Here are the 9 most common types of cancer
Socioeconomic Status Linked With Outcomes And Survival In Patients Treated For Non-small Cell Lung Cancer
Researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine found an association between "social determinants of health" and outcomes and survival in patients undergoing surgery and treatment for non-small cell lung cancer.
The findings are based on a statistical scoring system the researchers developed that consolidates and analyzes several measures of socioeconomic status and related factors.
"We believe our social determinants of health scoring system is the first to provide a composite perspective on many of the nonmedical factors that affect outcomes in patients receiving treatment for non-small cell lung cancer," said Dao Nguyen, M.D., Sylvester Thoracic Cancers Group co-leader. He said the study focused on patients with stage 2 or stage 3 NSCLC, with surgically confirmed metastasis to regional lymph nodes within the chest cavity.
Ideally, Nguyen said, patients with these cancers should receive 'multimodal' care—chemotherapy, immunotherapy and, in some cases, radiotherapy—and this high level of expertise and care may best be provided by specialized, comprehensive centers like Sylvester, a National Cancer Institute-designated center.
But studies have shown that better or worse outcomes result from more than just medical and surgical treatments. Socioeconomic disadvantages, for example, have been associated with lower-quality care and suboptimal outcomes. Social determinants of health, or SDH, include income, wealth, education, geographical location, access to specialized care and other nonmedical factors that influence health outcomes.
"Our analysis shows that SDH scores can identify patients who are at increased risk even if they undergo adequate initial treatment. Our research also may help point the way toward improving strategies and care for patients with lung cancer who are socioeconomically disadvantaged," said Nguyen, a thoracic surgeon who treats and studies lung and other cancers and is the senior author of an article published online ahead of print in The Journal of Thoracic and Cardiovascular Surgery.
Nguyen and colleagues analyzed data from 11,274 patients with locally advanced NSCLC in the National Cancer Database (NCDB), a registry provided by the American College of Surgeons and the American Cancer Society. Patients with locally advanced disease make up about one-third of the NSCLC population. In the study sample, average patient age was about 68, and 57% of patients were female. Eighty-four percent of patients in the sample were non-Hispanic white, 8.8% were Black, 3.0% were Hispanic, and 3.3% were Asian.
The researchers quantified results based on the medical research term "textbook oncological outcome," which considers several metrics and translates to the most desirable or optimal outcome for patients undergoing surgery to remove a primary cancer. These factors include complete resection, adequate lymph node removal, timely initiation of other therapies when needed, and short hospital stay. Textbook outcomes also are reflected in statistics on mortality, re-intervention, readmission, and major complications.
The Sylvester study aimed to determine the rate of achieving ideal outcomes in relation to social determinants of health scores, the association between these scores and optimal outcomes, and the association between SDH and overall survival.
The researchers focused on income, place of residence, level of education, and location of hospitals in proximity to patient residence. Other variables of interest included patient demographics, types of treatment facilities, surgical volumes at treatment facilities (representing experience and expertise), and whether patients had other medical conditions or diseases in addition to NSCLC.
"In this cohort, we found that socioeconomic status—indicated by SDH score—has an important association with both textbook outcomes and survival," said Ahmed Alnajar, M.D., the paper's first author. "Significant socioeconomic disadvantage was associated with a 21% decrease in textbook outcomes and a 32% decrease in overall survival when compared to a patient subgroup that was not disadvantaged. Vulnerable patient population groups living in areas with limited income, limited education, rural locations, and areas with limited access to specialized cancer care settings are at increased risk of poor outcomes and long-term mortality."
Among highlights from the article:
In addition to Nguyen and Alnajar, Karishma Kodia, M.D., and Nestor Villamizar, M.D., contributed from Sylvester and the University of Miami Miller School of Medicine. Syed Razi, M.D., contributed from Hackensack Meridian Health in Edison, New Jersey.
