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Delays in Lung Cancer Care More Common in Public Hospitals  

The length of time a patient has to wait between lung cancer diagnosis and treatment is influenced by a number of health-care system factors, a new U.S. study finds.

Researchers at the University of Texas Southwestern Medical Center analyzed data on 482 patients diagnosed with non-small cell lung cancer.

They found that factors such as type of hospital (private or public), insurance coverage, age and race have a major impact on the time it takes for a patient diagnosed with lung cancer to receive treatment.

For example, 59 percent of patients treated at a public hospital had advanced (stage 3) lung cancer, compared with 37 percent of patients treated at a private hospital. The researchers also found significant differences in patient populations at public and private hospitals in terms of age, race and socioeconomic status. . . .

The study appears in the November issue of the Journal of Thoracic Oncology.

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Five-Minute Survey Can Help Predict Lung Cancer  

A simple questionnaire can identify patients at high risk for lung cancer, researchers say.

In a study that began in 2001 with 1,000 people in Colorado who were seeing their primary care physician for general health issues, patients were asked to complete a five-minute questionnaire that collected information about lung cancer risk factors, including smoking, family history, exposure to chemicals and work environments.

Based on their responses, 430 patients were considered to be at high risk for lung cancer. Of those, 126 underwent a non-invasive breath measurement test called spirometry. Among patients who were found to have airflow obstruction, 88 underwent a full lung cancer screening. Five years later, lung cancer was confirmed in eight patients with obstructed airflow and in 10 patients without obstructed airflow, the researchers reported. . . .

The study is published in the November issue of the Journal of Thoracic Oncology.

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Smoking-related lung disease rising in Queensland  

A survey by the Australian Lung Foundation found 46 per cent of Queenslanders aged over 35 admit to being smokers, or to having been smokers in the past.

Dr Kwun Fong from Brisbane's Prince Charles Hospital says 600,000 cases of lung disease were reported in Queensland between 2007 and 2008.

He says smoking is one of the most common causes.

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11.5% rise in female deaths from lung cancer  

More women in Scotland are dying from lung cancer, while rates of the disease among men have fallen, new statistics have shown.

Death rates from the disease rose by 11.5% for women over the past 10 years, compared with a drop of 21% for men. A total of 4000 people now die from the condition every year.

The rise in female mortality, outlined in the figures published by ISD Scotland, bucks the overall trend for cancer deaths, which dropped by 7% in the decade to 2008.

But the new statistics reveal the extent of the health divide in Scotland, where people living in the most deprived areas are 75% more likely to die from cancer than those in the richest areas. They are also 40% more likely to be diagnosed with any form of the disease, with rates of lung and cervical cancer particularly high among poorer sections of society.

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• More Scottish women die of lung cancer 

Soaring numbers of Scottish women are dying of lung cancer despite survival rates among men improving significantly, new figures show.

The increase also bucks the trend for death rates from other types of cancer north of the Border, all of which are going down.

Lung cancer deaths in men plummeted by 21 per cent in the 10 years to 2008, but increased by more than 11 per cent among women. . . .

However, the figures also reinforced major health differences across Scotland, with those living in the poorest areas 40 per cent more likely to have cancer than those in the wealthiest neighbourhoods.

Death rates in the most deprived communities are 75 per cent higher than those in the richest areas.

Dr Richard Simpson, Scottish Labour health spokesman, said: "I welcome the general improvement in cancer survival rates, but I am both disappointed and deeply concerned that more women are dying of lung cancer.

"This mainly reflects the increase in smoking among women over the past 20 years."

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• Is Smoking Tougher on Women?  

Women may be more vulnerable than men to the carcinogens and other noxious substances in cigarette smoke, a growing body of research suggests.

In one study of nearly 700 people with lung cancer, Swiss experts found that women tended to be younger when they received the diagnosis, even though they smoked less than the men who developed lung cancer.

In another study, researchers from Harvard University and the University of Bergen in Norway evaluated more than 950 men and women with chronic obstructive pulmonary disease (COPD), known to be linked to smoking. The result: The women with COPD were younger when they got the diagnosis and had smoked less than the men with the respiratory ailment.

"Maybe women are more susceptible to the lung-damaging effects of smoking," said Dr. Inga-Cecilie Soerheim, a visiting research fellow at Harvard and a researcher at the University of Bergen, who led the COPD study. She presented the findings in May at the American Thoracic Society's annual conference.

In fact, several other studies in the past 20 years have suggested that female smokers may be more susceptible to lung cancer than male smokers.

