Skip to main content

Lung Carcinoma Surveillance Counterpoint: Canada

  • Chapter
  • First Online:
Patient Surveillance After Cancer Treatment

Abstract

There were approximately 23,900 new cases of lung cancer in Canada in 2008 and 20,200 deaths [1]. Between 1995 and 2004, age-standardized incidence and mortality rates decreased for men but have increased for women (Table 7.1) [2]. Non-small cell histology makes up over 80 % of lung cancer and the remainder is largely small cell lung cancer (SCLC), a disease which typically spreads early and is treated using nonsurgical approaches [3]. Patients with stage I or II and highly selected patients with stage III. A non-small cell lung cancer (NSCLC) are potential candidates for resection [3]. Only about 12 % of patients have stage I disease and 6 % have stage II. Approximately 30 % of patients present with locally advanced disease and are not candidates for curative resection. However, a subset of these patients with good performance status, minimal or no weight loss, and nonbulky disease are candidates for combined modality therapy consisting of chemotherapy and radical radiation administered with curative intent.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Canadian Cancer Society. Canadian cancer statistics. 2008. http:\\www.cancer.ca. Accessed 8 Feb 2009.

    Google Scholar 

  2. Marrett LD, De P, Airia P. Dryer D for the steering committee of Canadian Cancer Statistics 2008. CMAJ. 2008;179:1163–70.

    Article  PubMed  Google Scholar 

  3. Xie L, Ugnat A-M, Moriss J, Semenciw R, Mao Y. Histology related variation in the treatment and survival of patients with lung carcinoma in Canada. Lung Cancer. 2003;42:127–39.

    Article  PubMed  Google Scholar 

  4. Edelman MJ, Meyer FJH, Siegel D. The utility of follow-up testing after curative cancer therapy. A critical review and economic analysis. J Gen Intern Med. 1997;12:318–37.

    Article  PubMed  CAS  Google Scholar 

  5. Egermann U, Jaeggi K, Habicht JM, Perruchoud AP, Dalquen P, Soler M. Regular follow-up after curative resection of non small cell lung cancer: a real benefit for patients? Eur Respir J. 2002;19:464–8.

    Article  PubMed  CAS  Google Scholar 

  6. Richardson GE, Tucker MA, Venzon DJ, Linnoila RI, Phelps R, Phares JC, et al. Smoking cessation after successful treatment of small cell lung cancer is associated with fewer smoking related ­second primary cancers. Ann Intern Med. 1993;119:383–90.

    PubMed  CAS  Google Scholar 

  7. Martini N, Bains MS, Burt ME, et al. Incidence of local recurrence and second primary tumors in resected stage I lung cancer. J Thorac Cardiovasc Surg. 1995;109:120–9.

    Article  PubMed  CAS  Google Scholar 

  8. Ludwig Lung Cancer Study Group. Patterns of failure in patients with resected stage I and II non small carcinoma of the lung. Ann Surg. 1987;205:67–71.

    Article  Google Scholar 

  9. Feld R, Rubinsein LV, Weisenberger TH, The Lung Cancer Study Group. Sites of recurrence in resected stage I nonsmall cell lung cancer; a guide for future studies. J Clin Oncol. 1984;2:1352–8.

    PubMed  CAS  Google Scholar 

  10. Ginsberg RJ, Rubinstein L. Randomized trial of lobectomy versus limited resection for T1N0 nonsmall cell lung cancer. Ann Thorac Surg. 1995;60:615–23.

    Article  PubMed  CAS  Google Scholar 

  11. Burt M, Wronski M, Arbit E, Balicich JH, The Memorial Sloan Kettering Cancer Center thoracic surgical staff. Resection of brain metastases for non small cell lung carcinoma: results of therapy. J Thorac Cardiovasc Surg. 1992;103:399–410.

    PubMed  CAS  Google Scholar 

  12. Fairchild A, Harris K, Barnes E, Wong R, Lutz S, Bezjak A, et al. Palliative thoracic radiotherapy for lung cancer: a systematic review. J Clin Oncol. 2008;26:4001–11.

