My dad had lung cancer and I am worried that I made develop it. Is there any vitamin I can take to reduce my chances of developing lung cancer?

Stop worrying, there is nothing you can do for lung cancer except stop smoking. There is nothing out there that you can take to prevent cancer. There is a lot of hype made about vitamin C, vitamin e and selenium but there is no evidence that these minerals can prevent lung cancer. If you don’t smoke, then keep away from people who do.

My father was just told that he has asbestosis. How did he get it?

Asbestosis is not inherited and does not occur on its own. Your father most likely got it from the environment. 

The majority of people in the USA acquire asbestosis from work related exposure. Asbestosis is a chronic condition of the lung which occurs when tiny particles of asbestos fibers are inhaled. Over time, the lungs lose elasticity and breathing becomes very difficult. 

Asbestos in the home for insulation has practically been eliminated in North America. So my guess is that your father probably developed asbestosis from work.  If you have no asbestos insulation at home, find out what work your father did and speak to a lawyer.  He most likely was not given adequate protection and thus inhaled the asbestos particles while working.

Selenium sucks for lung cancer

There has been a lot written about selenium and its healing properties. For decades, people have been gulping down selenium to treat every disorder under the sun.

Now another study shows that selenium does not reduce the risk of developing lung cancer. This latest study from MD Anderson Cancer center confirms that selenium is junk. The researchers at MD Anderson followed more than 1,500 patients with early lung cancer who had their cancer removed and were cancer free. These patients took 200 microgram of selenium everyday. 

The results were abysmal to say the least. In fact, the study at MD Anderson was stopped prematurely because patients taking the sugar pill fared a lot better than those taking selenium.

In a previous study, these researchers also showed that selenium did not protect against skin or prostate cancer.

Now a number of major cancer hospitals in the country are recommending that consumers stop wasting their money on selenium in the hope of preventing lung cancer or any other cancer.

For consumers who want to prevent lung cancer, the best advice is to stop smoking.  If you do not smoke, then do not start this dreadful habit.

CT Scan to Screen for Lung Cancer: Part 2

However, CT scans do have some risks. Radiation exposure even at low doses is significantly much higher than the conventional x-ray. Moreover, CT scans are also expensive ($600-$1,000) and the majority of health insurance companies and Medicare do not pay for reimbursement. Moreover, when a lesion is identified, in most cases it has to be investigated further. This leads to more testing and a biopsy. This not only adds to increasing costs but also to a whole host of complications. Moreover, just like colonoscopy,  surgeons will definitely over utilize surgery just because they can make more money.

Nevertheless, Dr. Harold Varmus, Director of the National Cancer Institute indicates that this is the first clear evidence that a screening test can help reduce the high number of deaths associated with lung cancer. Added Dr Varmus, “Lung cancer is the leading cause of cancer mortality in the U.S. and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 percent has the potential to spare very significant numbers of people from the ravages of this disease."

Dr. Otis Brawley, chief medical officer of the American Cancer Society agrees. "This is the first baby step toward adopting lung cancer screening in smokers. This is the first time we have any study that truly proves that screening smokers can save lives and can be beneficial. It really does give us some hope."

For the consumers this is both good and bad news. Sure, the test will identify lung cancer early and hopefully lead to cure. But on the other hand, the costs of regular CT scans and all the associated procedures that may occur will also lead to excessive costs. In addition, with the way the health care system is running- only doctors will be the winners.

CT Scan to Screen for Lung Cancer: Part 1

The majority of people who develop lung cancer are not diagnosed until it is too late. One of the chief reasons for late diagnosis is because there are no suitable screening tests. Unlike breast or colon cancer, there are no radiological tests for screening lung cancer.  Plain chest x-rays are simply not sensitive enough to identify lung cancer in the early stages. For many years, it was believed that CT scans were not suitable for lung cancer screening. However, now a recent study funded by the National Cancer Institute showed that when CT scans were used to screen patients for lung cancer, at least 20 % fewer patients died from this horrible cancer.

This is the first time it has been shown that perhaps CT scans can be used as a screening test. The present study known as the  National Lung Screening Trial, involved more than 53,000 current and former heavy smokers ages 55 to 74, and was designed to compare two screening procedures for lung cancer—low-dose helical computed tomography and a chest X-ray.

The study clearly showed that lung cancer screening by CT scan reduced lung cancer deaths because it identified lung cancers at an early stage. The data were so statistically compelling the trial was discontinued and the results immediately made public. The results of the study revealed that CT screening could benefit older, high-risk patients.

Principal investigator Dr. Denise Aberle, for the American College of Radiology Imaging Network (ACRIN) said, "We have the potential to save thousands of lives if low-dose screening is implemented responsibly, and people with abnormalities are closely followed.”

The majority of participants in the study smoked at least a pack a day for 30 years and had no symptoms of lung cancer. They were screened once a year for three years and followed for an additional five years.

"This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial," said Dr. Christine Berg, NLST project officer for the Lung Screening Study. "The fact that low-dose helical CT provides a decided benefit is a result that will have implications for the screening and management of lung cancer for many years to come."

Coughing up Blood: Part 3

Investigations
Chest x ray

CT scan of the chest.

Bronchoscopy uses a small flexible camera to visualize the airways. The procedure can assess both the large and small airways, and biopsies can be obtained.

Sometimes a lesion may be seen on a chest x ray and a biopsy may be obtained by a needle using x ray guidance.

If it is believed that the hemoptysis is from a disorder of the heart, then one may undergo other studies like an ECG and an ECHO

One should always see a physician when hemoptysis occurs. While many benign causes may resolve spontaneously, the possibility of a lung cancer must always be ruled out, especially if one is a smoker. Sometimes no cause of hemoptysis is identified and monitoring is required.

Hemoptysis is not a symptom that should be managed at home. It is highly recommended that one see a health professional and determine the cause.

Coughing up blood: Part 2

Individuals who develop heart failure often develop episodes of hemoptysis. The coughing discontinues when the heart failure is treated.

In some rare patients with a blood clot in the lung will have hemoptysis. The hemoptysis is mild and usually resolves with time

Occasionally severe blunt or penetrating trauma to the chest can result in hemoptysis. In such a scenario, the individual is admitted and thoroughly worked up to ensure that no critical structure is damaged.

In very rare instances, some individuals who sniff cocaine or heroin also develop episodes of hemoptysis

The most feared and serious cause of hemoptysis is lung cancer. There are some lung cancers that grow centrally and these cancers can erode into major blood vessels and present with alarming hemorrhage. Sometimes, coughing up of blood may be the first sign of a presence of a lung cancer

Irrespective of the amount of hemoptysis, one needs to be seen by a physician. Some of the standard imaging studies in the work up of hemoptysis include: