Simple Lung Cancer Scans That Could Save Thousands of Lives a Year

Cancer can be exponentially easier to treat or cure when it’s caught early.

A new study found that fewer than 2 percent of heavy smokers in the U.S. get recommended lung cancer screenings, an imaging test that can catch tumors when they are small and potentially curable. The numbers fall far short of screening for other types of cancer, including mammograms and colonoscopies—both procedures that are much more uncomfortable than the CT scan used to detect tiny tumors in the lungs.

Lung cancer is the leading cause of cancer death in the U.S., killing an estimated 150,000 Americans each year. For the past five years, such groups as the U.S. Preventive Services Task Force and the American Society of Clinical Oncology have urged people aged 55 or older who have smoked a pack a day (or the equivalent) for three decades or more to get checked for early stage disease. Medicare, the U.S. government’s insurance program for the elderly, pays for the procedure. None of it has made an impact.

“It’s still truly abysmal,” said Danh Pham, chief fellow of hematology/oncology at the University of Louisville’s cancer center in Kentucky, who will present the findings at the ASCO cancer meeting next month in Chicago. “We would like to make this a true call to action, whether it’s for more education or more research, to know why this disparity exists for lung cancer.”

It took a while for public health officials to start recommending routine lung cancer screening, because of questions about its accuracy and its ability to make a difference once the disease was detected. Subsequent studies confirmed the benefits for the heaviest smokers, with the use of screening intended for those most vulnerable to tumors.

The researchers analyzed registry data for everyone who underwent lung cancer screening in 2016 and found that 141,260 of the 7.6 million people eligible, or 1.9 percent, received it. By comparison, from 60 percent to 80 percent of eligible people get screening for breast, cervical and colon cancer, said Bruce Johnson, president of the American Society of Clinical Oncology and chief clinical research officer at the Dana-Farber Cancer Institute in Boston.

The testing shortfall could stem from primary care doctors’ failure to refer high-risk patients to one of 1,800 approved centers nationwide which provide the service. Psychological issues could also play a role, including fear of being diagnosed with a disease that smokers are constantly reminded of, Pham said.

“It’s very difficult to get patients to have this conversation with their doctors because of the stigma,” he said. “People may not want to know if they have lung cancer because it could confirm they’ve made bad lifestyle choices.”

Lung cancer deaths exceed those from breast, colon, pancreas and prostate cancer combined. There are very compelling reasons to get screened, said Johnson.

“If you screened the entire population of the U.S. who fit the criteria for having smoked enough and being the appropriate age, which is about 8 million people, you could save about 12,000 lives a year,” he said. “The majority of lung cancers picked up are early stage,” and finding them before the malignant cells spread reduces the risk of dying by about 20 percent, he said.

Artificial Mole as Early Cancer Detection in Development

For those of you who aren’t enthused about some of the other modern methods of cancer screenings, this artificial mole will possibly provide another avenue sometime in the next several years or so.

Alongside cardiovascular disease, cancer has become the top cause of death in industrialised countries. Many of those affected are diagnosed only after the tumour has developed extensively. This often reduces the chance of recovery significantly: the cure rate for prostate cancer is 32 percent and only 11 percent for colon cancer. The ability to detect such tumours reliably and early would not only save lives, but also reduce the need for expensive, stressful treatment.

Researchers working with Martin Fussenegger, Professor at the Department of Biosystems Science and Engineering at ETH Zurich in Basel, have now presented a possible solution for this problem: a synthetic gene network that serves as an early warning system. It recognises the four most common types of cancer — prostate, lung, colon and breast cancer — at a very early stage, namely when the level of calcium in the blood is elevated due to the developing tumour.

The early warning system comprises a genetic network that biotechnologists integrate into human body cells, which in turn are inserted into an implant. This encapsulated gene network is then implanted under the skin where it constantly monitors the blood calcium level.

As soon as the calcium level exceeds a particular threshold value over a longer period of time, a signal cascade is triggered that initiates production of the body’s tanning pigment melanin in the genetically modified cells. The skin then forms a brown mole that is visible to the naked eye.

[…]

The researchers used calcium as the indicator of the development of the four types of cancer, as it is regulated strongly in the body. Bones serve as a buffer that can balance out concentration differences. However, when too much calcium is detected in the blood, this may serve as a sign for one of the four cancers.

“Early detection increases the chance of survival significantly,” says Fussenegger. For example, if breast cancer is detected early, the chance of recovery is 98 percent; however, if the tumour is diagnosed too late, only one in four women has a good chance of recovery. “Nowadays, people generally go to the doctor only when the tumour begins to cause problems. Unfortunately, by that point it is often too late.”

The implant also has an additional advantage: “It is intended primarily for self-monitoring, making it very cost effective,” explains the ETH professor.

[…]

So far, this early warning implant is a prototype; the associated work recently published in the journal Science Translational Medicine is a feasibility study. The researchers have tested their early warning system in a mouse model and on pig skin. It functioned reliably during these tests. Moles developed only when the calcium concentration reached a high level.

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The concept of the “biomedical tattoo,” as Fussenegger describes this new finding, would also be applicable to other gradually developing illnesses, such as neurodegenerative diseases and hormonal disorders. In principle, the researchers could replace the molecular sensor to measure biomarkers other than calcium.