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Potential future screening test could lead to earlier diagnosis of lung cancer and save thousands of lives

A potential new screening test, using cells taken from the mouth or nose, could be developed to indicate the likelihood of in smokers, helping target CT scans more effectively – and potentially saving thousands of lives, according to researchers presenting at the Winter Meeting.

The study reveals that when cells taken from the cheeks were tested with a pure beam of light, they reacted differently in patients with lung cancer to those who do not have lung cancer.

Three weeks spent underground at ‘The Diamond Light Source’ facility in Oxford have led researchers from University College London, to establish that the way pure light reacts and reflects with human cells may indicate the likelihood of a person having lung cancer.

Compared with some other types of cancer, the outlook for lung cancer hasn’t improved greatly over the decades. Only 10 per cent of patients will live for five years or more from being diagnosed. This is mainly due to the disease being diagnosed at a late stage.

So researchers are encouraged that their findings could, potentially, lead to earlier diagnosis and improved outcomes for lung cancer patients in the future.

Professor Sam Janes, a senior Wellcome Trust Fellow, from University College London and member of the British Thoracic Society (BTS), explains:

“Patients who develop lung tumours may have subtle abnormalities in all cells in their lungs, mouth and nose.

This signature of abnormality can be seen – very subtly – by shining light on the cells. The cells reflect or refract the light differently when compared to those who do not have lung cancer.”

In order to make testing as accurate as possible the researchers needed to consider the most effective light to measure cells’ reactions.

White light, for example, is not precise enough as it has too many patterns.The Diamond synchrotron in Oxford produces beams of light 10 billion times brighter than the sun through firing electrons around its kilometre long circuit.

This programme of work, funded by the Roy Castle Lung Cancer Foundation, meant researcher Dr Jim Brown could use the facility for three weeks to determine these subtle light scattering changes within the cheek cells of lung cancer patients.

Further study has shown that infrared light can achieve this in a laboratory setting. An Infrared Spectroscopy (IR) is a technique which can detect subtle biochemical differences in cells, and could potentially be performed in any laboratory across the country.

The research being presented at the British Thoracic Society Winter Meeting captures work using sample from 76 patients – 38 smokers without lung cancer, and 38 with lung cancer.

Sam Janes, senior author of the report, and member of the British Thoracic Society reveals:

“Tobacco smoke exposure seems to cause a different type of injury to cells in those that go on to develop lung cancer. If we can use this detection system early enough maybe we can spot lung cancer at a much earlier stage or even inform whether an individual is at risk of lung cancer.

Our study, using infrared light to examine such cells for the first time, revealed that the cells of smokers with lung cancer could be differentiated from those without lung cancer with an accuracy of 80 per cent.

This non-invasive test can help identify those who are at greatest risk within adult smokers, and may help target CT screening far more effectively.

Our vision for the future is that smokers could get a test in the GP or pharmacy, swab their mouth or nose, and the sample is then sent off for analysis. The earlier lung cancer is detected the better the outcome. ”

Next steps for the research team include plans to analyse samples from a larger population, following up over time, to better understand how many people develop lung cancer. The results would help to identify which patients are in need of CT scans.

Another study presented at BTS Winter Meeting, also by University College London, supported the need for screening and early diagnosis. The study highlighted that patients not yet presenting with any symptoms have better chances of a cure from lung cancer than those who are diagnosed later and with symptoms.

This is because non-small cell lung cancer can be treated surgically in its earliest stages; but only 25-30 per cent if patients receive medical attention at this earlier stage. A five year study (2007-2011) revealed that 61 per cent of patients treated surgically for lung cancer were diagnosed ‘incidentally’ through investigations performed by other specialties in the hospital. The patients who came to hospital with cancer-related symptoms had significantly higher cancer specific mortality.

Sam Janes comments: “This research clarifies the need for early screening, as certain forms of lung cancer can only be surgically treated in the earliest stages. More needs to be done to reach those in the community with have high risk factors, and encourage early screening to detect lung cancer as quickly as possible.”

?The sooner we can treat, the better the chance of survival for these patients.”

In the UK, 43,463 people were diagnosed with lung cancer in 2011 and there were 35,371 deaths from lung cancer in the UK in 2012.

In lung cancer, cells in the lungs start to multiply in an uncontrolled way, forming a growing area called the primary cancer or primary tumour. This is a malignant cancer that can cause symptoms such as a persistent cough, coughing up blood, and shortness of breath.

Source

Source: British Thoracic Society