Lung disease and Lung Cancer, natural supplements and alternative ways to have healthy pulmonary function

by Ray Sahelian, M.D.

Genetics may make people susceptible to certain lung diseases such as lung cancer, chronic obstructive pulmonary disease (COPD) and reduced lung function. If so, then a family history of these disorders should place individuals in the high-risk category. Because cigarette smoking is such an overwhelming risk factor and preventable, the importance of family history and genetic susceptibility to lung disease and lung cancer risk has been overlooked. Lung power normally declines as a person ages but being angry and hostile can speed up the process. Later on this page I discuss lung cancer prevention and treatment from a nutritional perspective.
A smog-filled sky can make it hard to breathe, but air pollution in the home may also be hard on people with lung disease. Those who live in homes with poor air quality endure worse symptoms. Cigarette smoke is the major indoor air-polluting culprit. Burning incense indoors releases air pollutants that cause inflammation in human lung cells.

Diet and lung disease, food selection
Eating plenty of fruit, vegetables and fish keep lungs healthy. Those who follow a diet closest to this ” Mediterranean ” ideal are less likely as their peers with eating habits furthest from this pattern to develop chronic lung disease. A good amount of fresh vegetable juices are a good way to start healing, along with adding a variety of spices such as ginger, onions, and garlic. The emphasis should be on eating as healthy a diet as possible.

Supplements for lung disease
Since there are many different types of lung disease, it is difficult to say which herbs, vitamins or supplements are helpful for lung health. I think several could be helpful including fish oils since they act as anti-inflammatory agents, acetyl cysteine since it is a potent antioxidant, and perhaps a wide range of carotenoids and flavonoids. I would discourage the use of a high dose of a single carotenoid such as beta carotene. A multivitamin preparation could be helpful such as MultiVit Rx in providing the basic vitamins and minerals to maintain healthy lung tissue. Since ginger, onions, and garlic are helpful, one could take supplements instead for instance Ginger extract.

Probiotics
The physiology and pathology of the respiratory and gastrointestinal tracts are closely related. This similarity between the two organs may underlie why dysfunction in one organ may induce illness in the other. For example, smoking is a major risk factor for COPD and IBD and increases the risk of developing Crohn’s disease. Probiotics regulate innate and inflammatory immune responses. Commonly used probiotics include lactic acid bacteria, particularly Lactobacillus, Bifidobacterium, and Saccharomyces, and these are often used as dietary supplements to provide a health benefit in gastrointestinal diseases including infections, inflammatory bowel disease, and colon cancer. In this respect, probiotics influence the immune system and activate host defence pathways which suggest that they could influence disease severity and incidence at sites distal to the gut. There is increasing evidence that orally delivered probiotics are able to regulate immune responses in the respiratory system.

Mediators Inflamm. 2013. Probiotics in the management of lung diseases. Probiotics have been defined as “live microorganisms which, when administered in adequate amounts, confer health benefits on the host.” In model systems probiotics regulate innate and inflammatory immune responses. Commonly used probiotics include lactic acid bacteria, particularly Lactobacillus, Bifidobacterium, and Saccharomyces, and these are often used as dietary supplements to provide a health benefit in gastrointestinal diseases including infections, inflammatory bowel disease, and colon cancer. In this respect, probiotics probably act as immunomodulatory agents and activators of host defence pathways which suggest that they could influence disease severity and incidence at sites distal to the gut. There is increasing evidence that orally delivered probiotics are able to regulate immune responses in the respiratory system.

Q. I have been a social smoker for several years. I have managed to quit and am very concerned about the condition of my lungs. I have gone online to research lung cleansers and have found a number of websites promoting lung cleansing herbs that are effective for smokers. Do you have such a product or an opinion on the matter. A representative from the American Lung Association. said he is very wary about such products. Of course quitting is the best step but if I can cleanse and repair my lungs somehow, that would be awesome!
A. First focus on diet as discussed above. There is little research on the optimal supplements that are useful for lung health. But, in general, any health promoting diet or lifestyle could be helpful for the lungs, too.

Major lung diseases include:
Asthma is common and the incidence is growing. Cigarette smoking and marijuana smoking increase the risk.

COPD (chronic obstructive pulmonary disease) is a chronic lung disease. Women who smoke are at greater risk than male smokers of developing lung diseases such as emphysema and chronic bronchitis.
Chronic bronchitis
Emphysema is also known as COPD.

