Stephen R. Veach, M.D.
|
|
|
- Clarence Casey
- 8 years ago
- Views:
Transcription
1
2
3 Stephen R. Veach, M.D. Memorial Sloan-Kettering Cancer Center International Oncology Programs 160 E. 53 rd Street New York, NY tel fax veachs@mskcc.org
4 SCREENING AND EARLY DIAGNOSIS OF LUNG CANCER IS IT POSSIBLE?
5 Lung CA: A Major Public Health Problem Tobacco exposure accounts for 50% of premature deaths Lung CA is now the leading cause of tobacco- related death In 2007 ACS F&F Cases: 213,380 Deaths: 160,390
6 Lung Cancer & Tobacco Mortality
7 Cum. Risk of Lung CA in UK Men Data from Sirs Doll & Peto unequivocally demonstrates that the risk of lung CA after smoking never returns to normal
8 Potential For Screening Benefit 5yr Survival ACS CA Facts & Figures ( ) Prostate CA- 99.9% Breast CA- 88.5% Colorectal CA- 64% Lung CA- 15% Premature Mortality Source-SEER Program, 2000 Site YPLL (X 1,000) Average YPLL Lung 2, Breast Uterus
9 Change in U.S. Life Expectancy ( ) Advances in clinical research have significantly increased the lifespan of the average American Lenfant, C: NEJM 349:868, 2003
10 Impact of CT on Lung Cancer Management CT resolution doubling every two yrs for > decade Improved microprocessor capabilities Image processing capabilities evolving rapidly Capability to image and resolve smaller critical nodules (contribution of LIDC & RIDER Databases) Imaging progress drives changes in clinical care
11 Nodule Volume Rendering & Slice Thickness
12 Nodule Volume Rendering & Slice Thickness
13 Nodule Volume Rendering & Slice Thickness
14 First scan -10mm Slice Thickness (I-ELCAP)
15 Second scan-5mm Slice Thickness (I-ELCAP)
16 Third Scan-2.5mm Slice Thickness (I-ELCAP)
17 Final Scan-1mm Slice Thickness (I-ELCAP)
18 Strategic Importance of Imaging Imaging Technologies Tagged For FDA Drug Development Initiative FDA is commencing an initiative to encourage use of imaging technologies to develop surrogate endpoints for drug submissions. There is tremendous potential for the use of imaging in drug development...from pre-clinical [applications] all the way to using surrogate markers for approval, Center for Drug Evaluation & Research Director Janet Woodcock told participants at the Fifth National Forum on Biomedical Imaging in Oncology in Bethesda, Md. Jan. 29.
19 Mayo Lung Cancer Project 9000 men High risk Randomized Chest x-ray x and sputum cytology 3x year for 6 years Usual medical care
20 Mayo Lung Cancer Project Results published 2000 Frequent xrays found more tumors Large 5 year survival difference Mortality was greatest in the screened arm Follow up in 2006 supported the over diagnosis conclusion
21 Early Lung Cancer Action Project 1000 high risk, > 60 years old, smokers screened All had chest x-ray x and low dose CT CT found > 3x as many suspicious nodules as xrays Malignant disease in 27, 4 x as many with xray 23 had Stage I disease Therefore, CT more sensitive at finding early tumors Henschke, CI et al Lancet 1999; 354:99-105
22 International Early Lung Cancer Action Project 7 countries, mostly smokers, age 40 31,567 patients Screening with LDCT from ,456 annual screening on some patients Found 484 lung cancers 412 in early stage As of May 2006, 75 patients had died of lung cancer NEJM Vol 355: Oct 26, 2006 Number 17
23 Kaplan Meier Survival Curves Henschke, CI et al. NEJM 355:1763, 2006
24 Criticism I-ELCAP patients from Japan who never smoked (some had tumors) probably indolent, skewing statistics year predicted survival based on only 2 patients 3. No mortality statistics 4. No staging (except after Stage I) 5. No pathologic staging
25 Criticism I-ELCAP (2) 6. How many lost to follow up and what % had annual screening? 7. No clear evidence to show benefit 8. No control arm suspicious nodules were investigated, may harm more people than helped
26 I-ELCAP Relevant Statistics Lead time bias: When you find a cancer early by screening, but the patient lives no longer than he would have without screening Length time bias: Screening detects more slow growing cancers as opposed to more aggressive rapidly growing cancers which show up in between screenings.
27 I-ELCAP Screening Risks 4000 suspicious nodules investigated Many benign nodules end up with biopsy 1-4% mortality from lung resection or biopsies No one knows risk of multiple CT scan; some estimates are 5% increase in risk of developing lung cancer.
