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• Gene Linked to Tripled Lung Cancer Risk 

Scientists in Germany may have solved a conundrum that has been puzzling cancer researchers for years -- why not all smokers develop the deadly disease, the British Journal of Cancer said on Tuesday.

It said research showed a particular variant of a gene necessary for healthy lung function appeared much more often in smokers with lung cancer than those without.

The scientists studied 117 patients with lung cancer and compared them to a similar number of healthy people and another group of smokers suffering from a variety of lung ailments but not cancer.

"The study showed that one version of the surfactant protein B gene, which is essential for normal lung function, was found in a significantly higher number of lung cancer patients than those in the other groups," it said.

The gene variant was found in a quarter of the group suffering the most common type of lung cancer, compared to nine percent of healthy people.

Anti-cancer campaigners welcomed the news.

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• Genetic Lung Cancer Risk Not Enough to Make People Quit Smoking 

If you knew you were genetically susceptible to smoking-related cancers, would you kick the habit?

Duke University Medical Center researchers got mixed answers when they did a study that asked that question of older, inner-city black smokers.

Those who were told their genetics put them at increased cancer risk when they smoked were no more likely to quit smoking than smokers who didn't have that genetic susceptibility, says the study, which is published in the July issue of Cancer Epidemiology, Biomarkers and Prevention journal. . .

The people in this study smoked an average of 15 cigarettes a day, and 59 percent of them said they tried to quit smoking within the last year. Sixty-eight percent of the study participants believed they would eventually get lung cancer if they didn't stop smoking.

Many of the people in the study already suffered adverse health effects caused by smoking.

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• Health Recommendations From Study on Aspirin and Lung Cancer Are Premature 

An epidemiological study published earlier this week in the British Journal of Cancer by NYU School of Medicine researchers shows an association between regular use of aspirin and reduced risk of a common type of lung cancer in women. But the NYU researchers emphasized today that until large clinical trials establish aspirin's beneficial effect, women shouldn't start taking the painkiller to prevent cancer.

"The results of our study suggest that aspirin may have even wider benefits than previously thought, " says Arslan Akhmedkhanov, M.D., Assistant Professor of Obstetrics and Gynecology at NYU School of Medicine, one of the study's authors. "However, we consider our results preliminary. Larger studies are needed to confirm our study's results before any recommendations about aspirin use for the prevention of lung cancer can be made, " he says. . .

Women should not begin taking aspirin to prevent lung cancer, cautions Dr. Akhmedkhanov. Aspirin can cause gastrointestinal bleeding and raise the risk of other bleeding disorders, especially in those with a family history of bleeding disorders. The exact dose of aspirin that should be taken also needs to be determined. Any woman who decides to take aspirin routinely should first consult her primary care physician, he advises.

"Aspirin definitely has side effects, " says Dr. Akhmedkhanov. "By far, the best way to avoid lung cancer is to not smoke, " he says.

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• Aspirin May Cut Risk of Lung Cancer Risk 

Aspirin, the century-old drug that relieves headaches and helps to prevent heart attacks and strokes, may also cut the risk of developing lung cancer, scientists said Tuesday.

Smoking is the cause of most cases of lung cancer but researchers at New York University School of Medicine have discovered that taking aspirin regularly may have a protective effect against the disease, which is a top cancer killer.

"Not smoking is by far the best way to avoid lung cancer, but our study suggests that regular aspirin use could also confer some degree of protection against the disease, " said the school's Dr. Arslan Akhmedkhanov.

The scientists questioned 14, 000 women in New York about their long-term use of aspirin and compared the medical histories of 81 women who developed lung cancer and more than 800 who didn't.

Smoking was the biggest factor in the development of the disease but the scientists found women who took aspirin regularly had less than half the normal risk of suffering from non-small lung cancer -- the most common form of the disease.

"We need larger-scale research to confirm the results of this study, but it's certainly consistent with other evidence for the health benefits of the drug, " said Akhmedkhanov, whose research is published in the British Journal of Cancer.

