Natural products as chemo-radiation therapy sensitizers in cancers
Study Finds Declining SCLC Incidence, But Stagnant Survival Rates
SEER data show that small cell lung cancer (SCLS) incidence has steadily declined due to reduced smoking rates, but survival outcomes have seen only minimal improvement, underscoring the need for more effective treatments.
The incidence of small cell lung cancer (SCLC) has steadily declined in the US over the past 2 decades, largely due to reduced smoking rates, but survival outcomes remain largely unchanged, according to a new study published in Cancer Medicine.1
The analysis, which examined data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020, highlights both the progress in cancer prevention and the urgent need for more effective treatment options.
Despite the implementation of CT lung screening in 2013, most patients already had distant metastatic disease at the time of diagnosis.Image credit: Dragana Gordic – stock.Adobe.Com
The researchers found that the age-adjusted incidence rate of SCLC decreased by an average of 3% per year, from 9 per 100,000 people in 2000, to 4.6 in 2020. This decline was consistent across all demographic groups, including different races, sexes, and age categories. Incidence-based mortality rates also decreased, from 6.6 per 100,000 in 2005, to 3.5 in 2020. However, while fewer people are being diagnosed with SCLC, survival rates have shown only minor improvements. The 1-year relative survival rate increased slightly from 33.1% in 2000 to 35.3% in 2019, while the 1-year observed survival rose from 32.4% to 34.5% over the same period.
"Since SCLC almost always occurs in smokers, the decrease in smoking prevalence in the United States, predominately driven by implantation of smoking-related policies is likely responsible for this notable decline," the authors said.
SCLC is a particularly aggressive form of lung cancer, with nearly 60% of patients presenting with metastatic disease at diagnosis.2 For years, platinum-etoposide chemotherapy has been the standard treatment, offering strong initial responses but limited long-term survival.3 More recently, the addition of immune checkpoint inhibitors (ICIs) such as atezolizumab and durvalumab has provided some improvement in extensive-stage SCLC, yet their impact on long-term survival remains modest.1
They also examined the impact of lung cancer screening efforts, particularly the implementation of low-dose computed tomography (CT) scans for high-risk individuals. While screening has led to earlier detection of non–small cell lung cancer, its effectiveness for SCLC is less clear due to the rapid progression of the disease. Despite the implementation of CT lung screening in 2013, most patients (55.9%) in the study already had distant metastatic disease at the time of diagnosis.4,1 According to the authors, this indicates that annual CT screening may not be the most effective tool for detecting SCLC early, as the cancer's aggressive progression and high likelihood of metastasizing within a year may outpace the 1-year screening interval.
At the same time, the study found a slight increase in the diagnosis of localized SCLC and a corresponding decline in metastatic cases over time, particularly after 2013. While the trend was slow before 2013—potentially due to the growing use of diagnostic CT scans—the more noticeable shift afterward suggests that screening may be helping detect some cases at an earlier stage.
"Moreover, advancements in radiation techniques, early-stage at diagnosis with screening CT scans, may have improved survival for patients with limited-stage disease," the study authors added. "Population-based studies to assess the survival benefit of improved cancer care, enhanced radiation techniques and the introduction of immunotherapy are lacking."
The study's limitations include the retrospective nature of SEER data, which does not capture detailed treatment regimens or emerging therapies in real time. Additionally, data before 2004 lacked complete staging information, limiting some analyses.
References
Survival Better With Lobectomy Vs. Wedge Resection In Early Stage Lung Cancer
January 31, 2025
3 min read
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Key takeaways:Among patients with stage IA non-small cell lung cancer, long-term survival was better with lobectomy or segmentectomy vs. Wedge resection, according to results presented at the Society of Thoracic Surgeons Annual Meeting.
Christopher Seder
"We believe that these results are quite powerful and informative," Christopher Seder, MD, thoracic surgeon at Rush University Medical Center, told Healio.
