Every week, the editors of Cancer Today magazine bring you the top news for cancer patients from around the internet. Stay up to date with the latest in cancer research and care by subscribing to our e-newsletter.
ACS Expands Lung Cancer Screening Recommendation
The American Cancer Society (ACS) has expanded its recommendation for who should get lung cancer screening to include those who are younger and who have a less intense smoking history. The guideline, published Nov. 1 in CA: A Cancer Journal for Clinicians, mostly mirrors the United States Preventive Services Task Force (USPSTF) recommendation on lung cancer screening that was updated in March 2021. Both the USPSTF recommendation and the ACS guideline advise annual low-dose computed tomography scans for adults ages 50 to 80 years old who have a 20 pack-year smoking history—the equivalent of one pack of cigarettes a day for 20 years. However, unlike the USPSTF guidelines, which recommend annual screening for 15 years after a person stops smoking, the ACS recommends people who meet the smoking history criteria and have quit continue screening annually indefinitely. The ACS notes that the rationale for the broader recommendation stems from an analysis of the data about risk—which challenges popular thought about former smokers having decreased risk of lung cancer 15 years after smoking. “When we look at that, actually the continuing absolute risk and people who had a significant number of years of smoking, we found that just wasn’t true. In fact, your risk declined a little bit after you stopped smoking. Then it flattened out and started increasing again as your age increased, and eventually, rising pretty steeply—about 9% a year if you smoked 20 cigarettes a day,” said Robert Smith, the lead author of the guideline and the senior vice president for Early Cancer Detection Science at the ACS, in a HealthDay article. The expanded guideline could extend screening to an additional 5 million Americans, the Washington Post reports.
Children With Down Syndrome More Vulnerable to Leukemia
Young people with Down syndrome are at increased risk for acute lymphoblastic leukemia (ALL), and a recent review found they also have higher rates of relapse and treatment-related harm. In the study, published Oct. 27 in the Journal of Clinical Oncology, researchers reviewed Children’s Oncology Group trial results from 2003 to 2019 and found the five-year survival rate for patients with Down syndrome was about 7% lower than for other patients. In many cases, survival for children with ALL has improved because of intensified treatments, the study’s corresponding author Karen Rabin, a pediatric hematologist at Texas Children’s Cancer Center in Houston, said in a Nov. 1 HealthDay article. “However, children with Down syndrome aren’t benefiting as much as other children because they experience a higher risk of life-threatening infection.” Kids who have lower white blood cell counts during treatment can be at greater risk for infection, and those who have Down syndrome also have a higher frequency of mouth sores, higher blood sugar levels and higher risk of seizures related to the chemotherapy, the article noted. Rabin said immunotherapies have been an important advance in treatment, and since they are less toxic than chemotherapy, could especially benefit children with Down syndrome.
The Upside and Downside of Liquid Biopsy
Mara Buchbinder describes the dark shadow cast by a liquid biopsy result that found signs of cancer cells in her husband’s blood after almost two years of being cancer-free in an essay published Oct 29 on STAT. Buchbinder’s husband, Jesse, was diagnosed with metastatic colon cancer in June 2021, but doctors said the cancer could be curable because the metastases were limited. They surgically removed two metastases in his liver along with the tumor in his colon and then treated him with chemotherapy. His follow-up scans were clear, Buchbinder writes, until June 2023, when a liquid biopsy, which detects cancer in the blood before it shows up on a scan, found minimal residual disease. Most oncologists recommend not treating cancer until it shows up on scans, Buchbinder notes. “The main thing to do, though, is wait. Typically, the values will creep up on repeat testing until a tumor eventually appears on a scan,” Buchbinder writes. In Jesse’s case, however, six weeks after the initial test, a repeat test produced a negative result—which created elation but also uncertainty. “It was a subtle shift, one that was imperceptible to friends and relatives who were understandably ecstatic to hear about the negative result. Yet simply receiving the lone positive result opened the door to a persistent new type of uncertainty. This, then, was the source of my grief: the loss of an easier time in which I knew less and had less reason to worry.”
Cancer Today magazine is free to cancer patients, survivors and caregivers who live in the U.S. Subscribe here to receive four issues per year.