28 CT and lung Cancer The Media and Public Opinion JCO, Vol 25, No. 36 (Dec 07), pp After publication of I-ELCAPI CBS News Using computerized scan to screen for lung cancer can help save lives and should be part of a regular check-up for people who have a high risk for the disease.
29 Avnnenberg National Health Communication Survey December % had heard or seen media coverage on results of I-ELCAPI Only 5% had heard or seen media coverage and were likely to get a scan.
30
31
32 I-ELCAP Conclusion I-ELCAP detected clinical Stage I lung cancer in a high proportion of persons who were found to have cancer Screening could prevent death from lung cancer Rates of detection 1.3% baseline 0.3% annual comparable to breast cancer.6% to 1% baseline and.2% to 0.4% for annual mammography. Cost effective if one compares treatment for Stage I disease compared to advanced Stage disease
33 Screening for Lung Cancer ACCP Evidence Based Clinical Practice Guidelines Bach,, P. et al, Chest, 132/3/Sept 2007 Supplement 1. Background 160,000 die in US 2007 from lung cancer Symptomatic patients present with advanced stage Can screening prevent or delay death? Chest x-ray x screening trials from 70 s s and 80 s s unable to confirm this prevention or delay Cancers found at screening may not be what kills the patient
34 Screening for Lung Cancer ACCP Evidence Based Clinical Practice Guidelines Bach,, P. et al, Chest, 132/3/Sept 2007 Supplement 2. Natural History of CT detected lung cancer Consider the growth rate by doubling times More rapid growth more aggressive Have to assume growth rate more or less constant Previous studies estimate 20 doublings to reach 1mm
35 Timeline of lung cancer progression by number of tumor doublings and volume doubling rate Bach, P. B. et al. Chest 2007;132:69S-77S
36 Screening for Lung Cancer ACCP Evidence Based Clinical Practice Guidelines Bach,, P. et al, Chest, 132/3/Sept 2007 Supplement 1. Epidemiologic Analysis SEER shows mean survival for clinical detected lung cancer < 1 year Consistent with doubling trial of days 2. SEER shows survival of Stage I lung cancer not treated with surgery is 14 months Consistent with doubling time of 70 days
37 Screening for Lung Cancer ACCP Evidence Based Clinical Practice Guidelines Bach,, P. et al, Chest, 132/3/Sept 2007 Supplement 3. If one stops smoking, risk begins to decline within a few years of smoking cessation Consistent with doubling time of days At this rate existing cancers would present in approximately years
38 Screening for Lung Cancer ACCP Evidence Based Clinical Practice Guidelines Bach,, P. et al, Chest, 132/3/Sept 2007 Supplement Epidemiologic Analysis 4. Cancers identified by CT screening and followed annually had doubling times of days (Hasegawa) Mayo lung screening with chest xray data suggested only a portion of Stage I with doubling times less than 100 days and 11% > 300 days
39 Screening for Lung Cancer ACCP Evidence Based Clinical Practice Guidelines Bach,, P. et al, Chest, 132/3/Sept 2007 Supplement 5. A portion of lung cancers detected through screening are indolent and are not the cancers that result in death within 1 to 2 years
40 Cost Effectiveness of Screening with CT Measured per Life-Year Gained Source Cohort Regimen Time Cost LYG Mahadavia ,000 current previous > 60 yo > 20 pack year 55% male Annual screening for 20 years 1-4 years $300 Current $116,300 Former $2.3 million Wisnievesky > 60 yo > 10 pack years One time screening 1 year after diagnos is $165 $2,500
41 Summary of Recommendations 1. Do not recommend that low dose computerized tomograph be used to screen for lung cancer except in a clinical trial. 2. Do not recommend the use of serial chest x-ray x to scan for presence of lung cancer. 3. Do not recommend the use of sputum cytology to screen for the presence of lung cancer.
42 What is the Future of Screening 1. New trials for Lung Cancer? National Lung Screening Trial NELSON Trial 2. Refining Risk Prediction 3. Biomolecular Markers Investigational at this time Limits exposure to radiation Cost effectiveness?
43 National Lung Cancer Trial 53,000 people 55 to 74 years old Heavy current or former smokers Randomized Arm A Helical CT scan Arm B Chest x-rayx Initial study then annually x 2 years Closed in 2004 Designed to show 20% mortality reduction by 2009
44 NELSON Trial (Dutch-Belgian Lung Cancer Screening Trial) Launched in ,428 cases aged years old Active and former smokers Randomized CT scan year 1, 2, 4 Smoking cessation advice Conclude 2015
45 What is the Future of Screening 1. New trials for Lung Cancer? National Lung Screening Trial NELSON Trial 2. Refining Risk Prediction 3. Biomolecular Markers Investigational at this time Limits exposure to radiation Cost effectiveness?