More information: Ahmed Alnajar et al, The Impact of Social Determinants of Health on Textbook Oncological Outcomes and Overall Survival in Locally Advanced Non-Small Cell Lung Cancer, JTCVS Open (2023). DOI: 10.1016/j.Xjon.2023.09.013
Citation: Socioeconomic status linked with outcomes and survival in patients treated for non-small cell lung cancer (2023, September 24) retrieved 24 September 2023 from https://medicalxpress.Com/news/2023-09-socioeconomic-status-linked-outcomes-survival.Html
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Small Cell Lung Cancer: New Approach To Overcoming Chemo-resistance
Small cell lung cancer accounts for about 15% of all diagnosed lung cancers and is still associated with a high mortality rate. SCLC tumors often develop resistance to chemotherapy and thus poor prognosis is due to tumor recurrence which occurs within only five to 14 months after initial diagnosis.
As a recent research study led by Balazs Döme and Karin Schelch from MedUni Vienna shows, resistant cell lines can be successfully fought with a combination of two already available therapeutic agents. The study results were published in the journal Clinical Cancer Research and offer a promising approach for the development of new therapies for this particularly aggressive type of tumor.
The study follows on from earlier, highly regarded findings by the research group led by Balazs Döme and Karin Schelch (Department of Thoracic Surgery at MedUni Vienna), according to which small cell lung cancer (SCLC) can be divided into subtypes that respond differently to chemotherapeutic agents and targeted drugs.
In this context, histone deacetylase inhibitors (HDACi) have been shown to be effective in two SCLC subtypes (known as SCLC-A and SCLC-N). HDACi are drugs that have already been shown in trials to be effective in fighting cells of different tumor types and have now been further investigated for their use in SCLC.
SCLC affects about 15% of lung cancer patients. This particularly aggressive tumor, which usually occurs in smokers, grows rapidly and has a high tendency to metastasize. About 70% of advanced cases are fatal within a year.
"The high mortality rate is due to the rapid and virtually inevitable recurrence of the disease, which is often accompanied by resistance to treatment," says principal investigator Karin Schelch, outlining the problem. HDACi in combination with standard chemotherapeutic agents turned out to be a possible solution during the studies. This significantly slowed down the growth of tumor cells that were resistant to individual therapy.
In further analyses, the molecular mechanism underlying therapy resistance was also revealed. The findings of the MedUni Vienna research group thus contribute significantly to a better understanding of the biology of SCLC, a disease in which promising progress in the development of therapeutic innovations has been decades in waiting.
"Our findings can provide the basis for research into successful new therapies that are superior to the resistance mechanisms of SCLC," says first author Anna Solta, also from MedUni Vienna's Department of Thoracic Surgery, highlighting the study's high clinical relevance.
More information: Anna Solta et al, Entinostat enhances the efficacy of chemotherapy in small cell lung cancer through S-phase arrest and decreased base excision repair, Clinical Cancer Research (2023). DOI: 10.1158/1078-0432.CCR-23-1795
Citation: Small cell lung cancer: New approach to overcoming chemo-resistance (2023, September 21) retrieved 24 September 2023 from https://medicalxpress.Com/news/2023-09-small-cell-lung-cancer-approach.Html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
What's The Difference Between Small-cell Lung Cancer (SCLC) And Non-small Cell Lung Cancer (NSCLC)?
Small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) are the two main types of lung cancer. SCLC typically spreads more quickly and is more aggressive than NSCLC.
Lung cancer — including both SCLC and NSCLC — is the third most common form of cancer among adults in the United States. Lung cancers account for about 12% of new cancer diagnoses.
Learn the differences between the two types, including stages, treatment options, and outlook.
In a person with SCLC, cancerous cells appear small and round under a microscope. The cells of NSCLC are larger.
Both SCLC and NSCLC have several subtypes. More common NSCLC subtypes include:
While SCLC also has subtypes, researchers do not typically distinguish between them.
Some NSCLC subtypes may be more aggressive than others, but generally, SCLC is more aggressive than NSCLC.
