LUNG CANCER MAY LIE DORMANT FOR OVER 20 YEARS

Lung cancers may lie dormant for over 20 years before suddenly turning into an aggressive form of the disease, says a study.

Survival from lung cancer remains devastatingly low with many new targeted treatments making a limited impact on the disease.

“By understanding how it develops we have opened up the disease’s evolutionary rule book in the hope that we can start to predict its next steps,” said Charles Swanton, professor at Cancer Research UK’s London Research Institute.

The wide variety of faults found within lung cancers explains why targeted treatments have had limited success.

Attacking a particular genetic mistake identified by a biopsy in lung cancer will only be effective against those parts of the tumour with that fault, leaving other areas to thrive and take over, the study pointed out.

The study also highlighted the role of smoking in the development of lung cancer.

Though early genetic faults are caused by smoking, as the disease evolved these became less important with the majority of faults being caused by a new process generating mutations within the tumour controlled by a protein called APOBEC.

The research highlights the need to find better ways to detect lung cancer earlier when it’s still following just one evolutionary path.

“If we can nip the disease in the bud and treat it before it has started travelling down different evolutionary routes we could make a real difference in helping more people survive the disease,” concluded professor Nic Jones, chief scientist at Cancer Research UK.

The study appeared in the journal Science.

OBESITY MAY SHORTEN LIFE EXPECTANCY UP TO EIGHT YEARS

'Tis the season to indulge. However, restraint may be best, according to a new study led by investigators at the Research Institute of the McGill University Health Centre (RI-MUHC) and McGill University. The researchers examined the relationship between body weight and life expectancy. Their findings show that overweight and obese individuals have the potential to decrease life expectancy by up to 8 years. The study, published in the current issue of The Lancet Diabetes and Endocrinology,further demonstrates that when one considers that these individuals may also develop diabetes or cardiovascular disease earlier in life, this excess weight can rob them of nearly two decades of healthy life.

In collaboration with researchers from the University of Calgary and the University of British Columbia our team has developed a computer model to help doctors and their patients better understand how excess body weight contributes to reduced life expectancy and premature development of heart disease and diabetes," says lead author Dr. Steven Grover, a Clinical Epidemiologist at the RI-MUHC and a Professor of Medicine at McGill University.

Diabetes and cardiovascular disease: the predictors of health

Dr. Grover and his colleagues used data from the National Health and Nutrition Examination Survey (from years 2003 to 2010) to develop a model that estimates the annual risk of diabetes and cardiovascular disease in adults with different body weights. This data from almost 4,000 individuals was also used to analyze the contribution of excess body weight to years of life lost and healthy years of life lost.

Their findings estimated that individuals who were very obese could lose up to 8 years of life, obese individuals could lose up to 6 years, and those who were overweight could lose up to three years. In addition, healthy life-years lost were two to four times higher for overweight and obese individuals compared to those who had a healthy weight, defined as 18.5-25 body mass index (BMI). The age at which the excess weight accumulated was an important factor and the worst outcomes were in those who gained their weight at earlier ages.

"The pattern is clear -- the more an individual weighs and the younger their age, the greater the effect on their health," Dr. Grover adds. "In terms of life-expectancy, we feel being overweight is as bad as cigarette smoking."

The next steps are to personalize this information in order to make it more relevant and compelling for patients. "What may be interesting for patients are the 'what if?' questions. What if they lose 10 to 15 pounds? Or, what if they are more active? How will this change the numbers?" says Dr. Grover. The research team is now conducting a three year study in community pharmacies across the country to see if engaging patients with this information and then offering them a web-based e-health program will help them adopt healthier lifestyles, including healthier diets and regular physical activity.

"These clinically meaningful models are useful for patients, and their healthcare professionals, to better appreciate the issues and the benefits of a healthier lifestyle, which we know is difficult for many of us to adopt and maintain, Dr. Grover adds.