Data were derived from Seder C. Anatomic lung resection is associated with improved survival compared with wedge resection for stage IA non-small cell lung cancer. Presented at: 2025 Society of Thoracic Surgeons Annual Meeting; Jan. 24-26; Los Angeles.Using the Society of Thoracic Surgeons General Thoracic Surgery Database, Seder and colleagues assessed 32,340 adults with stage IA non-small cell lung cancer less than or equal to 2 cm who experienced lung resection surgery to determine how 10-year overall survival and 7-year lung cancer-specific survival differ based on receipt of lobectomy vs. Sublobar resection (wedge or segmentectomy).
"We linked, for the first time ever, the Society for Thoracic Surgeons database to not only the CMS database, but also the [CDC] National Death Index," Seder told Healio.
Most of the study population underwent lobectomy (n = 19,778), followed by wedge resection (n = 8,283) and segmentectomy (n = 4,279), according to the abstract.
"Twenty percent of patients who had wedge resections did not have any nodes taken whatsoever," Seder told Healio. "Patients who got wedge resections also had less nodal sampling, less nodal stations sampled, less nodal upstaging and more positive margins."
Researchers found the largest proportion of survivors after 5 years in the lobectomy group at 71.9%. The segmentectomy group had the second highest 5-year overall survival rate at 69.6%, followed by the wedge resection group at 66.3%.
When evaluating 10-year overall survival, the lobectomy group and segmentectomy group had comparable proportions of patients (44.8% and 44.2%), with the wedge resection group following behind at 41.4%.
Researchers observed a link between improved overall survival and lobectomy vs. Sublobar resection (HR = 0.87; 95% CI, 0.83-0.92), as well as between improved lung cancer-specific survival and lobectomy vs. Sublobar (HR = 0.91; 95% CI, 0.86-0.96).
Notably, this link was still found after factoring out pathologic-upstaged cases in a sensitivity analysis, according to the abstract.
After breaking down sublobar resection into wedge resection and segmentectomy, the above relationship between lobectomy and better overall and lung cancer-specific survival continued only when placed against wedge resection (overall survival HR = 0.84; 95% CI, 0.8-0.88; lung cancer-specific survival HR = 0.88; 95% CI, 0.83-0.93).
Of the two sublobar resection procedures, researchers reported better overall survival with segmentectomy (HR = 0.88; 95% CI, 0.81-0.95), and the same was true for lung cancer-specific survival (HR = 0.91; 95% CI, 0.83-1). In contrast, survival was comparable between these two procedures in sensitivity analysis, according to the abstract.
"We found that what happens on the trial basis cannot necessarily be applied to the real world unless you follow the exact trial protocols ... But in the real world, our data are showing us that surgeons are not doing that," Seder told Healio.
"Surgeons are likely using sublobar or wedge resections as a compromise operation, meaning in a patient who may not tolerate a lobectomy, they may do a wedge resection on that patient, and you can't expect as good a result if you're selecting your patients that way," Seder continued.
When asked how these real-world data will be used moving forward, Seder said his team is working on a long-term risk calculator.
"The Society of Thoracic Surgeons has had short-term risk models for quite a long time," Seder told Healio. "You can predict what a patient's expected post-operative morbidity and 30-day mortality is.
"In the next couple months, we're going to incorporate long-term outcomes," Seder continued. "You will be able to put a patient in there with a given tumor and then toggle between wedge resection, segmentectomy and lobectomy and see how not only your short-term outcomes would change depending on what operation you do, but how your long-term outcomes are expected to change."
Seder also noted that these results do not necessarily mean that these patients should be sent to radiation rather than surgery because there are three benefits to surgery in terms of patient care.
"Surgery gives you adequate nodal staging," Seder told Healio. "It also gives us a piece of tumor to work with that can be sequenced with next generation sequencing, and finally, we know that surgery is extraordinarily safe."
References: Sources/DisclosuresCollapse Source: Seder C. Anatomic lung resection is associated with improved survival compared with wedge resection for stage IA non-small cell lung cancer. Presented at: 2025 Society of Thoracic Surgeons Annual Meeting; Jan. 24-26; Los Angeles.Disclosures: Seder reports no relevant financial disclosures.