Interstitial lung disease – also called interstitial pulmonary fibrosis or pulmonary fibrosis. Interstitial lung disease, or ILD, includes more than 180 chronic lung disease types. Interstitial lung diseases are named for the tissue between the air sacs of the lungs called the interstitium — the tissue affected by fibrosis (scarring).  The common link between the many forms of Interstitial lung disease is that they all begin with an inflammation. More than 80 percent of interstitial lung disease cases are diagnosed as pneumoconiosis, a drug-induced disease, or hypersensitivity pneumonitis.

Pulmonary fibrosis – Idiopathic pulmonary fibrosis has a poor prognosis. Perhaps garlic may help.
Mol Cell Biochem. 2014. Diallyl disulfide inhibits proliferation and transdifferentiation of lung fibroblasts through induction of cyclooxygenase and synthesis of prostaglandin E2. Platelet-derived growth factor-BB (PDGF-BB) and transforming growth factor-β1 (TGF-β1) are critically involved in idiopathic pulmonary fibrosis by inducing the proliferation and transdifferentiation of lung fibroblasts. In the present study, we examined the impact of diallyl disulfide (DADS), a garlic-derived compound, on such pathological conditions. DADS showed profound inhibitory effects on the PDGF-BB-induced proliferation of human and mouse lung fibroblasts. Results suggest that DADS, by inducing COX-2 expression, may have therapeutic potential in treating lung fibrosis.

Sarcoidosis – Sarcoidosis is an inflammatory condition characterized by granulomas (small rounded outgrowths made up of blood vessels, cells and connective tissues) that can produce many different symptoms. Sarcoidosis is a chronic disease lasting for several years or a lifetime. Some people, however, may have a type that only lasts a few months.

Additional Lung Diseases:

Bronchiolitis obliterans information is a chronic lung disease where the bronchioles are plugged with granulation tissue.

Pulmonary histiocytosis X is an uncommon interstitial lung disease related to tobacco smoking. It primarily affects young adults.

Black lung disease is an occupational lung disease caused by prolonged inhalation of coal mine dust. Black lung disease is also called silicosis, coal workers’ pneumoconiosis, or black lung.

Chronic eosinophilic pneumonia is a group of diseases of known or unknown etiology characterized by eosinophilic pulmonary infiltrates and, commonly, peripheral blood eosinophilia. Eosinophilic pneumonia is sometimes called the pulmonary infiltrates with eosinophilia (PIE) syndrome.

Restrictive lung disease is not the name of a particular lung disease, rather a term used to denote a chronic lung disorder that causes a decrease in the ability to expand the lung and sometimes makes it harder to get enough oxygen to meet the body’s needs. The most common restrictive lung diseases are Interstitial pulmonary fibrosis / interstitial lung disease (including sarcoidosis – granulomatous disorder) and extrapulmonary restrictive lung disease (including scoliosis).

Lung damage can occur from inhaling toxic substances including “poppers”, alkyl nitrites used as recreational drugs for brief sexual enhancement.

Lung disease symptom
The most common symptoms include cough, shortness of breath, and wheezing.

Definition of common terms involved with lung disease
* bronchiolitis – inflammation that involves the bronchioles (small airways)
* alveolitis – inflammation that involves the alveoli (air sacs)
* vasculitis – inflammation that involves the small blood vessels (capillaries)

Flying on an airplane with lung disease
People with emphysema and other serious lung diseases can safely travel by airplane. However, they should have approval by their doctor. In a 2007 study of 500 lung disease patients surveyed after a planned a flight, British researchers found that 18 percent suffered some type of respiratory symptom on the plane — most commonly shortness of breath, coughing and chest pain. However, the symptoms were moderate, and there were no serious incidents requiring an emergency landing. All of the study participants were evaluated by a lung specialist before their flight, and 11 percent of all patients ended up canceling their plans. This was often because their doctor advised against it. In other cases, the need to travel with supplemental oxygen was the obstacle; some patients did not want to do it, while others could not because the airline prohibited it.

Lung Cancer Treatment or Prevention with Supplements
Despite large declines in smoking rates, cigarettes still cause about one-third of cancer deaths in the United States. There are several steps you can take to reduce your chance of developing lung cancer or increasing your odds at improving survival after being diagnosed with lung cancer. Here are some suggestions:

Once people have been diagnosed with lung cancer they might think it pointless to stop smoking, but in fact it’s not too late to benefit from quitting. Those who quit smoking after the lung cancer diagnosis became less severely impaired by the lung disease than those who kept up the habit.

