Efforts by Congress and others in the battle against lung cancer, the nation’s No. 1 cancer killer — or the lack of such efforts — received failing grades for the second year, according to the 2006 Report Card on Cancer issued by the Lung Cancer Alliance (Washington).

The alliance, which issued the first such report card in January for 2005, says it is the only national organization dedicated solely to patient support and advocacy for those living with or at risk for lung cancer (Medical Device Daily, Jan. 23, 2006).

The alliance’s report card is meant to be “a public awareness tool,” Laurie Fenton, president of the alliance, told Medical Device Daily. She noted that the advocacy group compiles its research from a variety of sources from the National Institutes of Health to the American Cancer Society (Atlanta).

“The good news,” said Fenton, “is that we have improvements since the release of last year’s Report Card on Lung Cancer, specifically in the areas of early detection, new drug therapies and congressional activity.”

“But,” she continued, “the bad news is that overall we are still lacking a sense of urgency, compassion and support at the federal or state level to address this disease in its entirety, and thus failing grades were issued for a second year in a row.”

Lung cancer results in 30% of all cancer deaths and kills more people annually than breast, prostate, colon, liver and kidney cancers combined, with a 15% five-year survival rate, the organization said.

“It’s data and facts that we can provide to anyone who asks, so obviously the number of deaths and the number of late-stage diagnoses and the support for early detection [as well as] newly addicted youth smokers; these are buckets to evaluate progress,” she said.

Fenton said she would “like to think” that such benchmarks are “organic,” and there may be others that are added to the report card in the years ahead.

The effort to battle lung cancer got a major boost last week when the New England Journal of Medicine released what the alliance called a “landmark” study, which found that annual screening with spiral computed tomography (CT) can detect cancer when it is still very small, thus dramatically increasing the chance for survival.

“Remarkably, the study showed the 10-year survival rate is 92% for those whose early detected cancers are removed immediately,” the alliance said.

More good news for those patients with lung cancer came with the FDA approval of a biotech-type pharmaceutical, Avastin (bevacizumab), a monoclonal antibody drug, for the treatment of the disease. The agency approved Genentech ’s (San Francisco) drug based on studies that showed patient survival extended beyond one year.

Finally, the alliance noted as another positive advancement in 2006 — the U.S. Senate’s unanimous approval of a resolution declaring lung cancer a national public health priority. That resolution is pending in the House of Representatives.

Specifically, the alliance’s report card grades seven categories to evaluate progress using key annual benchmarks in the “battle to eradicate this disease,” which is the alliance’s stated purpose.

Receiving a grade of F was the number of deaths attributed to lung cancer, because as the No. 1 cancer killer, it claims more than three times as many fatalities in men than prostate cancer, nearly twice as many women as breast cancer and nearly three times as many men and women as colorectal cancer.

The alliance said that in 2006, an estimated 174,470 people were diagnosed, an increase over 2005, and 162,460 people will die.

“Five-year survival rate” also received a grade of F, since only 16% of those diagnosed live longer than five years.

“There has been virtually no improvement since President [Richard] Nixon and Congress declared ‘War on Cancer’ in 1971,” the alliance said. By comparison, it noted that breast cancer’s five-year survival rate is now 89% and prostate cancer’s is 100%.

The number of late-stage diagnoses received a failing grade, as well, since 70% of diagnoses are late-stage, which the alliance said is a “lethal diagnosis.”

Since about 1,140 new daily smokers under the age of 18 become addicted each day, the category of “Newly Addicted Youth Smokers” also received a failing grade. That amounts to 400,000 new addicted cigarette smokers under the age of 18 each year.

“Number of treatment options” received a grade of D+, since Avastin was approved in 2006. Still, the alliance said that “patients and those at risk are in significant need of more options.”

Another F was given to the category “federally supported early detection programs,” because the federal government continues to withhold its support for early screening for lung cancer.

The category of “overall federal commitment” was given a D- only because of the resolution passed by the Senate.

The NEJM study, launched by a team of researchers at New York Presbyterian Hospital/Weill Cornell Medical Center in 1993, has expanded into an international collaboration of 38 institutions in seven countries.

In speaking with MDD upon the release of the study in the NEJM, lead researcher Claudia Henschke, MD, PhD, said that she hoped the impact of the study would be that high-risk patients begin a dialogue with their doctors about whether a CT scan might be appropriate. Henschke also said that she hoped that ultimately, there are lung cancer screening centers and specialty units just as there are for mammography for women currently (MDD, Oct. 30, 2006).

Fenton called the researchers’ work “a mature study” conducted by the “world’s leading experts” on lung imaging, adding that it is “the longest term study of detection and management of early-stage lung cancer.” However, because the ongoing study is observational and did not include a control group, some criticized the study as flawed.

“We hope that [the findings] will be embraced with the same level of interest and support that we have seen for many of the other early detection protocols for other major cancers,” Fenton said, later adding, “A wait-and-see attitude is no longer acceptable.”

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