Arsenic, tobacco use, and lung cancer: An occupational cohort with 27 follow-up years

Abstract Introduction Lung cancer ranks second in new cancer cases and first in cancer-related deaths worldwide. Precision medicine is working on altering treatment approaches and improving outcomes in this patient population. Radiological images are a powerful non-invasive tool in the screening and diagnosis of early-stage lung cancer, treatment strategy support, prognosis assessment, and follow-up for advanced-stage lung cancer. Recently, radiological features have evolved from solely semantic to include (handcrafted and deep) radiomic features. Radiomics entails the extraction and analysis of quantitative features from medical images using mathematical and machine learning methods to explore possible ties with biology and clinical outcomes. Methods Here, we outline the latest applications of both structural and functional radiomics in detection, diagnosis, and prediction of pathology, gene mutation, treatment strategy, follow-up, treatment response evaluation, and prognosis in the field of lung cancer. Conclusion The major drawbacks of radiomics are the lack of large datasets with high-quality data, standardization of methodology, the black-box nature of deep learning, and reproducibility. The prerequisite for the clinical implementation of radiomics is that these limitations are addressed. Future directions include a safer and more efficient model-training mode, merge multi-modality images, and combined multi-discipline or multi-omics to form “Medomics.”

Download Full-text

The Role of Surgery in Lung Cancer Treatment: Present Indications and Future Perspectives—State of the Art

Cancers ◽

10.3390/cancers13153711 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3711

Author(s):

François Montagne ◽

Florian Guisier ◽

Nicolas Venissac ◽

Jean-Marc Baste

Keyword(s):

Lung Cancer ◽

Residual Disease ◽

State Of The Art ◽

Locally Advanced ◽

Small Cell Lung ◽

Lung Cancers ◽

Screening Programs ◽

Systemic Therapies

Non-small cell lung cancers (NSCLC) are different today, due to the increased use of screening programs and of innovative systemic therapies, leading to the diagnosis of earlier and pre-invasive tumors, and of more advanced and controlled metastatic tumors. Surgery for NSCLC remains the cornerstone treatment when it can be performed. The role of surgery and surgeons has also evolved because surgeons not only perform the initial curative lung cancer resection but they also accompany and follow-up patients from pre-operative rehabilitation, to treatment for recurrences. Surgery is personalized, according to cancer characteristics, including cancer extensions, from pre-invasive and local tumors to locally advanced, metastatic disease, or residual disease after medical treatment, anticipating recurrences, and patients’ characteristics. Surgical management is constantly evolving to offer the best oncologic resection adapted to each NSCLC stage. Today, NSCLC can be considered as a chronic disease and surgery is a valuable tool for the diagnosis and treatment of recurrences, and in palliative conditions to relieve dyspnea and improve patients’ comfort.

Download Full-text

Evaluation of telephone consultations for follow up lung cancer patients at Royal Papworth Hospital, undertaken instead of face-to-face consultations during the Covid-19 pandemic

Lung Cancer ◽

10.1016/s0169-5002(21)00244-0 ◽

2021 ◽

Vol 156 ◽

pp. S19

Author(s):

Claire Haslop ◽

Michael Bates ◽

Lavinia Magee ◽

Panagiota Chrysikaki

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Lung Cancer Patients ◽

Face To Face

Download Full-text

Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056528 ◽

2021 ◽

pp. tobaccocontrol-2021-056528

Author(s):

Thomas Martinelli ◽

Math J J M Candel ◽

Hein de Vries ◽

Reinskje Talhout ◽

Vera Knapen ◽

...

Keyword(s):

The Netherlands ◽

Tobacco Use ◽

Tobacco Smoking ◽

Longitudinal Design ◽

Positive Association ◽

Cigarette Use ◽

Convenience Sample ◽

Frequent Use ◽

Never Smokers

BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.

Download Full-text

Complete metabolic response in patients with advanced nonsmall cell lung cancer with prolonged response to immune checkpoint inhibitor therapy

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-002262 ◽

2021 ◽

Vol 9 (3) ◽

pp. e002262

Author(s):

Justin Ferdinandus ◽

Martin Metzenmacher ◽

Lukas Kessler ◽

Lale Umutlu ◽

Clemens Aigner ◽

...