46 The LLP Risk Model for Lung Cancer Risk Cassidy et al, Br. Journal of Cancer 18 Dec Lung cancer cases and 1157 age and sex matched population-based controls Lifestyle risk factors modeled to create profiles 2.5% risk as cut off to trigger increased surveillance equated a sensitivity of 0.62 and specificity of 0.7% A 6% risk cut off would give sensitivity of 0.34 and specificity of 0.90%
47
48
49
50
51 What is the Future of Screening 1. New trials for Lung Cancer? National Lung Screening Trial NELSON Trial 2. Refining Risk Prediction 3. Biomolecular Markers Investigational at this time Limits exposure to radiation Cost effectiveness?
52 Biomolecular Markers 1. Lung Sign Test 370 lung cancer found in 1235 high risk subjects 33% prevalence With sputum DNA cytometry 40% of all lung cancer detected and 31% of Stage I Conventional cytology 16% of lung cancers Possible additional tool for screening *Kemp, R.A., Journal of Thoracic Oncology Vol 2., Number 61, November 2007
53
54
55
56
57
58 Correlation of Lung CA & COPD Emphysema 338 Airway Obstruction 302 E + AO 154 No Airway Obstruction or Emphysema 691 (59%) Total population 1,176 (100%) Airway Obstruction and/or Emphysema 485 (41%) = diagnosis of lung cancer J Zulueta et al. I-ELCAP, 5/07 90% of lung cancers occurred in individuals with airways obstruction, emphysema or both
59 Contribution of the Inflammatory Response in Chronic Injury to Lung CA Carcinogenic Exposure Normal Epithelium Cell Injury Initiated Cell Clonal Expansion Invasion Competence Inflammation 5-LO Cytokines COX-2 Ballaz et al. Clin Lung Ca 5:46, 2003
60 Impact of Steroids for COPD on LCA 10,474 COPD patients followed for 4 years 423 lung cancers developed Lung cancer was 61% less frequent in COPD patients receiving 1.2 mg of inhaled steroids Parimon T, Chien JW, Bryson CL et al. Am J Resp Crit Care Med 175:712, 2007
61
62 Global Tobacco Surveillance System 1998 US Center for Disease Control, World Health Organization, Canadian Public Health Association Established Surveys Global Youth Tobacco Survey Global School Personnel Survey Global Health Professions Student Survey Global Adult Tobacco Survey
63 Global Youth Tobacco Survey % smoke % used other than cigarettes % never smokers but susceptible to Boy Girl Boy Girl Boy Girl 2005 Egyptian Students Age
64 Global Youth Tobacco Survey Egyptian Students years old Exposed to smoke from others at home 38.7% Public places 43.7% Favored ban in public places Had object with cigarette logo Offered free cigarette by tobacco company 87.5% 13.2% 10.4%
65 Global Youth Tobacco Survey Egyptian Students years old Desire to stop smoking Usually bought cigarettes at store Were not refused because of age Taught about dangers of smoking at school 76% 42.6% 88% 57.7%
Low-dose CT Imaging. Edgar Fearnow, M.D. Section Chief, Computed Tomography, Lancaster General Hospital
Lung Cancer Screening with Low-dose CT Imaging Edgar Fearnow, M.D. Section Chief, Computed Tomography, Lancaster General Hospital Despite recent declines in the incidence of lung cancer related to the
Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD
Epidemiology, Staging and Treatment of Lung Cancer Mark A. Socinski, MD Associate Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive Cancer Center University of
Lung Cancer Screening
Lung Cancer Screening Middlesex Hospital Total Lung Care Center Megin Iaccarino RN, BSN Lung Pathway Coordinator and Lung Nurse Navigator Middlesex Hospital Cancer Center and Surgical Alliance Lung Screening
Cancer Screening. Robert L. Robinson, MD, MS. Ambulatory Conference SIU School of Medicine Department of Internal Medicine.
Cancer Screening Robert L. Robinson, MD, MS Ambulatory Conference SIU School of Medicine Department of Internal Medicine March 13, 2003 Why screen for cancer? Early diagnosis often has a favorable prognosis
Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group
Screening for Cancer in Light of New Guidelines and Controversies Christopher Celio, MD St. Jude Heritage Medical Group Screening Tests The 2 major objectives of a good screening program are: (1) detection
Fact sheet Lung cancer screening for employees exposed to asbestos using CT screening (CTTS)
Version: February 2013 Fact sheet Lung cancer screening for employees exposed to asbestos using CT screening (CTTS) Dr. med. Susanna Stöhr, PD Dr. med. Dr. phil. David Miedinger, Dr. med. Marcel Jost 1.