    Article  PubMed  Google Scholar 

  13. Downey RJ, Martini N, Ginsberg RJ. Bronchogenic carcinoma. In: Johnson FE, Virgo KS, editors. Cancer patient follow-up. St Louis: Mosby; 1997. p. 226–30.

    Google Scholar 

  14. Association of Community Cancer Network. Oncology patient management guidelines version 3.0. Rockville, MD: Association of Community Oncology Centres; 2000.

    Google Scholar 

  15. Pfister DG, Johnson DH, Azzoli CG, Sause W, Smith TJ, Baker S Jr, et al. American Society of Clinical Oncology treatment of unresectable non-small cell lung cancer guideline: update 2003. J Clin Oncol. 2004;22:330–53.

    Article  PubMed  Google Scholar 

  16. D’Addario G, Felip E, ESMO Guidelines Working Group. Non-small-cell lung cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19 Suppl 2:ii39–40.

    Article  PubMed  Google Scholar 

  17. Rubins J, Unger M, Colice GL, American College of Chest Physicians. Follow-up and surveillance of the lung cancer patient following curative intent therapy. ACCP evidence-based clinical practice guidelines (2nd ed.). Chest. 2007;132 Suppl 3:355s–67s.

    Article  PubMed  Google Scholar 

  18. Follow-up of non-small cell lung cancer: American College of Radiology appropriateness criteria. 2005. http:\\www.acr.org. Accessed 8 Feb 2009.

    Google Scholar 

  19. National Comprehensive Cancer Network. Practice guidelines for non-small cell lung cancer. Rockledge, PA: National Comprehensive Network; 2000.

    Google Scholar 

  20. Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Mitettinen OS, et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet. 1999;354:99–105.

    Article  PubMed  CAS  Google Scholar 

  21. Korst RJ, Gold HT, Kent MS, Port JL, Lee PC, Altorki NK. Surveillance computed tomography after complete resection for non small cell lung cancer: results and costs. J Thorac Cardiovasc Sur. 2005;129:652–60.

    Article  Google Scholar 

  22. Weigel TL, Yousem S, Dacic S, Kosco PJ, Siegfried J, Luketich JD. Fluorescence bronchoscopic surveillance after curative surgical resection for nonsmall cell lung cancer. Ann Surg Oncol. 2000;7:176–80.

    Article  PubMed  CAS  Google Scholar 

  23. Smith TJ. Evidence based follow-up of lung cancer patients. Sem Oncol. 2003;30:361–8.

    Article  Google Scholar 

  24. Korst RJ, Kansler AL, Port JL, Lee PC, Altorki NK. Accuracy of Surveillance Computed tomography in detecting recurrence of new primary lung cancer in patients with completely resected lung cancer. Ann Thorac Surg. 2006;82:1009–15.

    Article  PubMed  Google Scholar 

  25. Westeel V, Choma D, Clement F, Woronoff-Lemsi M-C, Pujol J-F, Dubiez A, et al. Relevance of an intensive postoperative follow-up after surgery for nonsmall cell lung cancer. Ann Thorac Surg. 2000;70:1185–90.

    Article  PubMed  CAS  Google Scholar 

  26. Gilbert S, Reid KR, Lam MY, Petsikas D. Who should follow-up lung cancer patients after operation? Ann Thorac Surg. 2000;69: 1696–700.

    Article  PubMed  CAS  Google Scholar 

  27. Virgo KS, Naunheim KS, McKirgan LW, Kissling ME, Lin JC, Johnson FE. Cost of patient follow-up after potentially curative lung cancer treatment. J Thorac Cardiovasc Surg. 1996;112: 356–63.

    Article  PubMed  CAS  Google Scholar 

  28. Walsh GL, O’Connor M, Willis KM, Milas M, Wong RS, Nesbitt JC, et al. Is follow-up of lung cancer patients after resection medically indicated and cost effective? Ann Thorac Surg. 1995;60:1563–72.

    Article  PubMed  CAS  Google Scholar 

  29. Younes RN, Gross JL, Deheinzelin D. Follow-up of lung cancer: How often and for what purpose? Chest. 1999;115:1494–9.