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Not smoking is by far the best way to avoid lung cancer, but our study suggests that regular aspirin use could also confer some degree of protection against the disease.
Dr. Arslan Akhmedkhanov of the New York University School of Medicine.

• A detecting device fuels lung cancer debate 

They think: `People cause it themselves, so why should we pay money for them?' The very first question is always: `Did you smoke?'''

Parles's effort to raise funds to combat lung cancer is about to get an enormous boost. This summer, the National Institutes of Health will begin a landmark $200 million lung cancer research trial. About 50,000 Americans will be recruited to determine whether a special computerized scan can provide early detection.

As many as 15 percent of women and 5 percent of men who contract lung cancer had never smoked, according to government estimates. The reasons remain uncertain, but some cases may be associated with other carcinogens. Genetic factors may also come into play.

The NIH initiative itself has generated ire and controversy.

Some scientists argue that the scans, whose reliability has not been proven, will generate a large number of false positives, alarming patients and wasting resources. Others assert that far from rushing into things, the NIH may be unnecessarily delaying widespread use of the screening to conduct its study.

Patients, doctors, and researchers have stakes in the trial. Across the biotechnology industry, companies are beginning to increase lung cancer research, partly in anticipation of a boom in early detection.

Some companies have developed pills called ''molecule inhibitors'' that may reduce the impact of lung cancer. And there is hope that detecting lung cancer early will allow surgical removal of a cancerous lesion with 1-inch incisions for endoscopic surgery, rather than the current procedure, which involves cutting a 1-foot-long gap in the chest and removing all or part of a lung.

For now, there is no government-certified way to screen patients for lung cancer. And by the time symptoms appear, the cancer is usually untreatable.

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For breast cancer, we wear a pink ribbon, but for lung cancer the ribbon is clear because it is the invisible disease.
Michelle Slattery Tuohey, who works with the Cancer Care organization to try to ease the stigma of lung cancer. A Boston Globe article examines the lung-cancer screening debate. Kranish, M.

• Lung cancer: Three times better chances of survival than 20 years ago, according to the latest figures published in the June issue of the European Respiratory Journal (ERJ) 

Although lung cancer is increasingly widespread, particularly owing to the increased use of tobacco in the world, the chances of successfully crossing the decisive five-year survival threshold have improved considerably in the last 20 years.

This at any rate is the conclusion reached by the Finnish team of Dr. Riitta Mäkitaro, from the University Hospital of Oulu, in the light of the findings of a prospective study, which have been compared to those of a similar study conducted 20 years ago. . .

"small cell" carcinoma, a histological group that also accounts for about a fifth of all lung cancers, is still as aggressive as ever and its two-year survival rates have hardly improved, at 19% compared with 14% 20 years ago. . .

To sum up, although the spread of lung cancer has kept pace with that of tobacco smoking in the world, the related survival rate has tripled in 20 years. Nevertheless, only one in eight patients can hope to live for five years after the cancer has been diagnosed, with a chance after that of surviving for much longer still !

The Finnish authors of the article published in the June issue of the ERJ suggest that the progress observed is due mainly to the improvement in diagnostic and surgical techniques. Early diagnosis (well before metastases occur) and the surgical ablation of the tumor are factors which appear to offer better chances of survival. Some histological types of the observed lung cancer are also included among favorable factors, such as adenocarcinoma, for which the 5-year survival rate has risen from 4% 20 years ago to 19% at present.

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• Outlook Improving for Lung Cancer Patients-Study 

It's still not great but the outlook for patients with lung cancer is improving, thanks to better treatments and early detection of the first signs of the disease, Finnish scientists said on Monday.

Lung cancer is the biggest cancer killer, claiming as many as 300, 000 lives worldwide each year, but more patients are living longer than they would have 20 years ago.

"Survival of lung cancer patients has increased threefold, " Dr. Ritta Makitaro, of Oulu University in Finland, told Reuters.

