sure – it’s pure luck. A combination of factors so diverse that it’s as complicated, and with as many variables, as picking the correct lottery numbers… while blindfolded and sleeping!

So, until we know with absolute certainty what the cure is, what absolutely works, or what is an official recommendation, everybody do everything in moderation, give a lot of money to cancer research, and take all the cancer prevention advice you read with a grain of salt.

Hey, a grain of salt…hmm- I wonder if anyone has looked into …?

Donna-Lee Lista

Donna-Lee Lista is a lung cancer survivor and an advocate for lung cancer research. In this blog, she talks about lung cancer research, and her hope for lung cancer research and treatment in the future.

When I see all that has transpired in the last few years regarding lung cancer research, I can’t help but hope that maybe all the work the advocates are doing has something to do with it. I want to believe we are making a difference and want to hope if we keep it up, we can see it through. Maybe it is a dream that doctors will completely cure lung cancer, maybe it is more realistic to strive for treatments that make it a chronic disease, but why not reach for the sun and if we have to settle on the stars that will be ok for a short while too? Once we get there, we re-group and keep on going.

My wish is that people will start feeling hopeful when all the latest research and development in lung cancer becomes common knowledge. I know that any cancer diagnosis is awful and not a club anyone wants to willingly join, but let’s face it, there are some cancers that offer a lot more hope than lung. But now, it won’t be so hard to find survivors to hold your hand through the ordeal because more are living longer and more are being cured. I recognize we have a lot to still accomplish, but compared to where we were, the train has really started to leave the station.

I know we are only at the threshold of a new world order for lung cancer, a precipice of sorts, and I understand there is a lot more to do. But, there is finally something to see in the rearview mirror, because we are moving ahead and that my friend is exhilarating!

Learn More About Lung Cancer Treatment at Penn

Join Penn Medicine’s Abramson Cancer Center and the Pennsylvania Lung Cancer Partnership for a day of information about lung cancer treatment and research, as well as, a chance to network with others at the 5th Annual Focus On Lung Cancer Conference.

Get information about lung cancer and these topics:

• Ask the Experts
• Diagnosis
• Chemo and Personalized Therapies
• Coping
• Integrative Medicine and Wellness
• Nutrition
• Proton and Radiation Therapy
• Research and Clinical Trials
• Risk, Screening and Prevention
• Robotic Surgery
• Symptom Management

Register for the Focus On Lung Cancer Conference at Penn

Date: Friday, October 12
Time: 7:30 am to 3:15 pm
Location: Hilton Hotel, 4200 City Avenue, Philadelphia, PA 19131
Register: Registration is free. Register for the 5th Annual Focus On Lung Cancer Conference here.

Join Penn Medicine’s Abramson Cancer Center and the Pennsylvania Lung Cancer Partnership for a day of information about lung cancer diagnosis, treatment and prevention as well as a chance to meet others at the 5th Annual Focus On Lung Cancer Conference.

Get information about lung cancer and these topics:

• Ask the experts
• Diagnosis
• Chemo and personalized therapies
• Coping
• Integrative medicine and wellness
• Nutrition
• Proton therapy for lung cancer
• Radiation therapy for lung cancer
• Research and clinical trials
• Risk, screening and prevention
• Robotic surgery
• Symptom management

The day will feature:

5th Annual Focus On Lung Cancer: A conference for those diagnosed with lung cancer and their loved ones that focuses on treatment, and coping with lung cancer.
2nd Annual CANPrevent Lung Cancer: A cancer prevention series that focuses on lung cancer risk, prevention and screening.

Who should attend?

Anyone who is facing a lung cancer diagnosis as well as their loved ones, are invited to attend these conferences.

Those who are at risk, or who want to learn about preventing lung cancers are also invited.

