New lung cancer test predicts survival
One of the challenges of treating the disease is that it often goes undetected in its early stages, when it is most treatable, because it usually does not cause symptoms. Only about 30 percent of patients in the United States are detected in the earliest stage of the disease, contributing to the low overall survival rate.
Even people who have their cancer detected at the earliest stages, however, face serious odds. Unlike other types of cancer, where early diagnosis has significant survival advantages, some 35 to 45 percent of people with stage I lung cancer die within five years of recurrent disease, despite successful surgery. The prognostic test would address the inability to identify these patients, said Jablons.
Lung Cancer Treatment
For people with lung cancer that has metastasized to regional lymph nodes, the standard treatment is surgery followed by chemotherapy. For people without detectable lymph node involvement, the approach generally is surgery followed by clinical observation alone. With this “watch and wait” approach, doctors recommend additional treatment - surgeries, chemotherapy, or radiation therapy - only if the cancer recurs.
The challenge for doctors is that many people with early-stage lung cancer harbor tiny, undetectable clumps of cancer cells either in their lungs or throughout their bodies that grow into tumors in the months and years after surgery, giving rise to recurrent cancer. Almost half of all people with stage I lung cancer have these very early metastatic cancers.
Further tests you may have Back to top
If the first tests suggest that you have lung cancer, your specialist may want to do some of the further tests described below, to confirm the diagnosis and to see if the cancer has spread to any other part of the body. This process is called staging and may take some time. The results will help you and your doctor decide on the best treatment.
Sometimes these tests may be done again, during and after treatment, to check on your progress.
MRI scan - uses magnetic fields to build up a series of cross-sectional pictures of the body
Mediastinoscopy - a procedure done under a general anaesthetic, where the doctor can look inside your chest at the area behind the breast bone
Thoracoscopy - similar to a mediastinoscopy, but to look at a different part of your chest
Lung biopsy - some cells are removed from the abnormal area and examined under a microscope
Endobronchial ultrasound scan, endoscopic ultrasound scan and abdominal ultrasound scan - these procedures use sound waves to look at internal organs
Isotope bone scan - a scan to check for abnormalities in the bones
Lung function tests - breathing tests to check how well your lungs are working
Past studies involving people with stage II and III disease suggest that earlier treatment, before recurrent tumors can be detected, improves the chances of survival.
Given the danger of metastases even from stage I lung cancer, however, current guidelines also recommend the consideration of chemotherapy for a subset of stage I patients whose tumors have characteristics that are believed to put them at high risk for recurrence.
The data reported in The Lancet indicate that the new molecular assay does a better job at identifying patients at high risk of early death after surgery, and may therefore be a better guide for consideration of early chemotherapy.