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Massachusetts Supreme Court: Smokers Can Pursue Medical Monitoring Costs Against Philip Morris 

To the casual observer, tobacco litigation may seem very 1990s. But could it be making a comeback? A decision Monday by the Massachusetts Supreme Court hints that it's trying.

The court ruled that plaintiffs in a purported class action pending in federal court can pursue claims against Philip Morris USA for medical monitoring expenses even though they have not been diagnosed with smoking illnesses. In a unanimous opinion written by Justice Francis Spina, the court noted that theories of negligence have to be updated. . . .

Steven Phillips of Levy Phillips & Konigsberg, an attorney for the plaintiffs, told us that in fact most states have not addressed medical monitoring. He called the Massachusetts opinion "carefully thought out," and predicted that other courts would find it persuasive. He was also upbeat about the prospects of class certification. "I rather like my chances," he said.

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• DONOVAN v. PHILIP MORRIS USA, INC.  

In this case, it is not merely the risk of cancer of which the plaintiffs have notice, but the substantial increase in the risk of cancer, as reflected in their complaint. Because the harm involves subclinical changes that only will be discovered by a physician, notice most likely will take the form of advice by a physician, together with a recommendation for diagnostic testing conformably with the medical standard of care. In short, the statute begins to run when (1) there is a physiological change resulting in a substantial increase in the risk of cancer, and (2) that increase, under the standard of care, triggers the need for available diagnostic testing that has been accepted in the medical community as an efficacious method of lung cancer screening or surveillance.

As previously discussed, medical monitoring expense is the plaintiffs' only arguably provable damages. They could not have sued for pain and suffering or lost earning capacity. This is not a case where plaintiffs recovered damages for pain and suffering, lost earning capacity, but only some medical expenses based on existing medical technology. These plaintiffs, or so they allege, had absolutely no remedy until LDCT technology appeared. If they can establish these circumstances, which are unusual and perhaps unique to medical monitoring claims, then their claims are timely. This is a question that cannot be resolved on the record before us; it must be resolved on a motion for summary judgment or, if genuine issues of material fact remain, by a jury. The plaintiffs also must show that the standard of care of the reasonable physician did not call for monitoring of any precancerous condition prior to the statute of limitations period, not just that the technology at that time was less effective for monitoring.

We answer the second certified question in the negative, subject to determination as we have outlined it.

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SJC rules Philip Morris may have to pay for smokers’ chest exams  

The state's high court said yesterday that cigarette maker Philip Morris USA may have to pay for diagnostic chest exams so smokers can get early warning they have developed lung cancer, possibly opening a new front in tobacco liability lawsuits.

In a unanimous ruling, the Supreme Judicial Court said Massachusetts law has an antiquated definition of negligence. Historically, plaintiffs had to show explicit injury, such as a broken leg, before the other party can be ordered to pay for diagnostic tests.

Writing for the court, Justice Francis X. Spina said that such legal thinking must change. "We must adapt to the growing recognition that exposure to toxic substances and radiation may cause substantial injury, which should be compensable, even if the full effects are not immediately apparent,'' he wrote.

The court's decision means that a lawsuit filed by two Massachusetts smokers can move forward in US District Court.

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• SJC: Philip Morris may have to pay for diagnostic tests for smokers  

Massachusetts' high court said today that cigarette maker Philip Morris USA may have to pay for diagnostic chest exams so smokers can get early warning they have developed lung cancer.

In a unanimous ruling, the Supreme Judicial Court said that Massachusetts law has an antiquated definition of negligence that must be updated. Historically, plaintiffs had to show explicit injury -- such as a broken leg -- before the other party can be ordered to pay for diagnostic tests. Writing for the court, Justice Francis X. Spina said that legal thinking had to change.

"Modern living has exposed people to a variety of toxic substances," Spina wrote. "Illness and disease from exposure to these substances are often latent, not manifesting themselves for years or even decades after the exposure."

Spina added, "Our tort law developed in the late 19th and early 20th centuries ...We must adapt to the growing recognition that exposure to toxic substances and radiation may cause substantial injury which should be compensable even if the full effects are not immediately apparent." . . .

"The overwhelming majority of federal and state courts have rejected class certification of smokers' claims, including those seeking medical monitoring," Murray Garnick, Altria senior vice president and associate general counsel, said in a statement. "Six of the last seven state supreme courts to consider the issue have refused to recognize claims for medical monitoring based on the risk of future injury.''

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Modern living has exposed people to a variety of toxic substances. Illness and disease from exposure to these substances are often latent, not manifesting themselves for years or even decades after the exposure. Our tort law developed in the late 19th and early 20th centuries . . . We must adapt to the growing recognition that exposure to toxic substances and radiation may cause substantial injury which should be compensable even if the full effects are not immediately apparent.
MA Supreme Court Justice Francis X. Spina, writing for the court in the Donovan medical monitoring suit.