Plenty of sunshine and vitamin D may help people with early stage lung cancer survive longer after surgery. Patients who had high levels of vitamin D and had lung cancer surgery in sunny months were more than twice as likely to be alive five years after surgery compared to patients with low levels of vitamin D who had surgery in the winter. Exposure to sunshine is a significant source of vitamin D, which also comes from food and dietary supplements.

Eating cruciferous vegetables, such as cabbage, broccoli and sprouts, protects against the development of lung cancer. A person’s genetic makeup may influence these anti-cancer benefits. Eating a variety of vegetables decreases risk.

Garlic could help. Cancer Epidemiol Biomarkers Prev. 2016. Raw Garlic Consumption and Lung Cancer in a Chinese Population. Evidence of anticancer properties of garlic for different cancer sites has been reported previously in in vitro and in vivo experimental studies but there is limited epidemiologic evidence on the association between garlic and lung cancer. The results of the current study suggest that raw garlic consumption is associated with reduced risk of lung cancer in a Chinese population.

You must stop smoking, inhaling cigarette smoke, or taking nicotine in any form including nicotine chewing gum. Nicotine can prevent chemotherapy drugs such as Taxol from killing lung cancer cells. This may help explain why lung cancer is so difficult to treat in smokers. Even people who quit smoking but use nicotine supplements, such as patches or gum, may not be helped as much as they should be by cancer therapy.

Supplements for Lung Cancer
Although little human research is available regarding the use of natural supplements and herbs for prevention and treatment, the following show promise. It is possible that the benefits of these supplements or herbs could be additive if combined, but combinations should be done in low dosages to avoid overstimulation.

Arjuna is an Ayurvedic herb.

Astragalus has been tested in combination with platinum for treatment of lung cancer. The results with Astragalus root herb are encouraging.

Berbamine has been studied in vitro.

Curcumin – a dose of 500 mg a day of a combination curcumin and Turmeric.

Carotenoids and Flavonoids – Eating more fresh, organic fruits and vegetables or drinking vegetable juices is a good option.Quercetin is a flavonoid found in many fruits and vegetables that has anti lung tumor activity.

Green Tea – Green tea has been shown to be a potent chemopreventive agent against lung cancer formation in animal studies. The reported mechanisms for activity of green tea against cancer are antioxidation, induction of phase II enzymes, inhibition of TNFalpha expression and release, inhibition of cell proliferation, and induction of apoptosis. Cell cycle arrest and apoptosis induced by green tea are probably the two most significant factors. Consider drinking a cup of green tea in the morning and at lunch.

Inositol supplements have been studied for lung cancer.

Multivitamins taken as a daily supplement could be helpful

Noni is a tropical fruit whose juice or extract has been studied as a cancer treatment or prevention.

Resveratrol is found in red wine, consider drinking a 2 or 3 ounces in the evening with dinner.

Phytoestrogens

Saffron herb has been studied.

Silibinin is an extract from the plant milk thistle.

Vitamin D could be helpful – take a 20 to 30 minute walk a day and get some sun exposure.

I am in seventh grade and in my science class we are writing reports on diseases. i am doing lung cancer and in our reports we have to have a list of supplements. Do you have any information that would be helpful for me?
I am glad you are learning about this topic and its treatment in natural ways.

Lung Cancer and vitamins
Antioxidants and other vitamin supplements seem to offer no protection against lung cancer. In an analysis of eight previous studies, researchers found no evidence that vitamins A, C, E or folate lower a person’s risk of lung cancer. Across the studies, which followed thousands of adults for up to 16 years, people with the highest intakes of the vitamins were no less likely to develop lung cancer than those with the lowest intakes. Vitamins C and E are antioxidants, which means they help neutralize cell-damaging substances in the body called free radicals. Vitamin A and folate, a B vitamin, also help maintain normal, healthy cells. There is some evidence that vitamin C from food, but not supplements, is protective. It may just be that the overall flavonoids and carotenoids together could reduce the risk of lung cancer as opposed to megadoses of certain isolated vitamins and supplements. International Journal of Cancer, February 15, 2006.

