PET Scan Lung Cancer

Lung cancer accounts for the most cancer-related deaths in both men and women.

More people die of lung cancer than of colon, breast, and prostate cancers combined.

In 2009, there will be an estimated 219,440 new cases of lung cancer in the United States: 116,090 cases among men and 103,350 among women, according to the American Cancer Society.

**Experts predict that this year about 159,390 people will die of lung cancer.

Lung cancer may take many years to develop--it is a silent killer because it can grow for a long time before it is found. Once the lung cancer occurs, cancer cells can break away and spread to other parts of the body (metastasis). Lung cancer is such a deadly disease because it often spreads before it is found.

Most patients are between 55 to 65 years old when they are diagnosed. Sadly, the overall survival for 5 years in patients with the different types of lung cancer is less than 10%. However, when lung cancer is found early enough for surgery to remove it (before it has spread to other organs), patient 

 

There are many types of lung cancer, but most belong to one of two types:

• Small cell lung cancer (SCLC) - Although the cancer cells are small, they spread quickly to form large tumors that then can progress to other parts of the body, including lymph nodes, brain, liver, and bones.
• Non-small cell lung cancer (NSCLC) - This is the most common type of lung cancer and incorporates several different sub-types: Squamous cell, adenocarcinoma, and large cell. These types may also spread quickly to other parts of the body.

Although most lung cancers do not cause symptoms until they have spread, some of the most common early symptoms may be:

• A cough that does not go away
• Bloody or reddish colored mucous that is coughed up
• Shortness of breath or wheezing
• Chest pain
• Hoarseness
• Rapid loss of weight; loss of appetite

If lung cancer is found, prompt treatment could save your life.

Since most people with early lung cancer do not have any symptoms, only about 15% of lung cancers are found in the early stages. When lung cancer is found early, it is often because a chest x-ray, CT scan, or other test was being done for another reason.

This is where PET Scanning can help.

If your doctor suspects that you might have or be at risk for lung cancer, he/she will most likely talk to you about your medical history and do a physical exam. To get pictures of your lungs, your doctor might want to do an imaging test, such as a PET scan.

Lung masses are usually first evaluated through a chest x-ray or a CT scan. These tests can provide information regarding the size and location of a lung mass but most often they cannot tell if the abnormality is benign or cancerous. Solitary pulmonary nodules and other lung masses can be screened with high accuracy using PET.

PET scans, now available at the PET centers nearest you are a new test that help doctors learn more about the tumor-maybe even preventing an unnecessary biopsy. Click here for information about whether you might be a candidate for PET or to schedule a PET Scan.

Treatment

The doctors diagnose the cancer and determine what kind it is by looking at a sample of the tumor under a microscope. This alone does not determine what treatment you can have. Before treatment, your doctors must determine if or how much the lung cancer has spread. This is called staging the cancer.

The outlook for your recovery and your treatment options, which may include surgery, radiation therapy or chemotherapy depend upon the stage of the cancer. If lung cancer is found and treated with surgery before it has spread to lymph nodes or other organs, the five-year survival rate is about 42%. Knowing accurately whether you are a candidate for surgery is critical at this early point in time.

PET is the most useful test that you can have when doctors are staging or re-staging lung cancer because it is more accurate than CT or any other test. 

How PET works: In cancer, cells begin to grow at a much faster rate, feeding on sugars like glucose. PET works by using a small amount of a radioactive drug called a tracer in combination with a compound such as glucose. Once you are injected with the tracer and glucose, the tracer travels through your body. It emits signals as it travels and eventually collects in the organs targeted for examination. If an area in an organ is cancerous, the signals will be stronger since more glucose will be absorbed in those areas.

In the lungs, if the cancer has affected the nearby lymph nodes, they will take up more of the radioactive glucose. Whether or not lymph nodes are involved is a critical factor in deciding whether you can have surgery to remove the lung cancer. CT scanning which looks at the size of the lymph nodes, on average is only about 68% accurate in determining if the lymph nodes have been affected. PET is more than 82% accurate in determining the same thing. In the same whole-body picture, the PET scan can look throughout your whole body to see if there are any clumps of the cancer cells that have spread. The PET scan can make the difference in your recovery.

The type of treatment that can be done is based on both type of cancer cells and the stage. If the tests show that the cancer has not spread too far when it is first found, then surgery to remove it is done. Along with the surgery, your doctor may also recommend chemotherapy and/or radiation therapy as well.

In general, however, if the cancer has spread, it is treated by chemotherapy and/or radiation therapy. Lung cancer can spread to nearly anywhere in the body, but most commonly it spreads to the brain, bone and liver. After first showing the doctors where the cancer cells are, PET can also see if the chemotherapy and/or radiation therapy has been effective in killing them.

Call the doctors at the PET centers nearest you if you have lung cancer and would like to discuss whether PET would be useful in your care. 

Follow-up

After treatment, it is important to know if any active cancer cells remain in the body. In the past, the amount and type of chemotherapy that is used, as well as the area treated by the radiation beams in radiation therapy, was according to standard rules. PET allows the type and amount of therapy to be directed specifically to you, the patient, and the location, extent, and resilience of your type of cancer.

PET can be used to image lung tumor response to therapy and to detect recurrence in successfully treated lesions.

If the cancer cells have been killed by the treatment, they will not absorb any of the radioactive glucose given in the PET scan. After treatment, although the tumor masses may still be present and seen on CT scans, the cells may no longer be alive-which can be shown by PET. Conversely, if the cancer cells have come back either in lymph nodes or scar tissue from surgery or another lesion, PET can see the accumulation of the radioactive glucose much sooner than a CT scan-treatment can be re-started sooner and this can improve your chance of beating this disease.

Call the doctors at the PET centers nearest you if you have lung cancer and would like to discuss whether PET could be useful in your care.