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Country Star Merle Haggard Battling Lung Cancer

Country singer Merle Haggard, recently diagnosed with lung cancer, had part of a lung removed and is recovering at home, his spokeswoman said on Sunday. The 71-year-old singer-songwriter underwent surgery on Monday in a Bakersfield, California, hospital. "I'm feeling good ... better and better each day," Haggard was quoted as saying in a statement. "If not for the love and wisdom of my wife (Theresa), I might not be around today." Doctors removed the upper lobe of Haggard's right lung after a biopsy revealed that he had non-small cell lung cancer, the statement said. Tests revealed that all the affected tissue was removed. According to the American Lung Association, non-small cell lung cancer usually spreads to different parts of the body more slowly than the less-common small cell lung cancer. Lung cancer is the leading cancer killer of men and women in the United States. The expected 5-year survival rate for lung cancer patients is 16 percent, according to the association. Haggard has been touring and recording since 1965, combining folk, jazz, pop and blues traditions to compose songs that have been covered by the likes of Elvis Costello, the Grateful Dead and Lynyrd Skynyrd. He is perhaps best known for his anti-hippie anthem "Okie From Muskogee," which topped the charts in 1969. Haggard entered the business following a decade of run-ins with the law, culminating in a stint in California's San Quentin State Prison.

Study Points to Way of Stopping Lung Cancer Spread

Lung cancer cells produce a compound that helps the tumor spread to other parts of the body, a finding that could lead to a new way to prevent this dangerous development, researchers reported on Wednesday. They said a protein called versican hijacks elements of the immune system, generating inflammation that can spur the growth and spread of lung cancer. Michael Karin of the University of California, San Diego, and colleagues made the findings in experiments with mice, but said the protein is found in low levels in some normal human lung cells and other tissues. Versican is made in large amounts by lung cancer cells, especially in aggressive tumors, they reported in the journal Nature. Cancer becomes far more dangerous and hard to treat when it spreads from the original tumor site -- the lungs in this study -- to other parts of the body in a process called metastasis. The researchers said their findings could lead to new treatments to limit the metastasis of lung cancer, perhaps by blocking the cancer cells from secreting the protein. Versican was known to be involved in the development of embryos, and known to be active in some tumors, although its role was not clearly understood. The study showed that versican causes the production of immune system proteins called cytokines, generating inflammation that fuels the growth and spread of the cancer. "Our research showed that versican which (is) produced by cancer cells induced inflammatory response and this whole process enhances metastasis. This simply says that blocking versican or blocking the inflammatory response can reduce the metastatic incidence. However, it is not that easy," Sunhwa Kim, one of the researchers, said by e-mail. The immune system's complexity is one hurdle, Kim said. Kim, who previously worked in Karin's lab and now works for Johnson & Johnson, called the findings a good starting point for human studies focusing on this protein. Worldwide, lung cancer is the leading cause of cancer death in men and the second leading cause of cancer death in women, with about 975,000 men and 376,000 women dying annually, according to the American Cancer Society. About 1.5 million new cases of lung cancer occur per year.

BRCA1 Influences Lung Cancer Chemotherapy

Carriers of certain haplotypes of the BRCA1 gene, which plays a central role in the DNA repair system, do not appear to respond to platinum-based chemotherapy for non-small-cell lung cancer, Korean researchers report in the Journal of Clinical Oncology published online ahead of print.
"Results from this study," senior investigator Dr. Jeong-Seon Ryu told Reuters Health, "show that lung cancer patients with two copies of AACC of BRCA1 do not benefit from platinum doublets -- gemcitabine/platinum, docetaxel/platinum or paclitaxel/platinum -- that are standard regimens worldwide for locally advanced or metastatic non-small-cell lung cancer."
Dr. Ryu of Inha University Hospital, Inchon, and colleagues came to this conclusion after studying the relationship of 4 tagging single-nucleotide BRCA1 polymorphisms and their haplotypes on the outcome of treatment in 300 patients. The five haplotypes studied were AACC, AACA, GCTC, GATC and AATC.
Median survival was 13 months and the researchers did not find any significant associations between any of the tagging polymorphisms and overall survival.
However, patients with two copies of the AACC (wild type) haplotype had significantly shorter survival than those with one or no copy (8.47 versus 14.57 months). This continued to be true after adjustment for factors including weight loss and second-line treatment (hazard ratio, 2.097).
This effect on survival was seen in patient with squamous cell carcinoma but not in those with adenocarcinomas.
"Therefore," concluded Dr. Ryu, "this result suggests that a new strategy is needed for these patients, especially in squamous cell carcinoma."

Young Patients with Lung Cancer Have Better Survival than Older Patients

The 5-year survival rate of patients with lung cancer is twice as high among those between the ages of 15 and 39 years as in those 40 years of age and older, according to data from the California Cancer Registry Database.
The findings of lung cancer prevalence, incidence and survival in the database between 1988 and 2006 were presented here by Dr. Laveena Chhatwani of the Stanford Cancer Center, California, during the 74th annual scientific assembly of the American College of Chest Physicians.
There were 2,728 patients with lung cancer who were between 15 and 39 years of age, comprising 0.08% of the lung cancer population. Dr. Chhatwani reported that the incidence of lung cancer in 15-39 year olds was 1.2 cases per 100,000, and in the 40-and-older age group it was 141 cases per 100,000.
Ethnic distribution was markedly different in the two age groups. In the young lung cancer patients, 55% were white, 19% were Hispanic, 12% were black and 12% were Asian. In contrast, 78% of lung cancer patients aged 40 years and older were white, 8% were Hispanic, 7% were black and 6% were Asian.
Distant disease was found at first diagnosis in 57% of the younger population compared with 51% of the older group.
Distribution of histologic subtypes differed by age, as well. Among younger patients, 39% had adenocarcinoma, 9% had squamous-cell carcinoma, 7% had small-cell carcinoma, 6% had large-cell carcinoma, 3% had bronchioloalveolar carcinoma and 35% had various other histologic subtypes.
Among older patients, 30% had adenocarcinoma, 19% had squamous-cell carcinoma, 13% had small-cell carcinoma and 28% had various other subtypes.
"Mean five-year cause-specific survival was 34% in the 15-39 year age group and 16% in the 40-and-older age group," Dr. Chhatwani reported. "At each disease stage, mean one- and five-year cause-specific survival rates were better in the younger group," she added.
"These findings suggest that lung cancer in the very young exhibits distinct clinical features," Dr. Chhatwani concluded. She attributed the better survival in the younger group to a higher prevalence of histologic subtypes that are associated with better survival.