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New Technique Could Help Avoid Unneeded Lung Cancer

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Tuesday, August 23, 2005

By Miranda Hitti

•Screening, Treating and Surviving Lung Cancer •Better Predictor of Lung Cancer Survival? •Peter Jennings Loses Battle With Lung Cancer •WebMD Takes a Closer Look at Cancer •Visit WebMD's Cancer Health Center

Efforts to rein in lung cancer, the No. 1 cause of cancer death for U.S. men and women, continue to be a top health priority for doctors and patients alike.

The latest finding: A minimally invasive procedure may help gauge lung cancer stage, which could curb unneeded surgery in some patients.

The finding appears in The Journal of the American Medical Association. It comes from researchers including Jouke Annema, MD, PhD, of the pulmonary medicine division of Leiden University Medical Center in the Netherlands.

Screening, Treating and Surviving Lung Cancer

Searching for Disease

The procedure is called transesophageal ultrasound-guided fine needle aspiration, or EUS-FNA.

In EUS-FNA, doctors use ultrasound technology to guide a fine needle to lymph nodes in the lung. The needle harvests cells from the lymph nodes. Those cells are checked for signs of cancer.

That test was used on some of the 100 lung cancer patients in Annema's study. All of the patients had non-small cell lung cancer, the most common kind of lung cancer, according to the American Cancer Society.

Every patient in the study also got another test called mediastinoscopy. Doctors inserted a scope through a tiny hole in the chest to look at the patients' lungs; tissue samples can be taken and examined by this method.

Combining both tests gave doctors a better idea of lung cancer stage than either test by itself. The tests may complement each other, the researchers note.

Lung cancer staging helps determine how a person with lung cancer will do in the long term. It determines whether a person has cancer that is limited to the lung or has extended to other parts of the body. Lung cancer that has spread to distant sites may not require surgery.

Better Predictor of Lung Cancer Survival?

Goal: Better Diagnosis and Treatment

Better lung cancer staging might cut unneeded lung cancer surgeries, write the researchers.

They note that up to 40 percent of thoracotomies (partial or total removal of a lung) for non-small cell lung cancer have been reported to be unnecessary due to imperfections in determining the extent of the disease prior to surgery.

The researchers estimate that 16 percent of thoracotomies in their study could have been avoided by using EUS-FNA findings in addition to mediastinoscopy.

But the tests weren't perfect. A small number of the EUS-FNA tests (2 percent) yielded results which appeared to be positive for cancer but actually were not.

The researchers call for more studies of these abnormal results.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: Annema, J. The Journal of the American Medical Association, Aug. 24/31, 2005; vol 294: pp 931-936. American Cancer Society: "What Is Lung Cancer?" WebMD Medical Reference from Healthwise: "Lung Surgery (Thoracotomy) for Lung Cancer." News release, JAMA/Archives.

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