Early lung cancer screenings improve treatment options

id you know lung cancer is the leading cancer killer in both men and women in the United States? Dr. Min Kim, head of thoracic surgery at Houston Methodist Hospital, takes care of patients with thoracic disease and performs research and trials to understand the mechanism involved in lung cancer metastasis. I recently sat down with Dr. Kim to talk about the current state and future of lung cancer.

Lung cancer kills 160,000 Americans a year and we’re seeing about 200,000 newly diagnosed cases a year Click To Tweet
Min P. Kim, M.D
Dr. Min Kim

Lung cancer takes more lives than breast, prostate and colon cancers combined in the United States. In the last 35 years, the overall survival rate in lung cancer patients has only improved by about four to five percent. Why? 

Dr. Kim: The main reason for such poor overall survival is that by the time patients with lung cancer see a doctor, the majority of those patients have metastatic disease. We have effective treatments for early stage lung cancer but for patients with metastatic disease, there are few effective treatments available.

This has led me to devote my scientific career to the study of cancer metastasis. I have recently developed a 4D model that can mimic the biology of cancer progression. My hope is that this model can help us better understand the biology of cancer progression and ultimately develop treatments to stop metastasis.

How have you seen surgical treatment options evolve?

Dr. Kim: For patients with early stage lung cancer, we have developed minimally invasive approaches to treat lung cancer. There are two main minimally invasive approaches that are utilized at Houston Methodist Hospital. We are performing both video assisted thoracic surgery (VATS) lung resection as well as robot-assisted lung resection. Both approaches provide our patients with significantly fewer complications, less pain and faster recovery compared to the traditional open surgery.  

Lung cancer kills nearly 160,000 Americans a year and we’re seeing about 200,000 newly diagnosed cases a year. Do you think more people need to be screened in order to improve survival rates?

Dr. Kim: Yes. Recent low-dose computed tomographic (CT) screening for people who are at high risk for developing lung cancer has shown that screening will reduce the chance of dying from lung cancer by 20 percent. I advocate anyone who has a significant smoking history to undergo a screening CT scan. This will allow the person to get diagnosed with early stage lung cancer, which can be treated and potentially cured with surgery.

Low-dose CT scans can reduce the chance of dying from lung cancer by 20% Click To Tweet

In addition to screening for people with a significant history of smoking, I advocate for people to never smoke. Recently there has been a decrease in the death rate from lung cancer and this is due to a decrease in the number of smokers. If no one smokes, lung cancer can become a rare disease.

You still have several more decades of being in practice. What’s your hope by the time you retire? 

Dr. Kim: My hope is that by the time that I retire, lung cancer will become a chronic disease and people will no longer die from this disease.

lung cancer infographic

Tips for adjusting to daylight saving time

very fall, Americans love the idea of gaining an extra hour when daylight saving time ends. But if you’re already one of the millions of Americans who is sleep deprived, “falling back” an hour doesn’t mean you’re gaining sleep. Dr. Aparajitha Verma, a sleep neurologist at Houston Methodist Hospital, answers some of the most common questions about how to practice good sleep hygiene before (and after) November 2 rolls around.

What are the pros and cons of gaining an hour on Sunday from a health standpoint?

Pro – In theory, daylight saving time gives us the opportunity, at least twice a year, to practice good sleep habits that we should try to use year round. You should sleep in a quiet and dark environment and set the thermostat at a slightly cooler temperature; don’t allow pets in the bed; no reading, eating or watching TV in bed; don’t watch the clock; set a “wind down” time prior to going to bed; don’t take over-the-counter sleep aids and avoid caffeine, nicotine and alcohol close to bedtime, as these can disrupt sleep. Instead, try drinking warm teas or milk to increase your body temperature, which helps induce and sustain sleep; and exercise is good for sleep, but not within two hours of going to sleep.