Anticancer Res. 2013 Nov. Chemoprevention with acetylsalicylic acid, vitamin D and calcium reduces risk of carcinogen-induced lung tumors. The chemoprevention diet had a protective effect against tumor development in the mouse lungs.

Lung Cancer diagnosis
In people at high risk for lung cancer, low-dose CT scanning of the chest may detect early lung cancer. However, “its usefulness as a screening tool is limited because it misses tumors in certain areas of the lung and often falsely identifies harmless spots as being cancerous.
Many positive CT scans for lung cancer screening resolve after short-term follow-up. The value of CT screening for lung cancer is unclear. In people at high risk for the disease, CT scanning may detect early lung cancer, but it’s usefulness as a screening tool is limited because it misses tumors in certain areas of the lung and often falsely identifies harmless spots as being cancerous. Positive CT screening for lung cancer usually results in the diagnosis of early stage I lung cancer, but benign lesions are also found.

Jan. 9, 2014 — As fewer Americans smoke, the number of people who develop lung cancer continues to drop, U.S. health officials report.

Screening pitfalls
Imaging tests used to screen symptom-free people for lung cancer often find suspicious growths that turn out to not be cancer. There is a significant downside of using the tests — chest X-rays or spiral CT scans — to try to detect this disease early. In recent years, CT scans, in particular, have been promoted by some hospitals and advocacy groups for lung cancer screening, even though studies have not yet shown whether such screening saves lives. Annals of Internal Medicine, April 20, 2010.

Lung Cancer cause and aggravation
There are several factors that increase the risk.  Cigarette smoking is the single most important factor. Additional risk factors for lung cancer include industrial hazards such as radiation, asbestos, nickel, chromate, beryllium, arsenic, and coal. Air pollution is a cause in those living in urban congested areas with a lot of traffic. Radon exposure from soil in the house is another cause of lung cancer.
Workers exposed to the pesticide chlorpyrifos have an elevated risk of lung cancer and lung disease. Annual screening for lung cancer using computed tomography (CT) can help detect the disease at its earliest, most curable stage, but it does not reduce mortality from the disease and could actually result in more harm than good.
Among women who already have lung cancer, hormone replacement therapy – which has been tied to a higher risk of serious conditions including breast cancer and heart attacks – increases the risk of death from the tumor according to Dr. Rowan T. Chlebowski.  Dr. Apar Kishor Ganti, from the University of Nebraska Medical Center, Omaha recommends discontinuation of hormone-replacement therapy once lung cancer is diagnosed. The Lancet, 2009.
Women who use hormone replacement therapy combining estrogen and progestin have a higher risk of lung cancer than non-users. Journal of Clinical Oncology, online February 16, 2010.

Chronic bronchitis, emphysema and pneumonia are linked with a greater risk.

Radon and Lung Cancer
A study conducted in an area of Italy where residential radon levels are high confirms that the risk of lung cancer increases in step with levels of radon exposure, but that the Mediterranean diet may modify the effects. In the study, researchers examined the association between indoor radon exposure and lung cancer in 384 “case” patients with lung cancer and 404 control patients without lung cancer. They considered the potential role of smoking, diet, and other risk factors. The researchers determined residential history during the 30-year period ending 5 years prior to enrollment. Radon detectors were placed in the main bedroom and the living room in each residence for two consecutive 6-month periods. Confirming prior studies, the researchers found a positive link between indoor radon and lung cancer. The odds of developing lung cancer rose with increasing levels of residential radon exposure. Overall, the increase was generally not statistically significant, although significance was reached for some high radon exposure categories. They also report that individuals with low-medium consumption of dietary oxidants tended to be at greater risk. The possibility that dietary antioxidants may modify the effects of radon on lung cancer risk should be studied further, they conclude. International Journal of Cancer, May 10, 2005.

Marijuana and Lung Cancer
Although both marijuana and tobacco smoke are packed with cancer-causing chemicals, other qualities of marijuana seem to keep it from promoting lung cancer. The difference rests in the often opposing actions of the nicotine in tobacco and the active ingredient, THC, in marijuana, says Dr. Robert Melamede of the University of Colorado in Colorado Springs. Whereas nicotine has several effects that promote lung and other types of cancer, THC acts in ways that counter the cancer-causing chemicals in marijuana smoke. Lab research indicates that nicotine activates a body enzyme that converts certain chemicals in both tobacco and marijuana smoke into cancer-promoting form. In contrast, studies in mice suggest that THC blocks this enzyme activity.