Screening for asbestos-related lung cancer Nea Malila, Tony Miller, Riitta Sauni, Robert Smith, Kurt Straif, Tapio Vehmas
Screening for asbestos-related lung cancer Nea Malila, Tony Miller, Riitta Sauni, Robert Smith, Kurt Straif, Tapio Vehmas International Conference on Monitoring and Surveillance of Asbestos-Related Diseases
National Framework for Excellence in
National Framework for Excellence in Lung Cancer Screening and Continuum of Care declaration of purpose Rights and Expectations THE RIGHTS OF THE PEOPLE Lung cancer kills more Americans than the next four
An Update on Lung Cancer Diagnosis
An Update on Lung Cancer Diagnosis Dr Michael Fanning MBBS FRACGP FRACP RESPIRATORY AND SLEEP PHYSICIAN Mater Medical Centre Outline Risk factors for lung cancer Screening for lung cancer Radiologic follow-up
Lung Cancer Surveillance using low Dose CT scanning Where are We Now?
Lung Cancer urveillance using low Dose CT scanning Where are We Now? cott wanson Professor Thoracic urgery Brigham and Women s Hospital and Harvard Medical chool Disclosures These slides were kindly provided
MANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock Manchester 100 Hitchcock Way Manchester, NH 03104 (603) 695-2850
LEBANON Lung Cancer Screening Program One Medical Center Drive Lebanon, NH 03756 (603) 650-4400 (866) 966-1601 Toll-free cancer.dartmouth.edu/lungscreening MANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock
Non-Small Cell Lung Cancer Therapies
Non-Small Cell Lung Cancer Therapies Guest Expert: Roy, MD, PhD Assistant Professor of Therapeutic Radiology Scott, MD Assistant Professor of Medical Oncology www.wnpr.org www.yalecancercenter.org Welcome
Lung Cancer Screening: An Update for the U.S. Preventive Services Task Force
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ
Clinical Trials and Screening: What You Need to Know
Scan for mobile link. Clinical Trials and Screening: What You Need to Know What is a Clinical Trial? At A Glance A clinical trial is a research study that tests how well new medical techniques work in
Cancer Screening and Early Detection Guidelines
Cancer Screening and Early Detection Guidelines Guillermo Tortolero Luna, MD, PhD Director Cancer Control and Population Sciences Program University of Puerto Rico Comprehensive Cancer Center ASPPR Clinical
Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200
GUIDE TO ASBESTOS LUNG CANCER What Is Asbestos Lung Cancer? Like tobacco smoking, exposure to asbestos can result in the development of lung cancer. Similarly, the risk of developing asbestos induced lung
The Evaluation of Cancer Control Interventions in Lung Cancer Using a Canadian Cancer Risk Management Model
The Evaluation of Cancer Control Interventions in Lung Cancer Using a Canadian Cancer Risk Management Model WK Evans, M Wolfson, WM Flanagan, J Shin, FF Liu JR Goffin, K Asakawa, N Mittmann, L Fairclough
WA Asbestos Review Program
WA Asbestos Review Program Dr Fraser Brims Consultant Respiratory Physician, SCGH, Head of Occupational and Respiratory Health Unit, LIWA Asbestos awareness week seminar, 2014 Introduction Asbestos and
The PSA Controversy: Defining It, Discussing It, and Coping With It
The PSA Controversy: Defining It, Discussing It, and Coping With It 11 TH ANNUAL SYMPOSIUM ON MEN S HEALTH June 12, 2013 The PSA Controversy Defining It, Discussing It and Coping With It As of May 2012,
Measures of Prognosis. Sukon Kanchanaraksa, PhD Johns Hopkins University
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
Lung Cancer. This reference summary will help you better understand lung cancer and the treatment options that are available.
Lung Cancer Introduction Lung cancer is the number one cancer killer of men and women. Over 165,000 people die of lung cancer every year in the United States. Most cases of lung cancer are related to cigarette
GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER
GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT
co-sponsored by the Health & Physical Education Department, the Health Services Office, and the Student Development Center
Cancer is a group of more than 100 related diseases. Normally, cells grow and divide to produce more cells to keep the body healthy. Sometimes, this process goes wrong. New cells form when the body doesn
Male. Female. Death rates from lung cancer in USA
Male Female Death rates from lung cancer in USA Smoking represents an interesting combination of an entrenched industry and a clearly drug-induced cancer Tobacco Use in the US, 1900-2000 5000 100 Per Capita
Lung cancer is a lethal disease that claims the lives
Original Research Offering Lung Cancer Screening to High- Risk Medicare Beneficiaries Saves Lives and Is Cost-Effective: An Actuarial Analysis Bruce S. Pyenson, FSA, MAAA; Claudia I. Henschke, PhD, MD;
Lungenkrebs. Lungenkrebs Häufigkeit
Lungenkrebs Prof. Dr. E.W. Russi Pneumologie 1.9.2008 Lungenkrebs Häufigkeit The Principles and Practice of Medicine William Osler New York D. Appleton and Company 1892 Section IV DISEASE OF THE RESPIRATORY
OCCUPATIONAL LUNG CANCER
OCCUPATIONAL LUNG CANCER Anwar Jusuf, Agus Dwi Susanto Department of Pulmonology & Respiratory Medicine, Faculty of Medicine University Of Indonesia - Persahabatan Hospital-Jakarta INTRODUCTION Occupational
Lung cancer forms in tissues of the lung, usually in the cells lining air passages.