    Article  PubMed  CAS  Google Scholar 

  30. National Institute for Clinical Excellence: the diagnosis and treatment of lung cancer: methods, evidence and guidance. 2005. http://www.nice.org.uk/nicemedia/pdf/CG024niceguideline.pdf. Accessed 8 Feb 2009.

  31. Benamore R, Shepherd FA, Leighl N, Pintikie M, Patel M, Feld R, et al. Does intensive follow-up alter outcome in patients with advanced lung cancer? J Thorac Oncol. 2007;2:273–81.

    Article  PubMed  Google Scholar 

  32. Kavanagh BD, McGarry RD, Timmerman RD. Extracranial radiosurgery (stereotactic body radiation) for oligometastases. Semin Radiat Oncol. 2006;16:77–84.

    Article  PubMed  Google Scholar 

  33. Pastorini U, Buyse M, Griedel G, Ginsberg RJ, Girard P, Goldstraw P, et al. Long-term results of lung metastatectomy: prognostic analysis based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113:37–49.

    Article  Google Scholar 

  34. Curran WJ, Scott CB, Langer CJ, Komaki R, Lee J, Hauser S, et al. Long-term benefit is observed in a phase III comparison of sequential versus concurrent chemoradiation for patients with unresectable stage III non-small cell lung cancer: RTOG 9410. Proc Am Soc Clin Oncol. 2003;22:621. Abst. #2499.

    Google Scholar 

  35. Gandara DR, Chansky K, Albain KS, Leigh BR, Gaspar LE, Lara PN, et al. Consolidation docetaxel after concurrent chemoradiotherapy in stage IIIB non-small cell lung cancer: Phase II SWOG S9504. J Clin Oncol. 2003;21:2004–10.

    Article  PubMed  CAS  Google Scholar 

  36. Kelly K, Chanksy K, Gaspar LE, Albain KS, Jett J, Ung YC, et al. Phase III trial of maintenance gefitnib or placebo after concurrent chemoradiotherapy and docetaxel consolidation in inoperable stage III non-small cell lung cancer: SWOG S0023. J Clin Oncol. 2008;26:2450–6.

    Article  PubMed  CAS  Google Scholar 

  37. Choi NC, Kanarek DJ. Toxicity of thoracic radiotherapy on pulmonary function in lung cancer. Lung Cancer. 1994;10 Suppl 1:S219–30.

    Article  PubMed  Google Scholar 

  38. Rodrigues G, Lock M, D’Souza D, Yu E, Van Dyk J. Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer: a systematic review. Radiother Oncol. 2004;71:127–38.

    Article  PubMed  Google Scholar 

  39. Miller KL, Shafman TD, Marks LB. A practical approach to pulmonary risk assessment in the radiotherapy of lung cancer. Semin Radiat Oncol. 2004;14:298–307.

    Article  PubMed  Google Scholar 

  40. Miller KL, Zhour SM, Barrier RC, Shafman T, Golz RJ, Clough RW, et al. Long-term changes in pulmonary function tests after definitive radiotherapy for lung cancer. Int J Radiat Oncol Biol Phys. 2003;56:611–5.

    Article  PubMed  Google Scholar 

  41. Mah K, Caldwell CB, Ung YC, Danjoux CE, Balogh JM, Ganguli SN, et al. The impact of 18FDG PET on target and critical organs in CT-based treatment planning of patients with poorly defined non-small cell lung carcinoma: a prospective study. Int J Radiat Oncol Biol Phys. 2002;52:339–50.

    Article  PubMed  Google Scholar 

  42. Caldwell CB, Mah K, Ung YC, Danjoux CE, Balogh JM, Ganguli SN, et al. Observer variation in contouring gross tumor volume in patients with poorly defined non-small cell lung tumors on CT: the impact of 18FDG-Hybrid PET fusion. Int J Radiat Oncol Biol Phys. 2001;51:923–31.

    Article  PubMed  CAS  Google Scholar 

  43. Ashmalla H, Rafla S, Parikh K, Mokhtar B, Goswami G, Kambam S, et al. The contribution of integrated PET/CT to the evolving definition of treatment volumes in radiation treatment planning in lung cancer. Int J Radiat Oncol Biol Phys. 2005;63:1016–23.

