lung nodule symptoms :: Article CreatorIncidental Lung Nodule Detection May Help Save Lives, Study Finds
The study authors say their findings argue for careful reading of CT scans done for other reasons that may reveal the presence of lung nodules.
Imagine you're getting a chest scan for a potential heart problem, and instead of a heart issue, it reveals a small spot on your lungs. A recent study published in the Journal of Thoracic Oncology suggests that these unexpected findings could be a lifesaver, offering a rare opportunity to catch lung cancer early—when it's much easier to treat.
Lung cancer remains the leading cause of cancer-related deaths in the United States, with most cases diagnosed at later, less treatable stages. Although low-dose computed tomography (CT) screening has proven effective in reducing mortality by detecting early-stage lung cancer, fewer than 5% of eligible individuals currently participate in screening programs. As a result, researchers are now examining alternative ways to detect lung cancer early, including through incidental findings during imaging done for other health concerns.
A team of researchers, including Emanuela Taioli, M.D., Ph.D., director of the Institute for Translational Epidemiology at the Icahn School of Medicine at Mount Sinai in New York, explored the effect of incidental findings of pulmonary nodules on non-small cell lung cancer (NSCLC) mortality.
The researchers analyzed data from over 1,000 patients diagnosed with NSCLC using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. They focused on chest imaging performed up to a year before cancer diagnosis for reasons unrelated to cancer screening, such as evaluating heart issues.
At the time of diagnosis, the median tumor size was 25 millimeters (mm). The predicted tumor sizes at the time of prior imaging were 12.16 mm for fast-growing tumors, 17.3 mm for medium-growing tumors, and 20.42 mm for slow-growing tumors.
The study found that if the nodules had been detected earlier, it could have lowered the risk of death by 7.79% for fast-growing tumors, 4.5% for medium-growing tumors, and 2.45% for slow-growing tumors.
Emanuela Taioli, M.D., Ph.D.
"Our findings support the concept that CT scans performed for other clinical reasons, for example, a heart condition or other issues, should be read in their entirety and interpreted carefully because they may reveal the presence of lung nodules that may need clinical attention," Taioli, the study's corresponding author, told MHE in an interview. "This is particularly true for [patients] who do not meet the eligibility criteria for lung cancer screening."
The study also revealed that approximately 10.5% of patients diagnosed with NSCLC had undergone chest imaging for reasons other than cancer screening in the year prior to their diagnosis. The study's findings suggest that identifying tumors earlier, when they are smaller (less than 10 mm), could significantly improve survival rates. For fast-growing tumors, early detection could have decreased mortality by up to 8%.
However, the study had some limitations.The authors were unable to account for various factors, such as tumor density, which could affect tumor growth rates. Additionally, the study only included NSCLC patients, and it's expected that patients with more aggressive cancer types, such as small cell lung cancer (SCLC), could benefit even more from incidental detection. The study also had to rely on estimated tumor size due to limitations in the SEER database, which only reports tumor diameter.
Despite these limitations, the findings support the need for greater attention to chest imaging done for non-cancer reasons. In the discussion section of their paper, the researchers highlighted the importance of implementing programs to address incidental pulmonary nodules. Machine learning and artificial intelligence-driven tools, already approved for use in detecting lung nodules, could also play a significant role in identifying tumors early.
In many cases, "the incidental finding of a nodule in a CT scan performed for other reasons may be the only opportunity for early detection of lung cancer nodules," Taoli said. "Early detection of lung cancer has revolutionized lung cancer prognosis, from a deadly disease to a highly curable one."
What To Know About Stage 4 Non-Small Cell Lung Cancer
Stage 4 non-small cell lung cancer (NSCLC) is the most advanced form of the condition and can be challenging to treat. Treatments include chemotherapy, surgery, immunotherapy, and radiotherapy.
At stage 4, NSCLC is no longer isolated in one lung. It has spread to either your other lung or other organs and tissues elsewhere in your body.
Living with stage 4 NSCLC can feel scary. However, encouraging treatment developments are helping people live longer and enjoy a better quality of life.
A 2020 research review even states that new treatments are "turning lung cancer from an incurable disease into a chronic disease."
This article takes a closer look at stage 4 NSCLC, including symptoms, treatment, and outlook.
The symptoms of stage 4 NSCLC go beyond the coughing and congestion that come with earlier stages of NSCLC. It's often the severity of these symptoms that leads people to get a lung cancer screening.
The symptoms of stage 4 NSCLC include:
nagging cough shortness of breath chest pain hoarse voice coughing up blood blood-tinged mucus
Metastatic cancer symptoms
If the cancer has metastasized, meaning it has spread to other parts of your body, you may have other symptoms. Some of them may include:
headache aches and pains, especially in your bones jaundice (a yellowing of your skin and eyes) swollen lymph nodes, particularly those near your neck or collarbone conditions related to your nervous system, such as dizziness, balance problems, muscle weakness, or tingling in your limbs Moffitt Cancer Center specialists note that some symptoms may be more likely to develop based on where the cancer has spread. For example, headaches are more strongly associated with brain metastasis, while jaundice suggests liver metastasis.