Scan for mobile link. Lung Cancer Lung cancer usually forms in the tissue cells lining the air passages within the lungs. The two main types are small-cell lung cancer (usually found in cigarette smokers)
PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj.
PSA Testing 101 Stanley H. Weiss, MD Professor, UMDNJ-New Jersey Medical School Director & PI, Essex County Cancer Coalition weiss@umdnj.edu September 23, 2010 Screening: 3 tests for PCa A good screening
Lung Cancer Awareness Month Update
Lung Cancer Awareness Month Update Guest Expert: Frank, MD Professor of Thoracic Surgery Lynn, MD Professor of Pulmonary Medicine www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer Center Answers
Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015
Adjuvant Therapy Non Small Cell Lung Cancer Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 No Disclosures Number of studies Studies Per Month 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3
LUNG CANCER EVALUATION & TREATMENT. LungCancer. Prevention & Early Detection Save Lives. The Power Is Yours.
LUNG CANCER EVALUATION & TREATMENT LungCancer Prevention & Early Detection Save Lives. The Power Is Yours. Prevention Lung cancer. It s one of the most common cancers in both men and women more deadly
Asbestos Health Risks. Dr Andrew Pengilley Acting Chief Health Officer
Asbestos Health Risks Dr Andrew Pengilley Acting Chief Health Officer Asbestos Asbestos is a name given to several different fibrous minerals Three main commercial types are Chrysotile (white asbestos)
Lung Cancer & Mesothelioma 2011-2015
Lung Cancer & Mesothelioma 2011-2015 Annex G Mesothelioma 1. The vision for mesothelioma services is set out in the Mesothelioma Framework issued by DH on 26 February 2007 (supported by the British Thoracic
Prostate Cancer. Screening and Diagnosis. Screening. Pardeep Kumar Consultant Urological Surgeon
The Royal Marsden Prostate Cancer Screening and Diagnosis Pardeep Kumar Consultant Urological Surgeon Prostate Cancer Screening and Diagnosis 08 02 2013 2 Screening 1 3 Q1.Lots of men have prostate cancer
PSA Screening for Prostate Cancer Information for Care Providers
All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits
LOW DOSE CT LUNG CANCER SCREENING: IT S TIME HAS COME. Andrew D. Nish MD
LOW DOSE CT LUNG CANCER SCREENING: IT S TIME HAS COME Andrew D. Nish MD OBJECTIVES Understand the controversies of screening for cancer control in a large population Understand primary and secondary prevention
FAQ About Prostate Cancer Treatment and SpaceOAR System
FAQ About Prostate Cancer Treatment and SpaceOAR System P. 4 Prostate Cancer Background SpaceOAR Frequently Asked Questions (FAQ) 1. What is prostate cancer? The vast majority of prostate cancers develop
ONLINE CONTINUING EDUCATION ACTIVITY
ARTICLE TITLE: American Cancer Society Lung Cancer Screening Guidelines ONLINE CONTINUING EDUCATION ACTIVITY Take free quizzes online at acsjournals.com/ce CONTINUING MEDICAL EDUCATION ACCREDITATION AND
What If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide
What If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide A M E R I C A N C O L L E G E O F C H E S T P H Y S I C I A N S Lung cancer is one of the most common cancers. About 170,000
Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening.
