Winter 2008 Lung Cancer Care Review

Case Report Clinical Trials Available at SCCA	Literature Review

A Letter to Physicians

Dear Lung Cancer Physician:

All of us are well aware of the huge and underappreciated problem of lung cancer, with more than 160,000 deaths expected from lung cancer this year in the United States alone, more than from breast, colon and prostate cancer combined.  In spite of the staggering statistics, there is relatively little research funding for lung cancer. In addition, many physicians take a nihilistic attitude toward lung cancer prognosis, which results in fewer clinical trials and also in doctors referring patients for therapy with palliative rather than curative intent. 

However, tremendous recent progress has improved outcomes for many patients, including those with locally advanced or metastatic disease.  Surgery can now be offered to many patients with T3 or T4 tumors, and multi-modality therapy clinical trials are available for patients with mediastinal nodal disease.  Chemotherapy has recently been shown to improve survival, even in patients with completely resected lung cancer and also in patients with advanced disease who have failed first-line chemotherapy or have a poor performance status.  These are remarkable improvements for our patients that are clearly changing treatment recommendations compared to just a few years ago.

 At UW Medicine and the Seattle Cancer Care Alliance, we have responded to these changes in several ways.  Most importantly, we have recruited a prominent lung cancer oncologist, Dr. Renato Martins, from the Brazilian National Cancer Institute, where he had been chief of medical oncology. With Dr. Martins’ leadership we have created a new Thoracic Multidisciplinary Clinic where a patient can be seen simultaneously by thoracic surgery, medical oncology and radiation oncology, with a close link to our chest radiologists and PET radiologists and their ongoing research in lung cancer staging and prognosis based on PET imaging.  Dr. Martins and I have also met many of you at our lung cancer talks around Puget Sound and the Pacific Northwest as part of our regional educational outreach efforts.

This letter is to introduce the first of a series of ongoing newsletters in thoracic oncology and lung cancer.  Our goal is to provide an educational forum for regional communication among physicians caring for lung cancer patients. Initially, we plan a quarterly newsletter that may become more frequent in the future. In each issue, we plan to provide an interesting case report that sets the stage for discussion or review of an important, evolving or controversial topic.  We also intend to include short reviews of recent lung cancer literature and a listing of clinical trials currently open for patients at the University of Washington and SCCA.  However, we want this to be an interactive format that encourages input from other specialists.  If you have an interesting or challenging case that you would like to review, or suggestions to help make the newsletter more useful or informative, please let us know.  We hope to help foster a community of collaboration amongst all of us caring for lung cancer patients. 

We sincerely hope that you will take the time to review this, our first issue, and that you will give us your feedback.  We hope that more patients will be considered for curative intent therapy, that more patients will be entered onto clinical trials, and that the Pacific Northwest will become a model for the best lung cancer care in the United States.

Best regards,

Douglas E. Wood, M.D.

Professor and Chief, General Thoracic Surgery Endowed Chair in Lung Cancer Research