Pesticides
Daily on-the-job exposure to the pesticide diazinon appears to increase the risk of lung cancer and possibly other cancers, according to findings from the US government-sponsored Agricultural Health Study, a project begun in 1993 to investigate the health effects of pesticides on farm families in Iowa and North Carolina.

Lung cancer and phosphates
Phosphates may stimulate lung cancer tumors grow faster, at least in mice. Myung-Haing Cho of Seoul National University says that in mice phosphates – found in many soft drinks, baked goods and processed meats and cheese – may also help tumors develop in the first place. “Our study indicates that increased intake of inorganic phosphates strongly stimulates lung cancer development in mice. A diet high in phosphates increases lung surface tumor lesions as well as the size.” Myung-Haing Cho of Seoul National University said the research suggests that cutting back on inorganic phosphates may be critical for lung cancer treatment as well as prevention. Phosphates are critical to human nutrition and can be used in compounds that enrich calcium and iron content and prevent food from drying out but some people can get excessive amounts, up to 1000 mg a day.

Screening for Lung Cancer:
Screening for asymptomatic lung cancer by annual chest x-ray and sputum cytology in patients at high risk does not result in decreased mortality and cannot be recommended for the general population.

Lung Cancer in a Woman
Women who develop lung cancer appear to have lower survival rates if they have a history of using hormone replacement therapy.

Treatment of Lung Cancer
For the purposes of treatment, lung cancers into two groups: small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC). Small cell lung cancer often is widespread by the time of diagnosis, so that treatment is limited to chemotherapy and/or radiation therapy. By contrast, non-small cell carcinoma may not have spread at the time of diagnosis, so that surgical resection, or cutting away, of the tumor is possible.

Non Small Cell Lung Cancer (NSCLC)
The three types of non-small cell lung cancer are squamous carcinoma, large cell carcinoma, and adenocarcinoma. Adenocarcinoma is the most common non-small-cell lung cancer – especially in women.
With best supportive care alone, patients with metastatic non-small-cell lung cancer (NSCLC) have a median survival of 4 to 5 months and a 1-year survival rate of approximately 10%. Trials carried out in the 1980s and 1990s comparing chemotherapy to best supportive care reported variable efficacy results; however, a pivotal meta-analysis of these data indicated that cisplatin-based chemotherapy provided a survival benefit in advanced NSCLC. In the past decade newer agents such as gemcitabine(Gemzar), vinorelbine, paclitaxel, and docetaxel (Taxotere) have all demonstrated activity in NSCLC as single agents; consequently these agents have been combined with cisplatin or carboplatin.
A Pfizer Inc. kidney cancer drug has also shown promise in a small mid-stage trial as a treatment for the most common form of lung cancer. The new study involved 63 patients whose non-small cell lung cancer had progressed despite earlier treatments with standard chemotherapy. All patients were then given Pfizer’s once-daily pill, Sutent, as a stand-alone treatment and continued to take it until their disease progressed. Tumors shrank by at least 50 percent in six, or 9 percent, of the patients. They stopped growing in another 27, or 43 percent, of the patients. Sutent was generally well tolerated, with mostly mild to moderate side effects such as fatigue, nausea and shortness of breath. Sutent blocks specific proteins that allow tumor cells to grow, and therefore cause far milder side effects than standard cancer treatments that also harm healthy tissue as they go after tumor cells. U.S. regulators in January approved Sutent, whose chemical name is sunitinib, to treat kidney cancer as well as a rare stomach and intestinal cancer known as GIST. Larger trials will be needed to conclusively establish Sutent’s effectiveness against lung cancer.
In 2006 Avastin, the first drug designed to starve tumors of blood and nutrients, was approved as an initial treatment, in combination with chemotherapy, for patients with non-small cell lung cancer.

Historical perspective on herbs for cancer
Herbs have been considered natural and valuable sources for anticancer drug discovery. Herbal medicine has been prescribed in many countries over centuries for treating various diseases including infectious and malignant diseases. Nowadays, many of the drugs that have been used for treatment of malignant diseases are derived from natural products such as Taxol, a natural product isolated initially from Pacific Yew (Taxus brevifolia).