CANCER SCREENING Dr. Tracy Sexton (updated July 2010) What is screening? Screening is the identification of asymptomatic disease or risk factors by history taking, physical examination, laboratory tests
Low Dose CT Screening for Lung Cancer
Low Dose CT Screening for Lung Cancer Donna Edmondson, MSN, CRNP, AOCNP Division of Thoracic and Esophageal Surgery Fox Chase Cancer Center Philadelphia, PA Rohit Kumar, MD Assistant Professor of Medicine
Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer
Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer Lung cancer accounts for 13% of all cancer diagnoses and is the leading cause of cancer death in both males
Survivorship Care Plans Guides for Living After Cancer Treatment
Survivorship Care Plans Guides for Living After Cancer Treatment Institute of Medicine Report 2005 Recommendations for meeting needs of cancer survivors Implement survivorship care plan Build bridges
HANDLING LUNG CANCER CLAIMS
HANDLING LUNG CANCER CLAIMS JENNIFER S. KILPATRICK SWANSON, MARTIN & BELL, LLP 330 North Wabash Avenue Suite 3300 Chicago, Illinois 60611-3604 (312) 321-3517 (312) 321-0990 jkilpatrick@smbtrials.com 1
1992 2001 Aggregate data available; release of county or case-based data requires approval by the DHMH Institutional Review Board
50 Table 2.4 Maryland Cancer-Related base Summary: bases That Can Be Used for Cancer Surveillance base/system and/or of MD Cancer Registry Administration, Center for Cancer Surveillance and Control 410-767-5521
2009 Cancer Committee
2009 Cancer Committee Lung (non-small cell) Cancer Study Stage IIIA and IIIB John Clouse, M.D. Alicia Stark, RHIT Jeff Robinson Table of Cont ent s Table of Contents... 1 Lung (non-small cell) Cancer Facts.2
Lung Cancer in Vermont
Lung Cancer in Vermont Vermont Cancer Registry Chronic Disease Epidemiology November 2010 Vermont Facts Incidence: Lung cancer is the second most commonly diagnosed cancer in Vermont; approximately 260
Temporal Trends in Demographics and Overall Survival of Non Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008
Special Report Temporal Trends in Demographics and Overall Survival of Non Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008 Matthew B. Schabath, PhD, Zachary J. Thompson, PhD,
Lung Cancer: More than meets the eye
Lung Cancer Education Program November 23, 2013 Lung Cancer: More than meets the eye Shantanu Banerji MD, FRCPC Presenter Disclosure Faculty: Shantanu Banerji Relationships with commercial interests: Grants/Research
THINGS TO BE AWARE OF ABOUT PROSTATE AND LUNG CANCER. Lawrence Lackey Jr., M.D. Internal Medicine 6001 W. Outer Dr. Ste 114
THINGS TO BE AWARE OF ABOUT PROSTATE AND LUNG CANCER Lawrence Lackey Jr., M.D. Internal Medicine 6001 W. Outer Dr. Ste 114 WHAT IS CANCER? The body is made up of hundreds of millions of living cells. Normal
MEDICAL MALPRACTICE FACT BOOK
MEDICAL MALPRACTICE FACT BOOK - 1 - Firm Profile For over a decade, The Law Offices of Bruce M. Robinson have been dedicated to protecting the rights of victims who have been injured by the negligent and
Butler Memorial Hospital Community Health Needs Assessment 2013
Butler Memorial Hospital Community Health Needs Assessment 2013 Butler County best represents the community that Butler Memorial Hospital serves. Butler Memorial Hospital (BMH) has conducted community
1. What is the prostate-specific antigen (PSA) test?
1. What is the prostate-specific antigen (PSA) test? Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. The PSA test measures the level of PSA in the blood. The doctor
Alaska Comprehensive Cancer Control Plan 2011-15
Alaska Comprehensive Cancer Control Plan 2011-15 Alaska Comprehensive Cancer Plan 2011-2015 STATE of ALASKA Department of Health and Social Services ALASKA Comprehensive Cancer Partnership Prevention Promotion
Coding & Alan L. Plummer, MD Editor
Coding & Billing Quarterly july 2014 EDITOR ALAN L. PLUMMER, MD ATS RUC Advisor ADVISORY BOARD MEMBERS: KATINA NICOLACAKIS, MD Chair, ATS Clinical Practice Committee ATS Alternate RUC Advisor STEPHEN P.
Lung cancer. A guide for journalists on Non-Small Cell Lung Cancer (NSCLC) and its treatment
Lung cancer A guide for journalists on Non-Small Cell Lung Cancer (NSCLC) and its treatment Contents Contents 2 3 Section 1: Lung Cancer 4 i. Types of lung cancer 4 ii. Causes and risk factors 5 iii. Symptoms
Malignant Mesothelioma State of the Art
Malignant Mesothelioma State of the Art Paul Baas The Netherlands Cancer Institute August 12, 2011, Carlsbad, CA Summary Diagnosis; epithelial type subdivided Pleiomorphic vs other Staging: IASLC-IMIG
Smoking and Lung Cancer
Smoking and Lung Cancer Objectives! Students should be able to identify some of the other consequences of smoking other than lung cancer! Students should be able to identify the effects of the chemicals
Understanding. Pancreatic Cancer
Understanding Pancreatic Cancer Understanding Pancreatic Cancer The Pancreas The pancreas is an organ that is about 6 inches long. It s located deep in your belly between your stomach and backbone. Your
Recommendations for cross-sectional imaging in cancer management, Second edition
www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who
PROSTATE CANCER SCREENING PROSTATE CANCER SCREENING
3:45 4:45pm Screening Guidelines for Men's Health SPEAKER Radha Rao, MD Presenter Disclosure Information The following relationships exist related to this presentation: Radha Rao, MD: No financial relationships
Introduction Breast cancer is cancer that starts in the cells of the breast. Breast cancer happens mainly in women. But men can get it too.