    Article  Google Scholar 

  44. Dahele MR, Ung YC. 18FDG PET in planning radiation treatment of non-small cell lung cancer: Where exactly is the tumor? J Nucl Med. 2007;48:1402.

    Article  PubMed  Google Scholar 

  45. Stroom J, Blaauvgeers H, van Baardwuk A, Boersma L, Lebesque J, Theuws J, et al. Feasibility of pathology correlated lung imaging for accurate target definition of lung tumors. Int J Radiat Oncol Biol Phys. 2007;69:267–75.

    Article  PubMed  Google Scholar 

  46. Dahele M, Hwang D, Peressotti C, Sun L, Kusano M, Okhai S, et al. Developing a methodology for 3-D correlation of PET-CT images and whole mount histopathology in non-small cell lung cancer. Curr Oncol. 2008;15:62–9.

    Article  PubMed  CAS  Google Scholar 

  47. Ponn RB. Lightning can strike twice: second primary lung cancers. Chest. 2000;118:1526–9.

    Article  PubMed  CAS  Google Scholar 

  48. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin. 2000;50:7–33.

    Article  PubMed  CAS  Google Scholar 

  49. Ellis PM, Delaney G, Della-Fiorentina S, Moylan E. Assessing outcomes of cancer care: lessons to be learned from a retrospective review of the management of small cell lung cancer at the Cancer Therapy Centre, Liverpool Hospital, January 1996–July 2000. Australas Radiol. 2004;48(3):364–70.

    Article  PubMed  CAS  Google Scholar 

  50. Murray N, Coy P, Pater JL, Hodson I, Arnold A, Zee BC, et al. Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 1993;11:336–44.

    PubMed  CAS  Google Scholar 

  51. Turrisi 3rd AT, Kim K, Blum R, Sause WT, Livingston RB, Komaki R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Eng J Med. 1999;340:265–71.

    Article  CAS  Google Scholar 

  52. O’Brien ME, Ciuleanu TE, Tsekov H, Shparyk Y, Cuceviá B, Juhasz G, et al. Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small-cell lung cancer. J Clin Oncol. 2006;24:5441–7.

    Article  PubMed  Google Scholar 

  53. von Pawel J, Schiller JH, Shepherd FA, Fields SZ, Kleisbauer JP, Chrysson NG, et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol. 1999;17:658–67.

    Google Scholar 

  54. Johnson BE. Second lung cancers in patients after treatment for an initial lung cancer. J Natl Cancer Inst. 1998;90:1335–45.

    Article  PubMed  CAS  Google Scholar 

  55. Kawahara M, Ushijima S, Kamimori T, Kodam N, Ogawara M, Matsui K, et al. Second primary tumours in more than 2-year disease-free survivors of small-cell lung cancer in Japan: the role of smoking cessation. Br J Cancer. 1998;78:409–12.

    Article  PubMed  CAS  Google Scholar 

  56. Tucker MA, Murray N, Shaw EG, Ettinger DS, Mabry M, Huber MH, et al. Second primary cancers related to smoking and treatment of small-cell lung cancer. Lung Cancer Working Cadre. J Natl Cancer Inst. 1997;89:1782–8.

    Article  PubMed  CAS  Google Scholar 

  57. Cancer Care Ontario. Cross-sectional diagnostic imaging in lung cancer: a Cancer Care Ontario recommendations report. 2006. http://www.cancercare.on.ca/pdf/pebcdilungf.pdf. Accessed 8 Feb 2009.

  58. National Comprehensive Cancer Network (NCCN). Clinical practice guidelines in oncology: small cell lung cancer. V.2. 2009. http://www,nccn.org/professionals/physician_gls/PDF/sclc.pdf. Accessed 8 Feb 2009.

    Google Scholar 

  59. Sorensen M, Felip E, ESMO Guidelines Working Group. Small-cell lung cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19 Suppl 2:ii41–2.

    Article  PubMed  Google Scholar 

  60. Sugiyama T, Hirose T, Hosaka T, Kusumoto S, Nakashima M, Yamaoka T, et al. Effectiveness of intensive follow-up after response in patients with small cell lung cancer. Lung Cancer. 2008;59: 255–61.