Cigarette Maker May Have To Pay For Chest Exams, Mass. Court Rules 

The highest court in Massachusetts ruled unanimously Monday that cigarette maker Philip Morris may have to pay for computerized chest scans for its customers in an effort to detect early-stage lung cancer.

In its ruling, the Supreme Judicial Court upheld a federal lawsuit filed in 2006 by three Massachusetts residents -- Patricia Cawley of Rockland, Kathleen Donovan of Randolph and James Teague of Lowell -- who each wanted a diagnostic chest exam known as a CT screening, but whose health insurance plans would not cover the scans.

Lawyers for the three plaintiffs -- all of them long-time smokers -- argued in the suit that Philip Morris should have to pay for their CT screens because the company had manufactured a product that contains a known carcinogen, putting its customers at high risk of lung cancer.

Boston attorney Neil T. Leifer is one of the plaintiffs' lawyers.

"We allege that Philip Morris made a defective product that contained carcinogens at a time when they could have made a safe product," Leifer said, "and as a result there are a lot of people who used their product and are at risk for lung cancer."

So, he says, Philip Morris should have to foot the bill for a test that could help save their lives.

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Court: Smokers may sue for payment on lung cancer screenings  

Cigarette maker Philip Morris may now be sued by long term smokers who have not yet developed lung cancer, a Massachusetts court ruled Monday.

The Supreme Judicial Court's unanimous ruling gives a go-ahead to a group lawsuit in the state that seeks to force Philip Morris into paying for smokers' medical screening for lung cancer.

The "[court] said that Massachusetts law has an antiquated definition of negligence that must be updated," The Boston Globe reported. "Historically, plaintiffs had to show explicit injury -- such as a broken leg -- before the other party can be ordered to pay for diagnostic tests. Writing for the court, Justice Francis X. Spina said that legal thinking had to change."

In his opinion, Justice Spina explained that diseases caused by exposure to toxic substances are "often latent," the Globe added, "not manifesting themselves for years or even decades after the exposure."

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Court allows smokers’ lawsuit for chest scans  

Cigarette maker Philip Morris USA Inc. might have to pay for chest scans so long-time smokers can get early warning of lung cancer, the highest court in Massachusetts ruled today.

The Supreme Judicial Court ruled unanimously that under some circumstances, Massachusetts law recognizes a claim by individual smokers for medical monitoring even without the presence of an actual injury.

The ruling means a lawsuit filed by three Massachusetts smokers can move forward in U.S. District Court. If a jury decides in favor of the smokers, Richmond, Va.-based Philip Morris could be required to pay for low-dose computed tomography scans, which can detect early-stage lung cancer.

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Smoking tied to high cancer rate  

Cancer is the second leading cause of death on Guam, with lung and bronchus cancers combined having the highest mortality rate among both sexes, according to newly released figures from the Guam Comprehensive Cancer Control Coalition.

The coalition -- which includes members from the American Cancer Society, the Guam Cancer Registry, the University of Guam Cancer Research Center, the Department of Public Health and Social Services and the Cancer Information Service -- released the first complete set of published data regarding Guam's cancer statistics at a press conference yesterday.

Michael Ehlert, a member of the coalition's Data and Research Action Team, said that nearly 20 percent of deaths on the island from 2003 to 2007 were cancer-related.

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NCCN Teams with Discovery Health Channel to Focus on Living with Advanced 

NCCN program on Discovery Health Channel profiles patients battling advanced non-small cell lung cancer and highlights their physicians' use of the NCCN Guidelines for Non-Small Cell Lung Cancer in determining the best treatment regimen. The program, which provides free CME credits, premieres on Sunday, October 18 at 7:00 am EDT.

FORT WASHINGTON, Pa., Oct. 16 /PRNewswire-USNewswire/ -- Lung cancer is the second most common cancer and leading cause of cancer-related deaths in both men and women. Although tobacco use is the strongest known risk factor for lung cancer, many people who never smoked also develop the disease. Regardless of how one developed lung cancer, treating the disease in the advanced stage faces numerous challenges both for clinicians and patients as well as their families.

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world's leading cancer centers, has collaborated with the Discovery Health Channel to produce a program profiling three patients with advanced non-small cell lung cancer and their healthcare team as they determine each patient's best treatment regimen. The program, Living with Advanced Non-Small Cell Lung Cancer, premieres Sunday, October 18, 2009 on the Discovery Health Channel. This program is available for Continuing Medical Education (CME/CE) credits for physicians as well as nurses.

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