Register for the Focus On Lung Cancer Conference at Penn

Date: Friday, October 12
Time: 7:30 am to 3:15 pm
Location: Hilton Hotel, 4200 City Avenue, Philadelphia, PA 19131
Register: Registration is free.
Register for the 5th Annual Focus On Lung Cancer Conference here.

When it comes to lung cancer, the numbers are not good. More people in the U.S. die from lung cancer than any other type of cancer.






Consider these facts:

• In 2011, more than 220,000 Americans will be diagnosed with lung cancer and more than 156,000 people will die of lung or bronchus cancer.
• Smokers are 10 to 20 times more likely to get lung cancer. About 90 percent of lung cancer deaths in men and almost 80 percent of lung cancer deaths in women are due to smoking.
• There are more than 94 million current or former smokers in the U.S.
• Among both men and women in the United States, lung cancer is the second most common type of cancer, accounting for more deaths than breast cancer, prostate cancer, and colon cancer combined.

Screening uses tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 CANPrevent Lung Cancer Conference. You can view all the presentations from the conference here. In this blog, she discusses a presentation from Drew Torigian, MD, MA, about the National Lung Screening Trial, which compared cancer screens to detect lung cancer early.

Experts agree that if cancer is detected early, a patient has a better chance of recovery. The goal of detecting lung cancer early, however, has been elusive. 

Study after study has shown that standard chest X-rays do not detect early lung cancers. This is true even when X-rays are given on a regular basis to those at high risk for developing lung cancer. 

So how can lung cancer be caught earlier? And how can lung cancer deaths be prevented?

Lung cancer remains the second most common cancer in this country and the most common cause of cancer deaths. Additionally, lung cancer rates continue to rise in many countries around the world.


CT Scans for Lung Cancer
Computed tomography (CT) scans for cancer are more sensitive in finding lung abnormalities, and better able to detect more and smaller lesions. CT scans are, however, a more expensive technology than chest X-rays. They can also be non-specific in determining if abnormalities are lung cancers are benign nodules. 

The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer in high-risk smokers: low-dose helical computed tomography (CT) and standard chest X-ray.

The study aimed to find it is possible to detect lung cancers at an earlier, more treatable stage, and whether such screening would decrease cancer deaths.  

Drew Torigian, MD, MA, associate professor of radiology at the Perelman School of Medicine at the University of Pennsylvania, served as principle investigator at Penn for this national study, which involved more than 53,000 patients in 33 different sites. He described the results of this trial, the largest, most expensive randomized screening trial ever conducted, at the Abramson Cancer Center’s 2011 CANPrevent Lung Cancer Conference.

All clinical trials have a specific primary endpoint or goal by which success is measured. For the NLST, that goal was to determine if low dose CT screening could reduce the death rate from lung cancer among heavy smokers. Patients enrolled in the trial were current or past heavy smokers between the ages of 55 and 74. Half received regular chest X-rays while the other half received helical CT scans over a period of three years.

The results were encouraging.

CT scanning detected significantly more cancerous and pre-cancerous lesions than chest X-rays. However, finding lesions isn't enough. The study had to demonstrate early detection actually saved lives.Preliminary results of the study showed 87 more lives were spared by helical CT as compared to chest X-rays, which translates into a 20 percent reduction in the death rate.

While the NLST results are positive, Dr. Torigian points out there are many questions that still need to be addressed and answered before low-dose, helical CT scanning can be considered a standard screening procedure. Many of these questions relate to the overall costs and cost-effectiveness of implementing CT scanning programs, such as:

• Who should be get a cancer screen?
• How often should they be scanned?
• At what age should screening begin?
• Will insurance cover helical CT scanning?
• How many screenings are needed?
• What is the impact, both in cost and on the health of the participants of the high rate of false positives (non-cancerous, and generally non-clinically important lesions) found in CT screening?
• Are there biomarkers that will allow better targeting of populations that will benefit from this type of screening?

There are social policy questions as well, including the impact of undergoing CT screening on smoking behavior. Does the screening encourage people to quit, or give them a false sense of security?