    Article  PubMed  Google Scholar 

  61. Stewart BW, Kleihues P, editors. World cancer report. Lyon: IARC Press; 2003.

    Google Scholar 

  62. Gilmore J. Report on smoking in Canada, 1985 to 2001 (Statistics Canada, Catalogue 82F0077XIE). 2002.

    Google Scholar 

  63. Walker MS, Larsen RJ, Zona DM, Govindan R, Fisher EB. Smoking urges and relapse among lung cancer patients: findings from a preliminary retrospective study. Prev Med. 2004;39:449–57.

    Article  PubMed  Google Scholar 

  64. Godtfredsen NS, Prescott E, Osler M. Effect of smoking reduction on lung cancer risk. JAMA. 2005;294:1505–10.

    Article  PubMed  CAS  Google Scholar 

  65. Richardson GE, Tucker MA, Venzon DJ, Linnoila RI, Phelps R, Phares JC, et al. Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers. Ann Intern Med. 2005;119:383–90.

    Google Scholar 

  66. Gritz ER, Nisenbaum R, Elashoff RE, Holmes EC. Smoking behavior following diagnosis in patients with stage I non-small cell lung cancer. Cancer Causes Control. 1991;2:105–12.

    Article  PubMed  CAS  Google Scholar 

  67. Davison AG, Duffy M. Smoking habits of long-term survivors of surgery for lung cancer. Thorax. 1982;37:331–3.

    Article  PubMed  CAS  Google Scholar 

  68. Nakamura H, Haruki T, Adachi Y, Fujioka S, Miwa K, Taniguchi Y. Smoking affects prognosis after lung cancer surgery. Surg Today. 2008;38:227–31.

    Article  PubMed  Google Scholar 

  69. Browman GP, Wong G, Hodson I, Sathya J, Russell R, McAlpine L, et al. Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Engl J Med. 1993;328:159–63.

    Article  PubMed  CAS  Google Scholar 

  70. Yu GP, Ostroff JS, Zhang ZF, Tang J, Schantz SP. Smoking history and cancer patient survival: a hospital cancer registry study. Cancer Detect Prev. 1997;21:497–509.

    PubMed  CAS  Google Scholar 

  71. Fleshner N, Garland J, Moadel A, Herr H, Ostroff J, Trambert R, et al. Influence of smoking status on the disease-related outcomes of patients with tobacco-associated superficial transitional cell carcinoma of the bladder. Cancer. 1999;86:2337–45.

    Article  PubMed  CAS  Google Scholar 

  72. Monson JM, Stark P, Reilly JJ, Sugarbaker DJ, Strauss GM, Swanson SJ, et al. Clinical radiation pneumonitis and radiographic changes after thoracic radiation therapy for lung carcinoma. Cancer. 1998;82:842–50.

    Article  PubMed  CAS  Google Scholar 

  73. Videtic GMM, Stitt LW, Dar AR, Kocha WI, Tomiak AT, Truong PT, et al. Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol. 2003;21:1544–9.

    Article  PubMed  Google Scholar 

  74. Tsao AS, Liu D, Lee JJ, Spitz M, Hong WK. Smoking affects treatment outcome in patients with advanced non small cell lung cancer. Cancer. 2006;106:2428–36.

    Article  PubMed  Google Scholar 

  75. Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating tobacco use and dependence: 2008 update. Rockville, MD: Public Health Service, US Department of Health and Human Services; 2008. http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf. Accessed 8 Feb 2009.

    Google Scholar 

  76. U.S. Department of Health and Human Services. Clinical practice guideline: treating tobacco use and dependence. 2000. http://www.surgeongeneral.gov/tobacco/treating_tobacco_use.pdf. Accessed 8 Feb 2009.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bill Evans M.D., F.R.C.P.C .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Humana Press

About this chapter

Cite this chapter

Darling, G., Ung, Y., Ellis, P., Martelli-Reid, L., Evans, B. (2013). Lung Carcinoma Surveillance Counterpoint: Canada. In: Johnson, F., et al. Patient Surveillance After Cancer Treatment. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-969-7_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-969-7_15

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-968-0

  • Online ISBN: 978-1-60327-969-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics