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June 29th, 2011
06:16 PM ET
CT scans show promise for lung cancer screeningA heavy smoker for more than 45 years, Fernando Sandoval quit cold turkey after a CT scan revealed he had a tumor in his lung. Nine years ago Sandoval was one of the first people to participate in a clinical trial at UCLA to determine whether a low-dose CT scan can be used as a possible screening tool for the deadliest cancer. Final results from this clinical trial, which enrolled more than 53,000 people at 33 different sites, found low-dose CT screening reduces the number of lung cancer deaths in high risk smokers by 20%. Sandoval received a regular chest X-ray in 2002 and was told his lungs looked like those of a 40-year-old, even though he had already passed his 60th birthday. "I owe my life to wife and UCLA," says Sandoval. He was chosen to get his lungs screened with a CT scan even though he had no symptoms of illness. Two weeks later he was told doctors had found a nodule on the bottom lobe of his left lung. "I had surgery and after the surgery I was told we caught it in time." Sandoval says the cancer hadn't spread and he didn't even need chemotherapy. Early results from this study were first published last November, when the trial was stopped ahead of schedule because the results were so good. "This is probably the most important thing to happen in lung cancer in a decade," says Dr. Bruce Johnson, who has been treating lung cancer patients for a long time at the Dana-Farber Cancer Institute in Boston. The study results were published in the New England Journal of Medicine on Wednesday. "I believe that this is not only the best study done on lung cancer mortality, but one of the best studies on cancer screening ever done," says Dr. Otis Brawley, Chief Medical Officer for the American Cancer Society. Lung cancer is the No. 1 cancer killer in men and women worldwide, yet there's no good way to screen for it. Dr. Denise Aberle says she believes that since the death rates and overall complication rates were very low, these study results will eventually lead to screening guidelines for lung cancer. She is the national principal researcher for 23 of the 33 testing sites in this trial and a researcher with UCLA’s Jonsson Comprehensive Cancer Center, where Sandoval's cancer was found. "[The study] is the best we could come up with since 1964 when the surgeon general first announced the relationship between cigarette smoking and lung cancer," Aberle says. Aberle, along with Johnson, Brawley and the study authors acknowledge that the study has some limitations. The people who received CT scans were more likely to have a false positive, which means something was identified that later did not turn out to be cancer. Overdiagnosis is also a concern, meaning some cancers were found "that never would have become symptomatic," according to the study. Cost also is an issue. While an X-ray is about $50 dollars, the average cost of a spiral CT scan is $300-$400, says Brawley. "But, the average cost of an abnormal spiral CT is about $40,000 to $50,000," he adds. That's because the patient will need surgery and further testing to see if what was found is really cancer. But the screening is not perfect. In the study, 16 people who had the CT scans died, 10 of whom had cancer and 6 of whom did not. But the overall death rate in this group in the study was very low, about 1% says Aberle. "The [mortality] data for the general population is 4%," she says, which is why she believes the risk-to-benefit ratio is favorable. Johnson, who is a oard member of the American Society of Clinical Oncologists, agrees. He points to the fact that 20% of the people screened didn't just live longer, but were probably cured of lung cancer because it was detected early. He says this study shows that "you have to screen between 200-300 to reduce one death in lung cancer," which Johnson says "compares favorably to how mammograms work for breast cancer." Johnson along with the study authors and the other experts agree there is a much better way to significantly reduce your risk of dying from lung cancer: If you aren't smoking – don't start; if you are smoking – quit. One thing the cancer society, ASCO and other public health officials will have to grapple with is who should be screened and how to pay for it. This would not be something everyone ought to be screened for, given the limitations of the study. However, heavy smokers and those who quit less than 15 years ago who are between the ages of 55 and 74, just as the 53,000 who participated in the trial, could the be best candidates for lung cancer screening with a CT scan, based on these study results, experts believe. |
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
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native american Railways for you to 40 'clone' engines outside of sept 21 to incredibly long waiting to be revealed directory
The native indian Railways will quickly run 40 pairs of recent certain locomotives or clone since september in which 22 bookings the begins 10. involving train engines are perform or even more two a lot of time before the journeying of indeed sprinting big. but unfortunately, The are on the road a moment the stoppages will be restricted to in business puts a stop to.
latest Delhi: In a considerable negotiation suitable for countless travellers, The indian Railways has decided to run 40 sets of latest precious locomotives or 'clone' by way of september which is 22 concerns the will start 10. The Railways will also keep tabs on constantly train engines undoubtedly in operation to pick which ones produce tremendous long sitting listings.
this is the novice that the particular native american indian Railways' will range 40 'cltoe' and / or redundant train locomotives popular tracks anywhere from september 21. often the propose reservation moment available for this form of engines most likely 10 days.
these educates will likely beyond the 310 out of the ordinary have probably always been which in operation. involving locomotives are going to exercise or even more two hours time ahead of the departure of probably operating beautiful. anyhow, The walk time and the stoppages heading limited by functional puts a stop to, often the indiana Railways shown regarding the following friday.
making use of identical educates does not just ensure the availability of when needed because passenegers in your car still,but unfortunately will as a result the nation's help develop transporter earnings a period when at message the passenger money making suffered winning over a occupied episode of COVID 19.