Male Breast Cancer Introduction Breast cancer is cancer that starts in the cells of the breast. Breast cancer happens mainly in women. But men can get it too. Many people do not know that men can get breast
Lung Cancer. Public Outcomes Report. Submitted by Omar A. Majid, MD
Public Outcomes Report Lung Cancer Submitted by Omar A. Majid, MD Lung cancer is the most common cancer-related cause of death among men and women. It has been estimated that there will be 226,1 new cases
Emphysema. Introduction Emphysema is a type of chronic obstructive pulmonary disease, or COPD. COPD affects about 64 million people worldwide.
Emphysema Introduction Emphysema is a type of chronic obstructive pulmonary disease, or COPD. COPD affects about 64 million people worldwide. Emphysema involves damage to the air sacs in the lungs. This
How To Treat Lung Cancer At Cleveland Clinic
Treatment Guide Lung Cancer Management The Chest Cancer Center at Cleveland Clinic, which includes specialists from the Respiratory Institute, Taussig Cancer Institute and Miller Family Heart & Vascular
The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options
Why We re Here The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options What Are Lungs? What Do They Do? 1 Located in the chest Allow you to breathe Provide oxygen
The VEdeTTE cohort study: Effectiveness of treatments for heroin addiction in retaining patients and reducing mortality
The VEdeTTE cohort study: Effectiveness of treatments for heroin addiction in retaining patients and reducing mortality Federica Vigna-Taglianti www.oed.piemonte.it Piedmont Centre for Drug Addiction Epidemiology
Diagnosis and Treatment of Common Oral Lesions Causing Pain
Diagnosis and Treatment of Common Oral Lesions Causing Pain John D. McDowell, DDS, MS University of Colorado School of Dentistry Chair, Oral Diagnosis, Medicine and Radiology Director, Oral Medicine and
Role of taxanes in the treatment of advanced NHL patients: A randomized study of 87 cases
Role of taxanes in the treatment of advanced NHL patients: A randomized study of 87 cases R. Shraddha, P.N. Pandit Radium Institute, Patna Medical College and Hospital, Patna, India Abstract NHL is a highly
Non-small Cell Lung Cancer
Non-small Cell Lung Cancer Eva Szabo, MD Division of Cancer Prevention, NCI TRACO 11-2-15 Outline US Lung Cancer Statistics Tobacco use and lung cancer Risk Factors Tobacco, tobacco, tobacco (85% lung
L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer
Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,
Testimony of. Dr. James Crapo. April 26, 2005
Testimony of Dr. James Crapo April 26, 2005 Written Statement of Dr. James D. Crapo, Professor of Medicine, National Jewish Medical and Research Center and University of Colorado Health Sciences Center
Asbestos Related Diseases
Asbestos Related Diseases Asbestosis Mesothelioma Lung Cancer Pleural Disease Asbestosis and Mesothelioma (LUNG CANCER) Support Group 1800 017 758 www.amsg.com.au ii Helping you and your family through
Screening Guidelines for Malignancy Michael T. Milano, MD PhD
Screening Guidelines for Malignancy Michael T. Milano, MD PhD Department of Radiation Oncology University of Rochester School of Medicine and Dentistry Identify patient population to be screened General
Asbestos risks, safety and its role in lung disease
Asbestos risks, safety and its role in lung disease Fraser Brims Respiratory Physician, SCGH Head of Occupa9onal and Respiratory Health Unit, Ins9tute for Lung Health, WA Lung Founda9on Australia Educa9on
Breathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease
Breathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease By John W. Walsh, Co-Founder and President of the COPD Foundation Breathing Easier In
WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1557/14
WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1557/14 BEFORE: M. Crystal: Vice-Chair HEARING: August 20, 2014 at Toronto Written DATE OF DECISION: December 4, 2014 NEUTRAL CITATION: 2014
Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center
Protocol 1101-1088 Phase I study of intra-pleural administration of GL-ONC1 in patients with malignant pleural effusion: primary, metastases and mesothelioma Principal Investigator: Valerie W. Rusch, MD,
September 26, 2014. Re: National Coverage Analysis for Lung Cancer Screening with Low Dose Computed Tomography (CAG-00439N) Dear Ms.