Lung Cancer Recurrence
Researchers say they have developed a test that can predict with near certainty whether the most common form of lung cancer will return after surgery. The new test could save tens of thousands of lives every year by letting doctors prescribe more aggressive treatments for a patient whose lung cancer is likely to reappear. Called the Lung Metagene Predictor, the test scans non-small cell lung cancer cells’ genetic material to identify patterns that occur in cancers that are likely to reappear. The Lung Metagene Predictor is claimed to be 90 percent accurate.

Lung Cancer Research with herbs and vitamins
Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials.
J Clin Oncol. 2006. University of California, Berkeley School of Public Health, Division of Epidemiology, Berkeley, CA
Systemic treatments for advanced non-small-cell lung cancer have low efficacy and high toxicity. Some Chinese herbal medicines have been reported to increase chemotherapy efficacy and reduce toxicity. In particular, Astragalus has been shown to have immunologic benefits by stimulating macrophage and natural killer cell activity and inhibiting T-helper cell type 2 cytokines. Many published studies have assessed the use of Astragalus and other Chinese herbal medicines in combination with chemotherapy. We sought to evaluate evidence from randomized trials that Astragalus-based Chinese herbal medicine combined with platinum-based chemotherapy (versus platinum-based chemotherapy alone) improves survival, increases tumor response, improves performance status, or reduces chemotherapy toxicity. Conclusion: Astragalus -based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.

Resveratrol enhances radiosensitivity of human non-small cell lung cancer NCI-H838 cells accompanied by inhibition of nuclear factor-kappa B activation.
J Radiat Res 2005.
Resveratrol, a polyphenol in red wine, possesses many pharmacological activities including cardioprotection, chemoprevention, anti-tumor effects, and nuclear factor-kappa B (NF-kappaB) inactivation. The present study was designed to evaluate the effects and possible mechanism of resveratrol in enhancing radiosensitivity of lung cancer cells. Our results demonstrate that resveratrol enhances the radiosensitivity of NCI-H838 cells accompanied by NF-kappaB inhibition and S-phase.

Inhibition of lung cancer cell growth by quercetin glucuronides via G2/M arrest and induction of apoptosis.
Drug Metab Dispos. 2006. Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
Lung cancer is the leading cause of cancer death in many developed countries, including Taiwan. Quercetin, a widely distributed bioflavonoid, is well known to induce growth inhibition in a variety of human cancer cells. Quercetin glucuronides are the main circulating metabolites after dietary supplements with quercetin in humans. However, there is little information available as to how quercetin glucuronides affect human cancer cells. Conclusion: Taken together, we demonstrated that quercetin glucuronides inhibited proliferation through G2/M arrest of the cell cycle and induced apoptosis via caspase-3 cascade in the human lung cancer cell line NCI-H209. Delineation of the biological effects of specific major quercetin metabolites on chemotherapeutic potential or chemoprevention of human cancers warrants further investigation.

Dietary phytoestrogens and lung cancer risk.
JAMA. 2005. Schabath MB, Hernandez LM, Wu X, Pillow PC, Spitz MR. Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston
Despite lung-specific in vitro and in vivo studies that support a chemopreventive role for phytoestrogens, there has been little epidemiologic research focused on dietary intake of phytoestrogens and risk of lung cancer. RESULTS: Reductions in risk of lung cancer tended to increase with each increasing quartile of phytoestrogen intake. The highest quartiles of total phytosterols, isoflavones, lignans, and phytoestrogens were each associated with reductions in risk of lung cancer. CONCLUSIONS: While there are limitations and concerns regarding case-control studies of diet and cancer, these data provide further support for the limited but growing epidemiologic evidence that phytoestrogens are associated with a decrease in risk of lung cancer. Confirmation of these findings is still required in large-scale, hypothesis-driven, prospective studies.

Is voluntary vitamin and mineral supplementation associated with better outcome in non-small cell lung cancer patients? Results from the Mayo Clinic lung cancer cohort.
Lung Cancer. 2005. Jatoi A, Williams B, Nichols F, Marks R, Aubry MC, Wampfler J, Finke EE, Yang P. Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA.
Some previous studies report that 80% of cancer patients take multivitamin and/or mineral supplements. To our knowledge, the consequences of such self-directed supplementation have not been examined previously in non-small cell lung cancer (NSCLC) patients. The goal of this study was to determine whether vitamin/mineral supplementation is associated with improved survival and quality of life in a cohort of NSCLC patients. CONCLUSIONS: Vitamin  /mineral supplementation is associated with better survival and quality of life in this cohort of NSCLC patients. Future prospective clinical trials should focus on the role of such supplements in patients with NSCLC.

