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Lung Cancer: Where are We Now?
 
12:30
OncoLink -  Welcome to OncoLink's November webchat, so glad you could join us! Our lung cancer experts are here to take your questions, just type them into the box on your screen and hit submit. Please remember, that we cannot diagnose or recommend specific treatments, but we'll do what we can to help. We'll get started with a previously submitted question.
12:31
[Comment From Guest ]
Why are they going to radiate my brain if the cancer is not there yet?
12:32
Christine Hill-Kayser -  Large studies have shown that patients with small cell lung cancer, the type of lung cancer that affects about 25% of patients, may do better and live longer if they undergo brain irradiation even when there is no evidence of cancer in the brain. This is probably because microscopic cells are very likely to travel to the brain in patients with this type of lung cancer. Because they are so small and so few, they can not be seen on any type of scan – including MRI, CT, and PET scans. If they are left untreated, they may grow and cause neurologic problems. Giving radiation to the brain may kill these cells and reduce the risk of development of these neurologic problems. See this previous ask the expert question for more information: http://www.oncolink.org/experts/article.cfm?c=3&s=19&ss=51&id=2310
12:33
[Comment From Guest ]
My doc says I will need a feeding tube to get through my treatment...is that really necessary?  Why?
12:34
Katrina Claghorn -  Maintaining your weight during treatment is very important. Meeting your nutritional needs will help you complete your treatment course as scheduled and will also help your recovery. Radiation treatment can make your throat very sore and it may become difficult to eat and drink. If your medical team anticipates the treatment impacting your ability to swallow they may suggest a feeding tube. The feeding tube is temporary and is removed once you are able to follow a regular diet. Also, you can often continue to take some food and drink orally and use the tube to supplement your calorie intake. I tell my patients that the feeding tube is their nutritional insurance; it is there incase they are unable to maintain their weight and can be used to whatever extent they need.
12:36
[Comment From Guest ]
Why doesn't everyone get xrays or CT scans regularly to screen for lung cancer?
12:38
Dr. Vachani -  

Chest X-rays and Chest CT scans are still being studied for lung cancer screening.   Previous studies of annual CXR did not show that there was less deaths from lung cancer in the group that received yearly CXR.   Annual Chest CT is currently being tested in randomized clinical trials in the US and several other countries.     The results from these studies will likely be available in 2010 or 2011.   If it is shown that either of these imaging modalities can decrease deaths from lung cancer, then it will likely lead to Chest CT or chest x-ray being adopted in the US for lung cancer screening.  

12:40
[Comment From Guest ]
What is the point to quitting smoking when I already have lung cancer? My family is on my case to quit, but it seems pointless.
12:44
Dr. Weiss -  In the case of surgically curative disease, quitting decreases complications rates and improves wound healing.   Further, quitting reduces the odds of getting a new smoking-relates lung cancer or other cancer.   Patients with a previous history of lung cancer are at elevated risk of additional cancers and this risk goes up further if they continue smoking.

I used to think that there was no point in quitting after a diagnosis of metastatic lung cancer.   I saw my patients suffering from their cancer and figured that they had enough to deal with already.   I figured that they should enjoy their cigarettes and not be bothered by quitting.   My argument was one of quality of life.   In observing and talking to patients, I’ve become less comfortable with the idea that quality of life really is better with ongoing smoking.

My lung cancer patients complain about shortness of breath and cough more than any other symptom.   Although there is data, none of us need it to know that our patients feel much better from a pulmonary perspective without the cigarettes—we’ve seen it first hand.   But there’s also data out there showing that smoking can increase the clotting risk; clots in the leg and lung are a major source of morbidity and mortality for lung cancer patients and so this matters too.   There’s also data out there that patients who continue smoking have more pain than patients who stop.   Finally, there’s the cancer itself.   Data was presented at the Word Lung Conference this summer showing that lung cancer can bear receptors for nicotine; if this is true, smoking may actually spur the cancer on.

12:45
[Comment From Guest ]
I want to help my dad with his treatment...but I am so angry that he did not even try to stop smoking...how can I get over this and help him?
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