The National Cancer Institute reports that 40% of new NSCLC diagnoses are already at stage 4.
If you have lung cancer symptoms or a history of smoking or exposure to airborne toxins, your doctor may recommend that you have some imaging tests to diagnose or rule out lung cancer.
The first test may be a simple chest X-ray, which could reveal a suspicious nodule or mass. For more precision and to find lesions that may be missed on an X-ray, a CT scan might be ordered instead of or in addition to a lung X-ray.
Lung function tests may also be performed after a diagnosis to determine whether your lungs can withstand the removal of cancerous tissue.
Bronchoscopy
If you are coughing up mucus, a lab test may reveal the presence of cancer cells. Your doctor may also perform a bronchoscopy. In this procedure, they insert a thin, flexible tube with a camera attached down your throat and into a lung.
This provides a close-up view of lung tissue and any abnormal masses or nodules. A bronchoscopy may also include a biopsy.
Lymph node testing
If your doctor suspects the cancer has traveled to your nearby lymph nodes or other parts of your body, further tests may be appropriate. These may include:
endobronchial ultrasound endoscopic esophageal ultrasound mediastinoscopy mediastinotomy thoracoscopy The treatment timeline for NSCLC can vary significantly based on the type of treatment you're receiving and how your body and the cancer respond to various treatments.
Chemotherapy
In stage 4 NSCLC, treatment is usually indefinite. Chemotherapy and immunotherapy can last longer than months.
Chemotherapy generally starts killing cancer cells and reducing tumor size within a few weeks, whereas immunotherapy takes longer, at least a couple of months.
Surgery
When NSCLC has reached stage 4, surgery to remove cancerous tissue may not be an option. This is because the cancer may have spread to multiple sites, including organs and bones, and it may be inoperable.
In some cases of stage 4A, when the cancer has spread to one other site, surgery may be an option. It may be combined with radiation therapy and chemotherapy.
Immunotherapy
Another treatment producing encouraging results in recent years is immunotherapy. This treatment involves the use of medications that help your immune system destroy cancer cells.
A 2020 review states that immunotherapy medications prove to be effective in treating people living with advanced NSCLC. Some medications include:
Radiotherapy
A 2018 review found that radiotherapy, when combined with immunotherapy and chemotherapy, may be especially helpful in repressing the tumor's growth and providing systemic control over the condition.
The outlook for people living with stage 4 NSCLC can be a hopeful one, particularly if your body and the cancer respond well to treatment. In fact, the National Cancer Institute reported in 2020 that NSCLC mortality rates are falling in the United States due to remarkable advances in treatment.
A cancer outlook is often presented as a 5-year relative survival rate. People with the same type of cancer at the same stage are compared with people in the larger population. For stage 4 NSCLC, the 5-year relative survival rate is about 9%.
While coping with stage 4 NSCLC is certainly a challenge, know that there are plenty of people living and maintaining a strong quality of life with the condition.
Living with NSCLC means more than treating symptoms and side effects — it also means handling the emotional weight of the condition. Managing the emotional aspect of a serious condition like NSCLC is important and shouldn't be ignored as you focus on the cancer treatment itself.
Some of the important steps you can take include:
Find support: Emotional assistance can make a big difference, whether from friends, family, or a cancer support group. Lean on people close to you, and don't feel embarrassed about asking for help or feeling anxious about the future. Make small lifestyle adjustments: Follow your doctor's suggestions about a nutritious diet, regular exercise, sleep, and other facets of everyday life that support good health. Explore spirituality: If you have strong spiritual beliefs or even questions about spirituality, consider spending time contemplating those feelings and ideas and conversing with others who may share your beliefs. NSCLC support organizations
The following organizations provide support and resources for people with stage 4 NSCLC as well as their families and caregivers:
The American Lung Association oversees an online community of lung cancer survivors and helps you find support groups in your community. It also operates the Better Breathers Club, which educates people about breathing techniques, exercise, and news on treatment. The American Cancer Society offers information and inspiration for people living with lung cancer. It answers questions about treatment and life after treatment and explores other topics related to lung cancer testing and caregiving. The Foundation for Lung Cancer provides a wealth of information about lung cancer. It also offers free personalized help for people seeking resources and assistance as well as opportunities to volunteer or otherwise help people in their community or around the country. How bad is stage 4 non-small cell lung cancer?
Stage 4 NSCLC is the most advanced form of the condition and can be the most challenging to treat. That said, new treatments are available that can slow the progression of the disease and improve your quality of life.
Stage 4 NSCLC is the most advanced form of the condition and can be the most challenging to treat. That said, new treatments are available that can slow the progression of the disease and improve your quality of life.