Dr. Torigian stressed the unanswered questions do not detract from the importance of finding better ways to detect early lung cancers. Lung cancer is a global epidemic, and finding more early stage cancers will lead to better outcomes in treating lung cancer.

Watch all the presentations from the 2011 CANPrevent Lung Cancer Conference here.

Learn more about lung cancer treatment at the Abramson Cancer Center.

Proton therapy is external beam radiotherapy in which protons are directed at a tumor. The radiation dose that is given through protons is very precise, and limits the exposure of normal tissues. This allows the radiation dose delivered to the tumor to be increased beyond conventional radiation doses. The result is a better chance for curing cancer with fewer harmful side effects.

Unlike X-rays, protons can be manipulated to release most of their energy only when they reach their target. With more energy reaching the cancerous cells, more damage is administered by each burst of radiation while sensitive, healthy lung tissue is better protected from the effects of radiation.

Ramesh Rengan, MD, PhD, assistant professor of radiation oncology at Penn Medicine, evaluates the potential of proton therapy for lung cancer in this physician interview.

Listen to Dr. Rengan talk about the potential of treating lung cancer with proton therapy at Penn.

Penn's Abramson Cancer Center is hosting a free conference about preventing lung cancer on Friday, October 14.

Register for this free conference, or follow #LungCancerACC on Twitter on Friday, October 14 for live updates from the Focus On Lung Cancer Conference.

When it comes to lung cancer, the numbers are not good. More people in the U.S. die from lung cancer than any other type of cancer.

Consider these facts:

• In 2011, more than 220,000 Americans will be diagnosed with lung cancer and more than 156,000 people will die of lung or bronchus cancer.
• Smokers are 10 to 20 times more likely to get lung cancer. About 90 percent of lung cancer deaths in men and almost 80 percent of lung cancer deaths in women are due to smoking.
• There are more than 94 million current or former smokers in the U.S.
• Among both men and women in the United States, lung cancer is the second most common type of cancer, accounting for more deaths than breast cancer, prostate cancer, and colon cancer combined.

Screening uses tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.

In the past, no lung cancer screening test had been shown to lower the risk of dying from this disease. Studies involving spiral CT (or helical CT) have shown some promise in finding early lung cancers in heavy smokers and former smokers. So far, major medical groups have not recommended routine screening tests for all people or even for people at increased risk, such as smokers.

People who smoke, who smoked in the past, or who have been exposed to other people's smoke, as well as those who have worked around materials that increase the risk for lung cancer need to be aware of their lung cancer risk. They should talk to their doctors about their chances of getting lung cancer and the pros and cons of lung cancer screening.

For those who decide in favor of testing, the physicians in Penn Medicine’s Lung Cancer Program are experienced in lung scanning and the latest screening techniques for people at high risk.

For information about smoking cessation programs at Penn Medicine, visit PennMedicine.org/smoking or call 800-789-PENN (7366).

Join Our Lung Cancer Webchat Live from the Focus On Lung Cancer Conference
Lung cancer experts will answer questions about risk, diagnosis and treatment. Submit questions in advance, view and participate in the live webchat and read transcripts after the webchat.
Time: 12:15 PM, EST
Website: OncoLink.org/Webchat

When it comes to lung cancer, the numbers are not good. More people in the U.S. die from lung cancer than any other type of cancer.

Consider these facts:

• In 2011, more than 220,000 Americans will be diagnosed with lung cancer and more than 156,000 people will die of lung or bronchus cancer.
• Smokers are 10 to 20 times more likely to get lung cancer. About 90 percent of lung cancer deaths in men and almost 80 percent of lung cancer deaths in women are due to smoking.
• There are more than 94 million current or former smokers in the U.S.
• Among both men and women in the United States, lung cancer is the second most common type of cancer, accounting for more deaths than breast cancer, prostate cancer, and colon cancer combined.

Screening uses tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.