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PET scans help gauge lung cancer

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http://www.al.com/news/birminghamnews/i ... xml&coll=2

UAB study says process leads to optimal treatment

Thursday, August 04, 2005


News staff writer

A high-technology PET scanner is allowing doctors to better determine the lethality of lung cancer and to target tumors with the best treatments, according to a study announced Wednesday by a team of UAB researchers.

"It's an incredibly important and powerful study," said Dr. Robert J. Cerfolio, a thoracic surgeon at the University of Alabama at Birmingham who headed the research team.

The study adds scientific validity to what many doctors have believed for years - positron emission tomography, or PET, scans can precisely measure a lung cancer tumor's stage of development, or how soon it will kill a patient. In fact, the study showed, the PET scan is even better at predicting a patient's chance of survival than the established method of grading lung cancer, TNM cancer staging.

This is important because precisely staging lung cancer allows doctors to hit the disease with their most effective treatments - surgery, chemotherapy, radiation or a combination. It also keeps patients from undergoing unnecessary treatments.

The study involved 315 lung patients who went through normal TNM staging, which uses tests such as biopsies, chest X-rays and bone scans to determine a tumor's size and whether it has spread. Then, the patients went through a PET/CT scanner. Doctors followed patients for years to see their actual outcomes and then compared the two methods of staging to see which was better.

The PET scan was superior, Cerfolio said.

PET scans create ghostly images by measuring activity of a mildly radioactive solution. Mildly radioactive tracers are combined with compounds such as simple sugars, or glucose, to produce a solution that is injected into patients.

After being injected, a patient waits for an hour for the solution to travel throughout his body. Then the patient is moved through a doughnut-shaped PET scanner in an hour-long process that records signals from the tracers. A computer arranges the signals into ghostlike images of the human body.

UAB's scanner also includes computerized tomography, CT, which creates detailed images by X-raying cross-sections of a patient.

A new clarity:

These PET/CT images show cancer as it's never been seen before. Since cancer cells are highly active, the glucose solution is drawn to them along with the tracers.

A cancerous tumor will show up as a dark spot, and how much glucose is attracted to the tumor is called the maximum standard uptake value, maxSUV. It is this maxSUV reading that is the best gauge of a tumor's stage, researchers found.

Cerfolio said his team was able to conduct this research because of the high volume of lung cancer patients who come to UAB.

Alabama has one of the nation's highest rates of lung cancer - and of the behaviors that causes most of it, smoking. About 3,000 people a year die from lung cancer in Alabama, three times the number killed in traffic accidents.

Lung cancer has one of the lowest survival rates of all cancer - liver and pancreatic cancers are deadlier, but there are far fewer cases. When lung cancer is found before it spreads, patients have a 50-50 chance of living for more than five years, according to the American Cancer Society. If it has spread slightly, the chances of survival drop to 20 percent; and if it has spread to distant locations, the chances are 2 percent.

Lung cancer is more insidious than other cancers because there is no screening test for it. Contrary to popular belief, X-rays are not an effective method of screening. People usually learn they have lung cancer when they develop a persistent cough, begin spitting up blood, get chest pain or come down with recurrent pneumonia or bronchitis.

Results of the study were recently published in the Journal of Thoracic and Cardiovascular Surgery. Other members of the research team were Ayesha S. Bryant, Dr. Buddhiwardhan Ohja and Alfred A. Bartolucci.

E-mail: dparks@bhamnews.com

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Another thing certain areas of Alabama have is a very high incidence of Lung Cancer among never smokers who have NO second hand tobacco smoke exposure. I've mentioned that my Mom's family has been decimated by Lung Cancer in smokers and never smokers alike. They're from Alabama...

And the two other places I've been watching that appear to have the same kind of thing happening are ares in Michigan and Massachusetts.

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  • 4 weeks later...

There was a study in England. It showed that those who live within a certain distance of bus terminals had a (I think) 12X higher incidence of lung related problems.

I guess that makes sense but the study actually quantified this.

It was a small paragraph (that is all there was) in a Time magazine. Unfortunately I don't have the magazine anymore. I have not read the whole study

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