Con – You may think you’re gaining an hour, but only a minority of people actually use that extra hour for catching Zs. Instead, the one-hour shift in the sleep cycle can actually negatively affect sleep patterns. People wake up earlier, have more trouble falling asleep, and are more likely to wake up during the night. If you’re already sleep deprived (also known as a voluntary short sleeper) and regularly get less than seven hours a night, or an early riser (also known as a lark), you’ll probably have the most trouble adjusting to the new schedule.  

    

 

 

What effects might this time change have on our health?

There are the obvious problems such as increased fatigue level, decreased productivity at work, and increased risk of accidents due to sleepy drivers. But disrupted sleep patterns can lead to more serious sleep problems. More than 70 million people in the United States are already affected by some kind of sleep disorder. Add the time change, and it can cause serious health and lifestyle issues.

Daylight saving time gives us the opportunity to practice good sleep habits that we should try to use year… Click To Tweet

People need to make sure they are well rested before the time change. One way to do that is to start changing your sleep habits days before the time change. You can get up an hour earlier and go to sleep an hour earlier. You can also take a short nap in the afternoon on Sunday if you need it, but not within a few hours of your regular bedtime. Napping too close to bedtime can disrupt nighttime sleep.

Are there positive health effects on our body?

Each of us experiences physical, mental, and behavioral changes during the course of a day. These are called circadian rhythms. The daily cycle of light and dark keep them on a 24-hour cycle. Sleep is a component of circadian rhythms. When we lose an hour every spring, it can take days to get your circadian rhythms back on track. But in the fall, all it usually takes is one or two nights. Regular exercise, preferably at the same time each day, may help get your sleep cycle back on track. Going to bed and getting up on a schedule can help. Caffeine and alcohol intake in moderation is always recommended. And giving into brief afternoon nap during the week may be a pleasant and relaxing way to restore lost sleep.

Get more sleep tips by checking out our Sweet Dreams Pinterest board:

 Follow Houston Methodist’s board Sweet Dreams on Pinterest.

The importance of bone marrow donation: Chen’s story

Every year, more than 12,000 patients in the United States are diagnosed with life-threatening diseases such as leukemia or lymphoma for which a marrow or umbilical cord blood transplant from an unrelated donor may be their best or only hope of a cure.

Chen Gong is one of them.  A year ago, she was working well over 40 hours a week at an oil and gas manufacturing company doing paperwork in the supply chain department. During her free time, Chen would hang out with friends or go shopping with her mom. These days, she’s still spending a lot of time with her mom – but from a hospital bed at Houston Methodist Hospital, desperately waiting for one unknown person to give her a life-saving bone marrow donation.

Dr. Swaminathan Iyer, hematologist at Houston Methodist Cancer Center, says a staggering 70 percent of patients in need of a transplant do not have a matching donor in their family. They depend on an unrelated bone marrow donor or umbilical cord blood unit.

This illustration shows cells in bone marrow which produce approximately 500 billion blood cells per a day, supporting the body’s immune system.

In the Asian community, more than 720,000 potential donors exist, but that’s only 7 percent of the entire bone marrow donor registry. The numbers aren’t much better for African-Americans or Hispanics, and they’re even more dismal if you’re of mixed race.

A staggering 70% of patients in need of a bone marrow transplant do not have a matching donor in their family Click To Tweet

Chen, a 26-year-old native of Shanghai, China hates the thought of others seeing her sick but at the same time, she needs to find a donor who might help rid her body of recurrent acute myeloid leukemia. Chen was diagnosed in the summer of 2013 after she noticed red spots appearing on her legs. After her initial treatment seemed to work, Chen’s leukemia relapsed this March. She recently finished a round of chemotherapy and now she’s waiting to see if her blood count goes up.

Waiting is the hardest part. I sleep a lot because there isn’t much else to do, and it’s like I have to feel worse before I can get better. I still have a lot I want to do. I want to get married and have a family.

No one in Chen’s immediate family is a full match, which is the ideal candidate who would provide a perfect genetic match. Chen’s dad is a half match, but her medical team at Houston Methodist Cancer Center want to hold off, as her immune system might reject the marrow.