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Cancer Survival Rate Drastically Improved By Muscle Strength And Fitness – Here Are 3 Ways To Get Started
If your 2025 resolutions have started to stall out, and you're finding it that little bit harder to roll yourself out of bed and into the gym or onto your treadmill, then a new study just dropped that could completely change your outlook.
While it's well known that exercise provides mental health benefits, helps you burn calories and lose weight, and even has social benefits, a new study has revealed that being strong and fit can drastically improve your chances of surviving cancer.
Research published this week in the British Journal of Sports Medicine outlines the findings of a systematic review of 42 studies, examining the link between muscle strength and cardiorespiratory fitness (CRF) with all-cause and cancer-specific mortality in patients diagnosed with cancer.
The results are clear and pretty astonishing. The research team discovered that cancer patients with high muscle strength or CRF levels "had a significant reduction in risk of all-cause mortality by 31–46% compared with those with low physical fitness levels."
Having muscle strength and CRF was also associated with "an 8–46% reduced risk of all-cause mortality in patients with advanced cancer stages," and a 19-41% reduced risk of all-cause mortality in lung and digestive cancers.
The upshot? High muscle strength and CRF "were significantly associated with a lower risk of all-cause mortality" in cancer patients, while CRF was further associated with a reduced risk of cancer-specific mortality. What's more, both were "especially predictive" in patients with advanced cancer stages, lung, and digestive cancers.
A body of research
While it isn't the cheeriest of subjects, this new review builds on existing studies linking strength and fitness to cancer mortality and survival rates. This 2015 study found resistance training (lifting weights) specifically reduced all-cause mortality rates in cancer patients by 33%. Likewise, this 2017 study revealed that higher muscle strength is linked to prolonged survival in older patients with advanced cancer.
I caught up with TechRadar's very own Christian Guyton – Computing Editor and cancer survivor – to find out more. "Being in good shape was apparently a big factor in beating cancer for me," he shared. "It's not just about how your physical health affects the cancer's development itself, but it can also determine the degree of treatment your body is able to handle."
"Because I was fit and healthy when I was diagnosed, they were basically able to nuke me with a combination of heavy treatment approaches because they were confident the treatment itself wouldn't have a seriously detrimental long-term impact on me," he continued – "They said that in an older or less physically healthy patient, that treatment plan wouldn't be an option because it basically wouldn't be safe. It proved highly effective too since I'm two-plus years all clear now!"
So, we can definitely add cancer survival as another reason to get fitter and stronger, but where do you start? Here are a few tips.
Strength training apps
If you want to increase your muscle strength, you can get started pretty quickly by downloading one of the best fitness apps for building muscle. I recommend PUSH, but there are other great options. Find an app tailored towards building muscle and strength, with plans, progressive overload, rest counting, and more. You want an app that's pushing you to do a variety of exercises to support your whole body, with a good amount of structure, and of course some rest.
Get a smartwatch
One of the best smartwatches can help you track workouts for both strength and cardio. In fact, many smartwatches, like the best Garmins, even have strength plans built-in so you can follow the workouts on your wrist.
When it comes to CRF, a smartwatch can track runs, bike rides, hikes, and more. It'll keep a tab on your heart rate, calories, and progress. Personally, I've also found a nifty wearable is a real motivator that can encourage you to work out, even when you're not feeling it.
Lots of great smartwatches also come with wellness features like Daily Readiness scores (the best Fitbit trackers) or a Body Battery meter (the best Garmin watches) to help you keep on top of your sleep, rest, and recovery.
Take nutrition seriously
When it comes to either muscle strength or CRF, nutrition is a vital part of training that will help you grow and repair used muscles. A good nutrition scale like the COSORI smart scale can even track the calories of your raw ingredients, with a breakdown of macros like protein, carbs, and fats.
There are also great apps like MyFitnessPal to help you track your nutrition.
Tackling health, fitness, strength, and the gym can be a daunting task. But with a decent app, a smartwatch, or even a bit of willpower, you can definitely start moving in the right direction.
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