Keyword(s):

Lung Cancer ◽

Cell Lung Cancer ◽

Metabolic Response ◽

Standard Of Care ◽

Nonsmall Cell Lung Cancer ◽

Published Data ◽

Complete Metabolic Response ◽

Positron Emission ◽

Checkpoint Inhibitor Therapy

IntroductionImmunotherapy is the new standard of care in advanced nonsmall cell lung cancer (NSCLC). Recently published data show that treatment discontinuation after 12 months of nivolumab treatment is associated with shorter survival. Therefore, the ideal duration of immunotherapy remains unclear, and finding markers of beneficial outcomes is of great importance. Here, we determine the proportion of complete metabolic responses (CMR) in patients who have not progressed after 24 months of immunotherapy.MethodsThis is a retrospective analysis of 45 patients with positron emission tomography using 2-[18F]fluoro-2-deoxy-D-glucose imaging for assessment of residual metabolic activity after at least 24 months. CMR was defined as uptake in tumor lesions below background levels, using mediastinum as a reference. ResultsOut of 45 patients, 29 patients had a CMR (64%). CMR was observed more frequently in non-first-line patients. Patients with CMR were younger (median 65.7 vs 75.5, p=0.03). Fourteen patients with CMR have discontinued therapy and have not progressed until time of analysis; however, median follow-up was only 5.6 (range 0.8–17.0) months.ConclusionAfter a minimum of 24 months of palliative immunotherapy for NSCLC, CMR occurred in almost two thirds of patients. Potentially, achievement of CMR might identify patients, for whom palliative immunotherapy may be safely discontinued.

Download Full-text

Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

BMC Public Health ◽

10.1186/s12889-021-11502-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elizeus Rutebemberwa ◽

Kellen Nyamurungi ◽

Surabhi Joshi ◽

Yvonne Olando ◽

Hadii M. Mamudu ◽

...

Keyword(s):

Tobacco Use ◽

Tobacco Cessation ◽

Health Workers ◽

High Volume ◽

Health Facilities ◽

Hospital Treatment ◽

Management Support ◽

Tobacco Use Cessation ◽

Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

Download Full-text

Decelerated tumor growth due to hypothyroidism with prolongation of survival in a patient with lung adenocarcinoma: a case report

Journal of International Medical Research ◽

10.1177/0300060519885302 ◽

2019 ◽

Vol 48 (3) ◽

pp. 030006051988530

Author(s):

Jia Hou ◽

Shan-Shan Xiong ◽

Zhao-Qi Huang ◽

Xing-Dong Cai

Keyword(s):

Lung Cancer ◽

Lung Adenocarcinoma ◽

Immune Checkpoint Inhibitor ◽

Checkpoint Inhibitor ◽

Tumor Therapy ◽

Stage Iv ◽

Small Cell Lung ◽

Anti Cancer ◽

Advanced Stages

Lung adenocarcinoma is a form of non-small-cell lung cancer with high mortality in the advanced stages, and is one of the most common histological subtypes of lung cancer in most countries. Prognosis of lung adenocarcinoma is generally poor, with a median survival of 4–13 months. We report a case of unusually prolonged survival of a patient with advanced lung adenocarcinoma complicated by hypothyroidism. A 71-year-old man with stage IV lung adenocarcinoma presented with hypothyroidism. Surprisingly, without any anti-tumor and anti-hypothyroidism therapy, he survived this lung cancer for longer than 2.5 years before his last follow-up visit. Patients with advanced lung adenocarcinoma rarely survive for longer than 2 years, even after therapy. We hypothesize that hypothyroidism is the cause for this discrepancy. Thyroid hormones can promote growth of carcinoma. Therefore, hypothyroidism appears to be beneficial to anti-cancer therapy. We believe that hypothyroidism, as an adverse event commonly occurring in anti-tumor therapy (e.g., an immune checkpoint inhibitor), might not be able to be completely eliminated.

Download Full-text

Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041695 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1695

Author(s):

Zongshuan Duan ◽

Yu Wang ◽

Jidong Huang

Keyword(s):

Mental Health ◽

Cigarette Smoking ◽

Tobacco Use ◽

Mental Health Problems ◽

Cigarette Use ◽

Tobacco Products ◽

Estimation Equations ◽

Nationally Representative ◽

Prospective Association

E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51–6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43–15.68) than for girls (aOR = 1.10, 95% CI: 0.14–8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic.

Download Full-text