Chen and her Houston Methodist physicians, including oncologist Daniel Lehane, M.D., are hoping that more people, especially minorities, between the ages of 18 and 44 will join the registry. If you’ve thought about joining but haven’t made the decision yet, Dr. Iyer wants people to understand the following:

  • It’s a simple cheek swab. You don’t actually donate until you are a match for a patient
  • You don’t have to be the same blood type, but there are 10 markers in your DNA that have to match the recipient
  • Bone marrow donations are not painful. Donors are typically under general anesthesia during the withdrawal of liquid marrow from the back of the pelvic bone. Donors go home the same day and are back to their usual routines within a few days with only a small amount of discomfort.

Learn how you can donate bone marrow for a patient like Chen.

Genetic mutations: knowing your cancer risk

Just a few decades ago, mothers would have considered certain topics off limits when talking with their daughters.  Today, these kinds of conversations are less taboo, especially when it comes to talking about family medical history. Take time to ask about your family’s medical history, especially for breast and ovarian cancers.

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Mutations can be inherited from either parent and may be passed on. Each child of a genetic carrier has a 50 percent chance of inheriting the mutated gene.

Your family’s health history may mirror your own and give you a heads up on what you to expect. For example, the likelihood of developing common gynecological conditions such as endometriosis and polycystic ovary syndrome greatly increase if a close female relative, such as your mother or aunt, has a history of the condition. Tejal Patel, M.D., leads the high-risk clinic at Houston Methodist Cancer Center and says mothers can influence their daughters screening choices across their life span.

When cancer is present in a family, genetic counselors play a prominent role in helping families understand their risk.  Many of us have heard about BRCA gene mutations that can produce hereditary breast-ovarian cancer syndrome in affected families. Patel says mutations in BRCA1 and BRCA2 genes account for only five to 10 percent of all breast cancer cases in women, but the goal is to find the mutation in women before they develop cancer. Patients with either BRCA mutation have a 55 to 87 percent higher lifetime risk of developing breast cancer of (compared to a general population risk of 10 to 12 percent), as well as a 20 to 40 percent higher lifetime risk of developing ovarian cancer (compared to a general population risk of less than two percent).

“High-profile figures, like actress Angelina Jolie, have brought this topic to the forefront. Now it is up to all women to continue to increase awareness,” says Patel.

Patel stresses that a simple blood or saliva test can tell a woman whether she’s at a higher risk of developing breast or ovarian cancer.  In some cases, a woman with a negative genetic test may still be considered to be at an increased risk of developing breast cancer.  There are other gene mutations (besides BRCA 1 and 2) that may also increase a woman’s risk of developing cancer.  Knowing the risk can help both the patient and the doctor make more informed decisions about a health plan before cancer has a chance to develop.

Patients with BRCA mutations have a 55% to 87% higher lifetime risk of developing breast cancer Click To Tweet

Women should talk with their physicians about testing for hereditary breast and ovarian cancer syndrome if they have personal or family history of the following:

  • Breast cancer at age 50 or younger
  • Ovarian cancer at any age
  • Male breast cancer at any age
  • Ashkenazi Jewish ancestry and a personal or family history of breast or ovarian cancer
  • Two breast cancers in the same person or on the same side of the family
  • Triple negative breast cancer at age 60 or younger
  • A previously identified BRCA1 or BRCA2 mutation in the family

Mutations can be inherited from either parent and may be passed on to both sons and daughters. Each child of a genetic carrier, regardless of sex, has a 50 percent chance of inheriting the mutated gene from the parent who carries the mutation. That means half of the people with BRCA gene mutations are male.

Patel says men should consider testing if they have a personal history of breast cancer, a family history of breast or ovarian cancer, or a family member with a BRCA1 and BRCA2 mutation. Although male breast cancer is rare, men who carry BRCA mutations are more likely to develop breast cancer and prostate cancer.