Only four percent of people diagnosed with the cancer in Oulu in the 1970s were alive five years afterwards. By the 1990s the number had risen to 12 percent.

Makitaro, whose research was reported in the European Respiratory Journal, believes the figures may be even higher because more effective chemotherapy drugs are now on the market.

"It should be even better now since we collected our material in the 1990s, " she added. . .

Patients with adenocarcinoma, the most common type of lung cancer in women and in people who have never smoked had a 19 percent five-year survival rate. Smoking is the leading cause of lung cancer.

But for sufferers with small cell lung cancer, which accounts for about a fifth of cases, survival rates have barely improved during the two decades.

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• Cancer survival rates disputed 

Britain's biggest cancer charity advised caution yesterday over suggestions that long-term survival rates for lung cancer patients were showing sharp improvements.

Doctors in Finland have reported that the proportion of sufferers who live for more than five years after diagnosis has trebled in two decades, possibly due to earlier diagnosis, and better surgical techniques and post-operative treatment.

But figures in Britain show little movement in the 5% to 6% of patients clearing the five-year hurdle between the early 1970s and early 1990s, said Cancer Research UK.

A report by the Finnish team, published in the European Respiratory Journal, said a comparison of its recent study of 600 lung cancer patients in the northern province of Oulu with a study of nearly 450 sufferers in the same area 20 years before indicated that 12% of sufferers were now surviving five years compared with 4% earlier. . .

Lung cancer deaths among men in Britain have fallen sharply since the mid 1980s, reflecting big changes in their smoking habits since the 1950s. There were still 21,130 deaths in 1999, representing more than a quarter of all deaths from cancer among men. But this was a 39% drop on 1984. The incidence in the population fell by 34% in the same period.

However, deaths from lung cancer among women have gone up 4% over the same 15 years, and the incidence by 17%.

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• Scientists: Genes Found That May Slow Lung Cancer  

Scientists said on Wednesday they had discovered three genes involved in lung cancer and when they replaced the genes in mice the cancer stopped spreading and in some cases was cured.

Based on these findings, researchers said they hoped to begin gene therapy experiments in lung cancer patients within a year.

The three genes not only slowed the growth and spread of lung cancer tumors, but seemed to cause them to die off, the researchers, at M.D. Anderson Cancer Center and the University of Texas Southwestern Medical Center in Dallas, report in this week's issue of the journal Cancer Research.

The three genes, called 01F6, NPRL2 and FUS1, are all found on the same region of chromosome 3, said Dr. Jack Roth of M.D. Anderson, who helped lead the study.

"If you analyze the DNA in lung cancers you find that pieces of this chromosome are missing in many lung cancers," Roth said in a telephone interview. . .

Smoking seems to damage this area of the chromosome very early on, Roth said. "You even see it in cells lining the trachea and the bronchial tubes that look completely normal in patients who are heavy smokers," Roth said.

Some people seem to have more delicate chromosomes than others, the researchers found, which could explain why a few people seem to be able to smoke without developing cancer.

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• Women who smoke: are women more susceptible to tobacco-induced lung cancer?  

The importance of sex difference in lung cancer risk is a current topic of debate. Recent epidemiological and laboratory studies may indicate a sex difference. However, the mechanisms are still unknown and so far little research has been done at the experimental level. Appropriate studies include identifying factors related to sex that influence the initiation, promotion and progression steps in lung carcinogenesis (Figure 1). Lungs in males and females experience a different hormonal environment. Levels of many hormones are different in males and females and many of them are powerful regulators of gene expression. Important elements in lung carcinogenesis may be hormonal regulation of genes involved in the metabolism of tobacco carcinogens and DNA repair, interactions of smoking and hormone status, hormones and the activation of growth promoting pathways, cross talk between various signalling pathways and the interaction between stroma and epithelial cells during tumor development.

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• Study Ties Lung Cancer, Air Pollution 

Long-term exposure to the air pollution in some of America's biggest metropolitan areas significantly raises the risk of dying from lung cancer and is about as dangerous as living with a smoker, a study of a half-million people found.