Smoking is a major risk factor for both types of lung cancer. Very few people who have never smoked receive a diagnosis of SCLC.
DiagnosisIf a person consults a doctor about possible symptoms of lung cancer, the doctor may ask questions, take a medical history, and perform a physical examination.
If they suspect lung cancer, the doctor may request imaging scans, such as an X-ray or CT scan, and look for signs of a tumor, scarring, or a buildup of fluid.
They may also request samples of phlegm to perform a sputum test. This can indicate whether cancer is present. The doctor may ask the person to provide a sample every morning for 3 days in a row.
Doctors may also perform a biopsy. This involves using a needle to take a sample of cells from the lungs for examination under a microscope. They may do this during surgery.
A biopsy can show whether cells are cancerous and what type of cancer is present, if any.
Sometimes, the doctor requests a bronchoscopy. This procedure involves inserting a tool with a built-in camera through the mouth or nose and into the lungs. This helps healthcare professionals see the area and take tissue samples.
Healthcare professionals may also carry out other tests to determine whether the cancer has spread beyond the lungs.
What does lung cancer look like? Find out more.
SCLC and NSCLC have similar symptoms. Sometimes, symptoms do not appear until the cancer reaches a later stage.
Possible symptoms include:
Although the symptoms of the two types are similar, SCLC spreads more rapidly.
A person may be more likely to experience symptoms once lung cancer has reached a later stage.
Does lung cancer affect women differently? Learn more.
Can shoulder pain be a sign of lung cancer? Find out more.
The causes and risk factors for SCLC and NSCLC tend to be similar.
Smoking is the main risk factor. Cigarette smoke and the chemicals it contains can damage the lungs, leading to cellular changes that may result in cancer.
Additional risk factors include:
Smoking is a major risk factor for lung cancer. Find some ideas for how to quit.
The stage of cancer describes how far it has spread within the body.
There are different ways to describe the stages. One simple way is:
However, each type of lung cancer has its own specific method of staging.
Stages of NSCLCFor this type of cancer, doctors typically use a 5-stage system:
Doctors generally categorize SCLC into one of two stages:
Some doctors use further staging for SCLC.
Can a person have both types?Researchers estimate that 5–28% of SCLC cases are "mixed." This means the person has both SCLC and NSCLC. Research suggests that mixed lung cancer may be easier to treat than SCLC alone.
After making a diagnosis, a doctor can describe the treatment options and develop a treatment plan.
Factors that affect the plan include:
Each person's situation is different, and treatment will vary accordingly.
NSCLC treatment optionsTreatment options for NSCLC include:
For SCLC, treatment mainly aims to manage the disease.
Options include:
Doctors may use a combination of treatments for lung cancer, depending on the person's needs, the stage of cancer, and the tumor's location. Treatment may also include palliative care, or procedures and medications to relieve symptoms and improve a person's quality of life.
Experts use past statistics to estimate the percentage of people who are likely to live for 5 or more years after a diagnosis of cancer. These estimations are called survival rates.
They represent averages and do not account for factors such as a person's age or overall health.
Researchers developed the following survival rates for 2023 based on people who received a lung cancer diagnosis between 2012 and 2018.
NSCLC survival ratesFor NSCLC, the American Cancer Society (ACS) reports the following 5-year relative survival rates:
The overall average likelihood of living for at least 5 years after NSCLC diagnosis is 28%.
SCLC survival ratesThe ACS estimates the following 5-year survival rates for people with SCLC:
The overall average likelihood of living for at least 5 years after a diagnosis of SCLC is 7%.
Other factors that may affect survival rates include a person's age and whether the cancer has come back after treatment. Recurring cancer and advanced age can have a negative effect on survival rates.
People who receive a diagnosis of NSCLC or SCLC now may have a better outlook than these numbers show, based on improved treatments and other factors.
There are two main types of lung cancer: small-cell and non-small cell. Small-cell lung cancer is less common and more aggressive.
Quitting smoking — or never smoking at all — can significantly reduce the risk of developing any type of lung cancer.
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