As far as diagnosis and possibly screening, there's a lot of work being done in a couple of arenas: One is looking at the gene patterns of people who have lung cancer, the protein patterns of people who have lung cancer, with hopes that there can be a constellation of proteins [that] may be detected on a blood test that might suggest very, very early cancer, early enough to treat with a curative intent. That's a ways away [but] both those are the kinds of things that are being looked at.
The other area, and where [the Cleveland Clinic] is involved in looking is analysis of the exhaled breath of patients . . . .We collect and analyze that breath to see if there are patterns of chemicals in the breath of lung cancer patients that are unique and therefore we can identify people with lung cancer just by collecting their breath. This would be a very nice diagnostic test, because it's noninvasive, breath is easy to get, there's no risks and if we can detect cancers early enough, it could perhaps be considered for studies of a screening test.
What about possible advances in therapy?
Advances in therapy are always being looked at. There are many different targeted therapies trying to use chemotherapy in a less-broad manner. Right now, the chemotherapies don't just go to the cancer cells and kill them, but they can affect any cells that are growing. The hope would be that targets could be identified that are specific to the cancer cells so that our chemotherapy agents could kill the cancer cells without damaging normal cells.
Other people are looking into delivery of chemotherapy agents directly to the cells with nanoparticles -- very, very tiny molecules that will hold chemotherapy agents and will attach themselves to the cancer cells and then release that chemotherapy agent locally within those cancer cells.
Those, again, are a sort of distant hope for major advancement in treatment of lung cancer, but a lot of work is being done in those areas.
And if there is a take-away message from all of this, given that lung cancer incidence is so dependent on smoking, is it that if you avoid that habit, this is very unlikely to happen to you?
Absolutely. Our technologies will advance, we'll get better at diagnosing and treating, there's no question whatsoever about that.
But the much, much simpler answer is that if you don't smoke, you are extremely unlikely to get lung cancer. The sooner you quit smoking if you've started, the less likely you are to develop lung cancer. And that really, really should be the take-home message. People can do that for themselves.•