The study echoes previous research and provides the strongest evidence yet of the health dangers of the pollution levels found in many big cities and even some smaller ones, according to the researchers from Brigham Young University and New York University.

The risk is from what scientists call combustion-related fine particulate matter – soot emitted by cars and trucks, coal-fired power plants and factories.

The study appears in Wednesday's Journal of the American Medical Association.

It involved 500,000 adults who enrolled in 1982 in an American Cancer Society survey on cancer prevention. . .

"This study is compelling because it involved hundreds of thousands of people in many cities across the United States who were followed for almost two decades," said study co-leader George Thurston, an NYU environmental scientist. . .

Thurston said the lung cancer risks were comparable to those faced by nonsmokers who live with smokers and are exposed long-term to secondhand cigarette smoke. Such risks have been estimated at 16 percent to 24 percent higher than those faced by people living with nonsmokers, Thurston said.

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• Hodgkin's Treatment Raises Lung Cancer Risk -Study 

People who are treated for Hodgkin's disease usually are cured but have a higher risk of developing lung cancer later in life, researchers reported on Wednesday.

But the researchers stressed that it was well worth being treated for Hodgkin's, a form of lymphatic cancer. They said it was especially important for people who are treated for Hodgkin's to stop smoking.

"It was the combined effect of smoking and treatment that accounted for the bulk of lung cancers in this study, underscoring the importance of smoking cessation in the management of patients with Hodgkin's disease," the researchers wrote in their report, published in Wednesday's issue of the Journal of the National Cancer Institute.

But the researchers, led by Dr. Lois Travis of the National Cancer Institute, said it also was important to study the type of drugs and radiation used to treat Hodgkin's to see what they do to the body besides killing the cancerous blood cells. . .

The researchers said 96 percent of the Hodgkin's patients who went on to develop lung cancer were smokers.

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• Lung cancer: behind the smoke screen 

Each year, more than 40,000 British people are diagnosed with lung cancer, 90 per cent of whom are current or former smokers. But a vaccine for this deadly disease could be just around the corner. That could mean thousands of lives may be saved or prolonged and – for the company that patents it – millions of pounds in profits. Years of research and trials are beginning to show results and a vaccine could be on the market by 2005.

That research, however, has been mired in controversy. It was revealed last week that Japan Tobacco, the world's third largest tobacco company, is funding some of the leading teams of scientists. In return, the tobacco giant gets marketing rights to the vaccines when they are developed.

The American pharmaceutical company Cell Genesys struck a multi-million dollar deal with Japan Tobacco in 1998. Earlier this year, it completed a trial on 22 patients with advanced lung cancer, most of whom had not responded to chemotherapy or radiation therapy.

In three of the patients, the tumours disappeared completely. In five of them, the disease stabilised. The company is now expanding its manufacturing capabilities and expects to launch the product on to the market in 2004 or 2005. . .

Visions of future generations of smokers freed from the spectre of lung cancer should be dispelled immediately, however. The drugs that are currently in the development phase will never be a cure. "I don't think these vaccines will be used to prevent cancers," says Poulem Patel, of the Imperial Cancer Research Fund. "They will be used to stop them recurring. Even then, they will only be part of the armoury."

It is this fear of raising false hope that Clive Bates, director of Action on Smoking and Health (ASH), says is really worrying. "Smokers will latch on to these vaccines as a reason for not quitting. We may find people who may never have got lung cancer, who get it because they think treatments are in the pipeline." . .

Responding to the criticism, Japan Tobacco claims it is protecting smokers' interests as well as those of cancer sufferers. "Tobacco is a known controversial product," says Roy Tsuji. "Yet many adults choose to enjoy it as a legal product, knowing the health risk associated with smoking. Based on the belief that our mission is to supply the best products and services, responding to our customers' needs in the respective business areas, we will do our best in the future."

In response, ASH's Clive Bates described this statement as "nauseating cant".