Curcumin enhances Vinorelbine mediated apoptosis in NSCLC cells by the mitochondrial pathway.
Biochem Biophys Res Commun. 2005. Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
Elderly lung cancer patients and those with poor performance status/co-morbid conditions are deprived of chemotherapy because of high toxicity of multidrug regimens. Human squamous cell lung carcinoma H520 cells treated with Curcumin were sensitized to the cytotoxicity caused by chemotherapeutic agent, Vinorelbine. Both caused apoptosis by increasing the protein expression of Bax and Bcl-xs while decreasing Bcl-2 and Bcl-X(L), releasing apoptogenic cytochrome c, and augmenting the activity of caspase-9 and caspase-3. The findings suggest that Curcumin has the potential to act as an adjuvant chemotherapeutic agent and enhance chemotherapeutic efficacy of Vinorelbine in H520 cells in vitro. Thus, Curcumin offers the prospect of being beneficial in the above-mentioned patient groups.

Phase I study of green tea extract in patients with advanced lung cancer.
Cancer Chemother Pharmacol. 2005. Laurie SA, Miller VA, Grant SC, Kris MG, Ng KK.
Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, 1275 York Avenue, New York, NY, USA.
Epidemiologic studies suggest that consumption of green tea may have a protective effect against the development of several cancers. Preclinical studies of green tea and its polyphenolic components have demonstrated antimutagenic and anticarcinogenic activity, and inhibition of growth of tumor cell lines and animal tumor models, including lung cancer. Green tea may also have chemopreventive properties, and enhancement of cytotoxicity of chemotherapeutic agents has been demonstrated. This trial was designed to determine the maximum tolerated dose (MTD) of green tea extract (GTE) in patients with advanced lung cancer. This study suggests that while relatively nontoxic at a dose of 3 g/m2 per day, green tea extract likely has limited activity as a cytotoxic agent, and further study of green tea extract as a single-agent in established malignancies may not be warranted. Chronic lung disease.

Genetics
First-degree relatives of non-smoking individuals diagnosed with lung cancer have an increased likelihood of developing any type of cancer. These relatives are also more likely to be diagnosed with lung cancer themselves, especially at an early age, compared with first-degree relatives of healthy non-smokers without lung cancer.

Lung cancer scan does not save lives
Screening smokers and former smokers for lung cancer with a CT scan doesn’t save lives or prevent advanced disease and may lead to unneeded and harmful treatment. Some experts have hoped that the scans, which are a special kind of X-ray that can detect tiny lung abnormalities, will prevent lung cancer deaths by getting people into treatment earlier. But there hasn’t been convincing evidence of that. The American Cancer Society doesn’t recommend the lung cancer test, which costs $300 to $400, and most insurance companies won’t pay for it. The latest research, appearing in the March 2007 Journal of the American Medical Association, analyzed lung cancer deaths and cases of advanced lung cancer among 3,246 smokers and former smokers who had annual CT scans for about four years. Researchers compared deaths and advanced cancer cases with rates predicted by a mathematical model. The model — based on a person’s age, gender, asbestos exposure and smoking history — has proven valid in previous studies. The model predicted there would be 33.4 cases of advanced cancer; there were 42. The model predicted 38.8 lung cancer deaths; there were 38. “We don’t see a trace of evidence that a single life was saved, that a single case of advanced cancer was avoided,” said study co-author Dr. Peter Bach of Memorial Sloan-Kettering Cancer Center in New York. CT screening did increase diagnosis and treatment. The people screened were three times more likely to have lung cancer diagnosed and 10 times more likely to have lung surgery than predicted.

Farming and lung disease
Farm workers are more likely than those with other occupations to show signs of chronic obstructive pulmonary disease. COPD is the collective term for emphysema and chronic bronchitis, progressive diseases of the airways most commonly associated with smoking. While smoking is the major risk factor for COPD, non-smokers can also develop it. Farming has been linked to other health consequences, including higher risks of asthma and lung cancer, possibly due to pesticides or other chemicals. Farmers consistently inhale “agricultural dusts,” which consist of organic materials from animal and plant sources as well as inorganic materials in soil that can cause inflammation in the airways. American Journal of Industrial Medicine, June 2007.