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Screening For Lung Cancer: New Findings And Continued Controversy

Lung cancer screening has been an area of considerable controversy. Before today, there had been no evidence that screening patients for lung cancer, either with a CT scan or chest x-ray, saved lives.

For years, doctors have been waiting for the results of the large, randomized National Lung Screening Trial (NLST), conducted by the National Cancer Institute.

[Yesterday] it was announced that the trial was stopped early, with a bold, positive finding:

All participants had a history of at least 30 pack-years, and were either current or former smokers without signs, symptoms, or a history of lung cancer.

As of Oct. 20, 2010, the researchers saw a total of 354 deaths from lung cancer in the CT group, compared with 442 in the chest x-ray group.

That amounts to a 20.3% reduction in lung cancer mortality — a finding that the study’s independent data and safety monitoring board decided was statistically significant enough to halt the trial and declare a benefit.

Previously, only breast, colon, and cervical cancer has had the evidence back up its screening recommendations. It’s still early in the game, but it appears that lung cancer may be following in that same path. That said, there are a variety of concerns before opening up the floodgates to screening chest CTs. Read more »

*This blog post was originally published at KevinMD.com*

A Poem About An Ending

She coughs
and heaves a breathless goodbye
into the bedside phone.

Her lungs
damp, bloated, sacked honeycomb
wheeze with vanishing bees.

The room
of sensors and startling noise
has not air to float upon.

Morphine
slakes a thirst for breathable sky
and calms the panic within.

The shame
of living, of death smiling,
savoring smoke and ash.

Eyes closed
she imagines her son, boy,
man, precious evermore.

Flowers.
Beautiful white, red, and black
from a husband who waits.

Starstuff
spinning in galaxies far,
with summer lightning bugs.

And then
it is upon her, the moment,
dreaded, practiced, boundless.

We run
through soft sands lit by moonlight,
now tumbling under waves.

All that matters
doesn’t.
And all that happens
matters.

The absence of pain and hunger
the end of struggle and story
mark an indifferent,
yet decent,
finish.

*This blog post was originally published at The Examining Room of Dr. Charles*

How A Gynecologist Thinks About Lung Cancer

Out of the Shadows: Women and Lung CancerA new report on lung cancer in women has been published by the Women’s Health Policy and Advocacy Program at Brigham and Women’s Hospital.

Called “Out of the Shadows,” the report seeks to raise awareness about lung cancer, currently the leading cause of cancer death in women, and more importantly, to increase funding for research for its prevention, detection and treatment. (Thanks to Booster Shots, the LA Times‘ fabulous health blog, for highlighting the report.) I encourage you to read the report, which is well written and comprehensive. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Smokeless Tobacco And The U.S. Launch Of Snus

This week the respected CBS documentary news show “60 Minutes” included a feature on smokeless tobacco, focusing on the recent launch of snus in the United States. The show was relatively balanced in focusing on the main potential risks and benefits of snus.

It started by featuring a young man who enjoys using snus in places where he cannot smoke, while continuing with a pack-a-day smoking addiction. The interviewer gave him the bad news: “You are a dual user.”

It then had a segment with the widely respected Swedish nicotine addiction expert, Dr Karl Fagerstrom, who stated that snus is 90-99% less harmful than smoking (while admitting some risks, including of pancreatic cancer). Read more »

This post, Smokeless Tobacco And The U.S. Launch Of Snus, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Once You Have Lung Cancer, Should You Bother To Quit Smoking?

Most smokers dread lung cancer. They are aware that by continuing to smoke the chances of developing lung cancer are increased 20 times, and that once it has developed the treatment is unpleasant and prognosis poor. Many patients (and unfortunately many clinicians) assume that once you have lung cancer it is too late to quit.

This week a new report was published in the BMJ, based on a review of the evidence that smoking cessation after diagnosis of a primary lung tumour affects prognosis. The study, by Drs Parsons, Daley and Aveyard at the UK Centre for Tobacco Control Studies, combined the data from 10 studies. They found that those who quit smoking after diagnosis were significantly less likely to develop another tumor and significantly more likely to still be alive 5 years later. Read more »

This post, Once You Have Lung Cancer, Should You Bother To Quit Smoking?, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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