|
Lung cancer is the leading cause of cancer death in men and women in the United States. The United States Center for Disease Control (CDC) calculates that there are approximately 438,000 premature deaths in the United States that are attributed to smoking, and $92 billion in productivity losses annually due to illness and early death related to smoking. Almost 40% of these deaths were attributed to lung cancer. The CDC estimates that there were more than 173,000 Americans diagnosed with lung cancer in 2004, and of those, more than 160,000 will die. Most lung cancer is diagnosed at late stage when survival is poor. Metastasis (spread) of lung cancer is present in over 50-60% of patients at the time of diagnosis. Even after lung surgery to completely remove all of the visible cancer, only 40-50% of patients currently survive for more than 5 years. Most patients develop cancer again either in the lung, or elsewhere in the body following attempted curative surgery. Most importantly, only 15% of lung cancer cases are found at localized early stages. When lung cancer is detected and diagnosed in an early-stage and surgery is possible, the five-year survival rates can reach 85%, compared to less than 15% 5 year survival for later stages. Therefore, improved methods for early diagnosis of airway cancer are essential. The research outlined in this proposal involves experiments using a new type of optical device to allow better examination of the airways and lungs while looking for lung cancer. The technique, called optical coherence tomography, or OCT, is very similar to ultrasound imaging, but uses light instead of sound waves. Because of certain properties of light, OCT can provide a much more detailed look at the structures and tissues in the body, and allows us to see much smaller objects, such as very early lung cancers. OCT has been used in the diagnosis of eye disease for several years. OCT has the ability to see very small developing lung tumors (less than 1um or 1/300 of an inch) at the surface and up to 2-3 mm beneath airway surfaces. This research focuses on advancing the use of OCT into the area of lung cancer diagnosis. Special tools and modifications to scopes (bronchoscopes) must be developed in order to allow the use of OCT in the airways and lungs. Part of this research involves developing the special small, rigid and flexible tools needed. The work here also involves testing of these special tools in an animal model of lung cancer. Researchers will place the small OCT devices through bronchoscopes and take OCT pictures of the airway and lungs to look for cancer. The cancers seen will then be removed for biopsy to confirm the diagnosis. At the successful conclusion of the testing, the OCT tools developed will be tested in a human clinical setting to determine whether OCT is a useful addition to the methods now used for diagnosing lung cancers, and whether it can find smaller cancers than current techniques. If so, it will possibly help physicians to find lung and airway cancers at earlier, more treatable stages, help direct their surgical treatment of the cancers, and will help improve upon the disappointing statistics for lung cancer survival. |