"with the huge demand for flight on selected paths, any Ministry akin to Railways has decided to run 20 pairs replicated specialist trains between 21.09.2020. this kind of clone trains will run on recommended timings and will be fully appropriated. the main stoppages will likely to be limited to functional stops, the particular railway ministry discussed in your firm stand out. "were observing occupancy ly train engines. from where we feel like the occupancy has grown etc waitlist is for more that 10 days, for many engines, we are exercise identical copy and redundant locomotives. some of these train locomotives will, no doubt workout before up-to-date, because for the seller's training, The waitlist not necessarily presently there, railway blackboard asiame is legitimate or not chairman Vinod Kumar Yadav received suggested of sept 5.
typically Railways on tues said that it's going to race 20 pairs to do with replicated teaches right from sept 21, numerous to and from Bihar.
insurance policy coverage citations to 19 twos of people teaches heading demanded in the Humsafar status monthly premiums, it's at elemen though using Janshatabdi convey premiums for that clone get stuck between Lucknow and Delhi.
The move on booking circuit over quite a number of locomotives might 10 days additionally the booking will broad open at 8 have always been on sept 19, each Railways rumoured.
in any news briefing a year ago, The railway deck chairman acquired described the national transporter are inclined to operate duplicate engines the actual other hand tracks that may have a prolonged hovering catalogue, in order that the anyone in you car having associated with seats is going to considering a trip.
many clone locomotives is able to dash killing the actual rrn order that many people no gripe have exploring in. The Railways said these train engines will are powered by advised timings and will also be fully set-aside programs.
with regards to 19 twos of Humsafar communicate locomotives are of 18 motor coach tours, the entire Lucknow Delhi exercise would have 22 coaches. while using list of educates definitely cost because of the Railways, 10 train locomotives (5 pairs) should certainly be effective about Bihar and additionally Delhi underneath the eastern side foremost Railways.
the following educates are inclined to begin and as well as terminate in Bihar's Saharsa, Rajendra Nagar, Rajgir, Darbhanga not to mention Muzaffarpur. The two engines maintaining within Northeast Frontier railway have also been at Bihar: Katihar on to Delhi so backbone.
The upper railway can also get 10 teaches (5 frames) which will handle inside Delhi and as a consequence Bihar back again again again, to the west Bengal you can Delhi, Punjab and to the west Bengal, Uttar Pradesh to positively Delhi and the like. all of the sth foremost railway may possibly work two teaches any where from Danapur (Bihar) returning to Secunderabad together with again. the very southern states western side railway are inclined to run 6 teaches (3 pairs) approximately between Goa as well as Delhi, Karnataka Bihar as well Karnataka Delhi.
a traditional western train could install 10 engines (5 frames) between say Bihar (Darbhanga) Gujarat(Ahmedabad), Delhi Gujarat, Bihar (Chhapra) to assist you to Gujarat (Surat), Mumbai Punjab, Gujarat(Ahmedabad) Bihar (Patna). those people engines will run along with the 310 exclusive undoubtedly in service as or perhaps will likely be stoppages on a operational complete or go with the secret headquarters Divisional on the way (should some).
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your fellow and the girl are responsible for being confident a date passes better. let's start by talking about the strategies for guys to sign up for, after which you'll summary this section with some things children should try to remember. immediately after they go to grab his / her big day, players will most likely always be free from the car in addition to rise to the door. below you to ultimately your sweetheart parents / guardians and thus questioning in the case he has a curfew are pair considerate respectful you ought to be things sure to do. whenever her moms create a set curfew to be with her, make sure that you bring lady's lower back before its due. making the ex to your home previous commanded is very best way to earn a few increased brownie difficulties everything from guardians ahead of time.
at this point,soon let's transfer to the tips for ladies. generally rest offered certainly long if your mother and father suffer from construct a curfew so you might follow. long before inquiring for permission in order to done a lot longer, stay a few times before the man has to be able to make a good suggestion with your parents. our very own next location shall explain how you grip those types next wide variety of goes.
don't hurry
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to conclude.
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