September 26, 2014 Tamara S. Syrek Jensen, J.D. Acting Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services Mail Stop C1-09-06 7500 Security Boulevard Baltimore, MD 21244 Re:
A new score predicting the survival of patients with spinal cord compression from myeloma
A new score predicting the survival of patients with spinal cord compression from myeloma (1) Sarah Douglas, Department of Radiation Oncology, University of Lubeck, Germany; sarah_douglas@gmx.de (2) Steven
A new score predicting the survival of patients with spinal cord compression from myeloma
A new score predicting the survival of patients with spinal cord compression from myeloma (1) Sarah Douglas, Department of Radiation Oncology, University of Lubeck, Germany; sarah_douglas@gmx.de (2) Steven
Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing
Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing ASBESTOSIS November 2013 Bruce T. Bishop Lucy L. Brandon Willcox & Savage 440
Tricia Cox on 7/18/2012 at Oncology Center. Sarah Randolf. Female
SAMPLE This Survivorship Care Plan will facilitate cancer care following active treatment. It may include important contact information, a treatment summary, recommendations for follow-up care testing,
Journal of. Employee Assistance. The magazine of the Employee Assistance Professionals Association VOL. 36 NO. 2 2 ND QUARTER 2006
Employer Initiatives to Stop Smoking by Mary Hill, LCSW, CEAP As more employers take aggressive steps to reduce health care costs arising from employees tobacco use, EAPs can and must help ensure the process
SMALL. 1-800-298-2436 LungCancerAlliance.org
Understanding series SMALL CELL LUNG CANCER 1-800-298-2436 LungCancerAlliance.org A guide for the patient I TABLE OF CONTENTS ANATOMY OF THE LUNGS The following image shows different parts that make up
Individualizing Your Lung Cancer Care: Informing Decisions Through Biomarker Testing
Individualizing Your Lung Cancer Care: Informing Decisions Through Biomarker Testing These Are Hopeful Times for Lung Cancer Survivors When people first learn they have cancer, they are often afraid. But
Facing Lung Cancer? Learn why da Vinci Surgery may be your best treatment option for lung cancer.
Facing Lung Cancer? Learn why da Vinci Surgery may be your best treatment option for lung cancer. The Condition: Lung Cancer The lung is the organ that moves oxygen through your body. You have two lungs
Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1
Mesothelioma Introduction Mesothelioma is a type of cancer. It starts in the tissue that lines your lungs, stomach, heart, and other organs. This tissue is called mesothelium. Most people who get this
Guidance for Industry FDA Approval of New Cancer Treatment Uses for Marketed Drug and Biological Products
Guidance for Industry FDA Approval of New Cancer Treatment Uses for Marketed Drug and Biological Products U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation
Cancer screening: indications, benefits and myths
Cancer screening: indications, benefits and myths Silvia Deandrea Institute for Health and Consumer Protection Public Health Policy Support Unit Healthcare Quality Team Joint Research Centre The European
Malignant Mesothelioma: an Update
Malignant Mesothelioma: an Update Nico van Zandwijk Asbestos Diseases Research Institute Bernie Banton Centre University of Sydney Australia Physicians Week RACP 19-5-2009 Health Risks of Asbestos Fibers
Cancer in Ireland 2013: Annual report of the National Cancer Registry
Cancer in 2013: Annual report of the National Cancer Registry ABBREVIATIONS Acronyms 95% CI 95% confidence interval APC Annual percentage change ASR Age standardised rate (European standard population)
TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER
TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER DILEMMA Thomas J Stormont MD January 2012 http://www.youtube.com/watch?v=8jd 7bAHVp0A&feature=related related INTRODUCTION A government health panel (the
Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies
Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies Richard Wender, MD Session code: www.worldcancercongress.org A Five Step Framework to Guide Screening
Danish Lung Cancer Screening Trial (DLCST).
Danish Lung Cancer Screening Trial (DLCST). Röntgenveckan, Karlstad 11.september 2014 Jesper Holst Pedersen, MD, DMsci, Associate Professor Rigshospitalet University of Copenhagen, Denmark DLCST (Danish
Lung cancer is the most lethal cancer in our society,
POPULATION HEALTH MANAGEMENT Volume 13, Number 1, 2010 ª Mary Ann Liebert, Inc. DOI: 10.1089=pop.2009.0010 An Actuarial Approach to Comparing Early Stage and Late Stage Lung Cancer Mortality and Survival
Table of Contents. Acknowledgments. Executive Summary. Chapter 1: Introduction. Chapter 2: Cancer Incidence
Table of Contents Table of Contents Acknowledgments Acronyms Executive Summary Chapter 1: Introduction Chapter 2: Cancer Incidence Section I. Cancer Incidence Section II. Stage at Diagnosis Chapter 3:
Prostate Cancer Guide. A resource to help answer your questions about prostate cancer
Prostate Cancer Guide A resource to help answer your questions about prostate cancer Thank you for downloading this guide to prostate cancer treatment. We know that all the information provided online