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Improving Low Dose CT Scans for Patients

<p>Making a lung cancer test lightning fast.</p>


It's a technology that's helping dramatically reduce lung cancer deaths.

Low dose CT scans have revoluntionized early diagnosis and early treatment, but sometimes it's hard to tell if the abnormalities they detect are really cancer.

Researchers have discovered something in our blood that could make the scanner even better.

An internet search may have saved Lawrence Moore's life.

Lawrence Moore says, "I just happened to run across the article."

The article about low-dose CT Scans detecting lung cancer motivated the former smoker to get one done.  A mass was found, but it was inconclusive.  Lawrence had to wait seven months and go through more scans before he was finally diagnosed with lung cancer.

Moore:  "You're sitting there sort of gnawing your fingernails and wondering what's happening."

Duke University Doctor Edward Patz says it happens to many patients and can mean more testing or invasive biopsies, but his team disovered three blood proteins.

Doctor Edward Patz says, "...which we found to be, ah, higher in patients with cancer."

The doctor says when an abnormality is inconclusive images from a low-dose CT scan that show its size and the blood biomarkers, can help determine if lung cancer risk is high or low.  The test can be completed in about a day and could help patients...

Doctor Patz: "...avoid some unnecessary procedures and not delay treatment in other patients."

Lawrence had a portion of his lung removed within 24 hours of his diagnosis.

Moore: "I was very glad it was over with."

He's cancer free and his biggest worry these days is watering his orchids.

The doctor tells us using the blood biomarkers and images together is 80-85% accurate in determining if an inconclusive abnormality is cancerous.

It is FDA approved, will cost around $100 and is just about ready to be rolled out.

Doctor Patz says the labs that will handle the test are currently getting their infrastructure ready for it.

BACKGROUND:   Lung cancer is the second most common cancer in both men and women, accounting for about 14% of all new cancers.  The American Cancer Society estimates that in the United States in 2013 there will be over 200,000 new cases of lung cancer.  There will also be an estimated 159,480 deaths from lung cancer, about 27%.  Lung cancer is the leading cause of cancer death among men and women.  It mainly occurs in older people.  About two out of three people diagnosed with lung cancer are 65 years or older.  The average age at the time of diagnosis is about 71.  The chance of a man developing lung cancer is one in 13; for a woman the risk is about one in 16.  (Source: www.cancer.org)

RISKS:  Patients at high risk for developing lung cancer are those who are between the ages 55 and 74, are current smokers or quit within the last 15 years, or smoked for 30 or more pack years (pack years means the average number of packs smoked per day multiplied by the number of years a person has smoked.  (Source: www.seatlecca.org)

LOW-DOSE CT SCAN:  Early detection is proven to be a successful strategy for fighting many forms of cancer.  More than 75 percent of people with lung cancer have incurable, locally advanced, or metastatic disease at the time of diagnosis, with a five-year survival rate less than 5 percent.  Detecting lung cancer at its earliest stage and having it removed surgically can mean that a person can expect a five-year survival rate that is closer to 70 percent.  During a randomized national trial involving more than 53,000 participants who were current or former heavy smokers between the ages of 55 and 74, the low-dose helical computed tomography (CT) found 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT. Helical CT uses X-rays to obtain a multiple-image scan of the entire chest during a 7 to 15 second breath-hold.  A standard chest X-ray requires only a sub-second breath-hold but produces a single image of the whole chest in which anatomic structures overlie one another.  It was the first time that clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial was discovered.  (Source: http://www.cancer.gov/newscenter/newsfromnci/2010/NLSTresultsRelease)

NEW TECHNOLOGY:  Researchers at Duke developed a new diagnostic test that employs an instrument called "MALDI-TOF MS" to detect proteins in the blood that signal inflammatory diseases and cancers.  By finding a disease-causing protein, doctors can diagnose the disease and develop new ways to block its detrimental effects.  The specific protein, serum amyloid A, was elevated in the blood of lung cancer patients but not in the blood of normal patients.  Serum amyloid A has previously been shown to be elevated in cancers and other diseases, but researchers at Duke were the first to use MALDI-TOF MS to identify this protein and others that may be involved in lung cancer.  Once the proteins are identified, they can be used as biologic markers to diagnose the earliest stage of cancer, possibly before a CT scan can pick up the image of a tumor on the lungs. Based on their findings, researchers plan to develop a blood test that will measure serum amyloid A and other specific proteins that can detect lung cancer in the blood before a tumor is apparent.  (Source: http://www.dukehealth.org/health_library/news/7037)

FOR MORE INFORMATION, PLEASE CONTACT:

Edward Patz, Jr., MD
James and Alice Chen Professor of Radiology
Professor in Pharmacology and Cancer Biology
Duke University School of Medicine
(919) 684-7367

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