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CT Scan Added to Fox Chase Cancer Center Study Examining Genetic Link to Lung Cancer Risk in Women

PHILADELPHIA (July 12, 2000) -- Doctors at Fox Chase Cancer Center have added the use of the CT scan to a lung cancer prevention study which is designed to determine the susceptibility to lung cancer among high-risk female smokers. Earlier studies suggest that a CT scan can be an excellent tool in the detection of certain cancer lesions in the lungs.

Michael Unger, M.D., director of pulmonary cancer detection and prevention at Fox Chase, is leading the study. "Early detection of lung cancer is difficult because there is no screening mechanism readily available like mammography is for breast cancer," said Unger. "Symptoms of lung cancer often do not appear until the disease is advanced and has spread. If caught early, lung cancer survival and cure rates are greatly improved when compared with cases detected later."

Women with a significant history of cigarette smoking are at an increased risk of developing lung cancer. This new study will determine if there is a link between cigarette smoking and women with a particular gene mutation, and if there are early indications of lung cancer found in sputum (mucus coughed up from the lungs) evaluation and bronchoscopy (examination of the lung's main airways).

Research conducted in the lab of Fox Chase scientist Margie Clapper, Ph.D., comparing lung cancer patients and healthy individuals, revealed an association between an increased risk of lung cancer and the presence of the CYP1A1 gene mutation. This association was only significant for females. Data collected suggests that CYP1A1 may serve as a biological marker of lung cancer risk in women and, therefore, as a potential marker for selecting a target group of women most appropriate for screening.

Eligible participants for the study are women, 25 years of age or older. Additional requirements include the following:

  • Must have at least a 15 pack year smoking history (A pack year is the number of packs smoked per day multiplied by the number of years a woman has smoked.)
  • Must be a current smoker defined as: at least  pack per day within the last year and/or stopped smoking within the past two months
  • Must not be pregnant or breast feeding
  • Must not have received radiation therapy to the chest area or had chemotherapy within the past six months

A woman who qualifies for the study will complete questionnaires and have a physical examination as well as clinical testing to make sure her medical condition is good.

Participants will be asked to produce sputum for analysis. A low dose chest "CT" scan will also be performed. A "CT" or "CAT" scan is an imaging test in which many x-rays are taken from different angles of a part of the body. A computer produces cross-sectional pictures of internal organs by combining these images.

In addition to the CT scan, a physician will look at the airways of the lungs during bronchoscopy and LIFE (lung imaging fluorescence endoscopy). Areas that appear suspicious will be biopsied for further evaluation. LIFE is used in addition to routine bronchoscopy. Its fluorescent light identifies pre-malignant and early malignant lesions as small as one to two millimeters, undetectable by any other technique. Such tiny tumors would be missed by routine bronchoscopy alone - the standard procedure using a lighted tube that physicians ordinarily use to diagnose thoracic tumors.

If the results of this study verify a link between cigarette smoking, the CYP1A1 gene mutation and abnormal findings in sputum, then CYP1A1 may be used as a marker to indicate high-risk women. A simple blood test to detect the gene mutation would determine which women are at highest risk for lung cancer and therefore warrant screening. Future studies are still required to continue working toward an effective method of early detection of lung cancer.

Since it is too early to determine the significance of this gene mutation in terms of lung cancer risk, the women who participate in the study will not be informed about their CYP1A1 status.

Patients diagnosed with minimally invasive carcinoma will be offered the opportunity to participate in photodynamic therapy (PDT), a technique using activation of a special photosensitizer by laser minimizing damage to normal tissues; brachytherapy, a type of radiation treatment; and surgical resection studies.

The American Cancer Society estimates that 75,000 American women will be diagnosed with lung cancer and 68,000 will die from the disease this year.

For more information about the study or to find out how to enroll, call 1-800-ENROLL-ME (1-800-367-6556).

Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic and clinical research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities, visit the Center's web site at:

Fox Chase Cancer Center, part of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence four consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach.  For more information, call 1-888-FOX CHASE or (1-888-369-2427).

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