What is the survival rate for stage 4 non-small cell lung cancer?
According to the American Cancer Society, the 5-year relative survival rate for stage 4 NSCLC is 9%. This survival rate is based on people who received a diagnosis of NSCLC between 2012 and 2018.
It's worth noting that treatments for NSCLC have improved since then. In addition, survival rates are only estimates, and everyone responds to the disease and its treatments differently.
According to the American Cancer Society, the 5-year relative survival rate for stage 4 NSCLC is 9%. This survival rate is based on people who received a diagnosis of NSCLC between 2012 and 2018.
It's worth noting that treatments for NSCLC have improved since then. In addition, survival rates are only estimates, and everyone responds to the disease and its treatments differently.
How fast does non-small cell lung cancer grow?
NSCLC may spread at different rates. The average time for a tumor to double in size is 7 months. However, this is different for everyone.
Factors that may influence the progression of NSCLC include the type of NSCLC, its stage at diagnosis, and how a person and the cancer respond to treatment.
NSCLC may spread at different rates. The average time for a tumor to double in size is 7 months. However, this is different for everyone.
Factors that may influence the progression of NSCLC include the type of NSCLC, its stage at diagnosis, and how a person and the cancer respond to treatment.
Do people ever beat stage 4 non-small cell lung cancer?
While there is no cure for stage 4 NSCLC, some people may live for many years after receiving a diagnosis. Advances in treatments are helping people live longer and improving their quality of life.
While there is no cure for stage 4 NSCLC, some people may live for many years after receiving a diagnosis. Advances in treatments are helping people live longer and improving their quality of life.
Advancements in the treatment of stage 4 NSCLC are making it possible for people to live longer and enjoy more comfortable lives.
If you or someone you know has stage 4 NSCLC, the best thing you can do is become educated about the condition and treatment options. The more you know, the better you can discuss these topics with your doctors and make decisions about your care.
Advanced Robotics For Early-stage Lung Cancer Diagnosis And Treatment
The robot-assisted bronchoscopy system comprises a seven-axis manoeuvrable arm, a flexible articulated bronchoscope and an electromagnetic navigation subsystem.Credit: LungHealth MedTech
Lung cancer typically is diagnosed at a later stage than other malignancies, due to the lack of early warning indications. In 2020 it was China's most common cancer and the leading cause of cancer-associated mortality. LungHealth MedTech, a medical robotics company in Shanghai, has developed a robotic-assisted bronchoscopy platform that can address some of the current diagnostic challenges and treatment limitations.
Routine screening programmes and advancements in imaging technologies are improving the discovery of lung nodules. Once a nodule is detected, a bronchoscopy can be used to inspect the suspicious areas and take tissue samples. However, a bronchoscopy requires a high degree of skill gained through years of clinical training. Additionally, lung nodules are often located in peripheral regions of the lungs that are hard to reach with traditional bronchoscopy.
Human lungs are a complex, fractal network of airways. "Imagine the lung as a tree and early-identified lung nodules as its fruit that typically grows on the treetops, but not on the trunk," explains Jiajun Ma, the founder and chief executive of LungHealth MedTech. "The bronchoscope has to go through many branches to reach the target, which requires appropriate tools and accurate navigation."
In conventional hand-held bronchoscopy, a skilled operator passes a long and relatively wide tube into the patient's airways. Once the lesion is found, the operator must press the controller with steady force and at a certain amount of angulation — a process that may result in slippage or displacement to adjacent airways. The deeper the bronchoscope goes,the more complex the branching, and the easier it is to 'get lost', resulting in poor diagnostic yield.
LungHealth's robotic-assisted bronchoscopy system, UnicornTM, is designed to overcome these limitations. It has a flexible robotic-articulated bronchoscope with precise motion control, free angle adjustment and high stability, and a smart navigation and positioning system for more accurate biopsy and treatment. The controller appears similar to one used for video games consoles, and operators can get started after just a few practice attempts.
"The tricky part is to balance flexibility and precision to get safe and reliable diagnoses," says Ma. "Physicians want the endoscope to be thin enough to access the narrow peripheral lung, yet wide enough for any operation; it also needs to pass smoothly through bending airways, while providing supporting force to avoid missing the target."
To tackle the challenge, scientists and engineers at LungHealth MedTech simulated and experimented with a variety of structural designs and materials. Precise motion is enabled through the closed-loop actuator, and UnicornTM's robotic tool can be turned 360 degrees at its distal end, with a maximum bending angle of more than 200 degrees in any direction. This allows it to navigate into a bronchial tree beyond its tenth segment.
The team is now conducting a clinical trial of the robotic system. It is also further refining the robotic system for even better diagnosis and new surgical treatment uses. Ma envisions that medical robotics will be a pioneer in the intelligent digital transformation of precision medicine. "Through integrating advanced materials, real-time imaging, an AI algorithm and clinical big data, the robotics will help reduce manual error and support clinical decision making."
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