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• Spectre of lung cancer 

George Harrison, who survived a frenzied attack at his house near Henley, is now fighting an equally vicious but less visible foe - lung cancer. The former Beatle, who has just written his first song for ten years, previously had cancer of the throat, but it had been hoped that he had made a recovery... Both cancer of the throat and cancer of the lung are closely associated with smoking. The most common malignancy to affect the upper respiratory tract, as opposed to the bronchial tubes and lungs, is a squamous cell carcinoma of the larynx. More than 80 per cent of people who suffer from head and neck cancers are heavy smokers. . .

There are four major types of lung cancer, which are divided into two groups. One group, encompassing the non-small-cell lung cancers, includes the squamous cell carcinomas, which develop from the cells lining the airways; the adenoma carcinomas, which stem from the mucus-producing cells; and the large cell carcinoma. The other major group is small cell carcinoma of the lung. . .

Smokers and others should beware: coughing blood is the first symptom in only 7 per cent of people with cancer of the lung. The variety of other symptoms that have persuaded someone with cancer of the lung to seek a medical opinion are legion and include weight loss, shortness of breath, hoarseness and a feeling of being generally unwell, fatigued and lacking appetite.

Cancer of the lung is one of the diseases in which the first manifestations may appear to have little to do with the lung. . .

some years ago when I was attending a public dinner, the guest opposite me asked questions about his prostatic symptoms. I had meanwhile noticed that he had severe clubbing of his fingers: the ends of his fingers, instead of being slim and well- rounded, had become swollen, spatulous and beak-like. This sign is sooner or later developed by one in three people with cancer of the lung.

This situation produced a social problem that needed the expertise of a Philip Howard or John Morgan to solve.

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• Biotech Deals with Japan Tobacco 

GeneWatch UK warned today that granting patents on genes could lead to exclusive control over new treatments and medicines falling into the wrong hands. The warning came as GeneWatch and The Guardian newspaper revealed exclusive deals between two US biotech companies and Japan Tobacco for the rights to develop and market new lung cancer vaccines (1,2). Anti-tobacco campaigners and the World Health Organisation also condemned the deals.

"Giving a tobacco company exclusive rights to lung cancer vaccines is like putting Dracula in charge of a blood bank," said Dr Helen Wallace, Deputy Director of GeneWatch UK. "The system of granting patents on genes underpins one of these exclusive deals, allowing companies to seize genetic information and sell it to the highest bidder. Governments must end the patenting of genes and stop biotech companies like Corixa and Cell Genesys riding roughshod over patients’ interests."

Clive Bates, Director of Action on Smoking and Health (ASH) said: "Even for the tobacco industry, the attempt to integrate smoking and sickness marks a new frontier in cynicism and greed. While they’re frantically promoting the image of a carefree smoking lifestyle, they’re planning to cash in on a dreadful illness."

Derek Yach, Director of Non-communicable Diseases at the World Health Organisation (WHO) said: "We tackle lung cancer by breaking the addictive grip of the tobacco industry and taking action to help people quit smoking or never start. The last company that should control the rights to a lung cancer vaccine is one that makes huge profits from products that cause the disease in the first place." . .

"Smoking kills," said Dr Wallace. "It seems unlikely that these patients would have wanted the results of research on their genes to end up in the hands of Japan Tobacco. Cancer research must not be controlled by companies who make cancer-causing products. Patents on genes make immoral deals like this more likely and more damaging."

In June 1999, the Corixa Corporation granted Japan Tobacco a 3-year exclusive licence to develop and sell vaccine products aimed at preventing or treating lung cancer in North America, Japan and many other countries (3,4). The potential vaccines are based on Corixa’s sequencing of human genes from lung cancer cells.

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It seems unlikely that these patients would have wanted the results of research on their genes to end up in the hands of Japan Tobacco. Cancer research must not be controlled by companies who make cancer-causing products. Patents on genes make immoral deals like this more likely and more damaging.
Dr Helen Wallace, Deputy Director of GeneWatch UK.