The sex hormone oestrogen could play a key role in influencing human susceptibility to lung cancer, providing a possible explanation for the increased risk of the disease among women. In a review article in this month's issue of THE LANCET ONCOLOGY, Jill Siegfried PhD from the University of Pittsburgh, USA, examines a wide range of clinical and epidemiological research into female lung-cancer risk. As nearly a quarter of adult women in the USA smoke (with an increasing proportion of female teenage smokers), the increased lung-cancer risk among women has serious implications; female deaths from lung cancer in the USA have already overtaken breast-cancer mortality. She reports that for a given amount of smoking, women may be up to twice as likely to develop lung cancer as men, and non-smokers who develop lung cancer are two and a half times more likely to be female than male. Although not all male-female differences in response to smoking and other lung carcinogens may be explained by the effects of sex steroid hormones, she believes that the higher susceptibility of women to the adverse effects of tobacco could be associated with their higher levels of oestrogen, with this hormone exacerbating the effects of exposure to environmental tobacco smoke, cooking oil, radon, or other weak lung carcinogens.
Contact: Professor Jill Siegfried PhD, Department of Pharmacology, E1340 Biomedical Science Tower, University of Pittsburgh, Pittsburgh PA 15261, USA; T) 1-412-648-1942; F) 1-412-648-2229; E) firstname.lastname@example.org
Leading Edge - Unresolved crisis in clinical research
This month's editorial comments on the declining numbers of physicians involved in clinical research over the past 20 years. A variety of widely-accepted reasons for this are given, including a severe decline in funding for patient-oriented research and the financial need for newly-qualified physicians to go directly into clinical practice rather than research. The editorial concludes: "Large-scale, long-term policy changes must be introduced quickly, and then followed through in a collaborative and coordinated effort with hospitals and medical schools. The current efforts alone are not enough."
see also this month's interview with Emil J Freireich: a pioneer of modern oncology
Depression in cancer patients
Clinical depression is a relatively common, and yet frequently overlooked, source of suffering among patients with cancer. All patients who face a life-threatening diagnosis such as cancer experience a normal albeit painful emotional reaction, but a substantial minority will become clinically depressed. This review questions why so few of these patients receive treatment for depression, and urges oncology care providers to recognise clinical depression, and to become familiar with the diagnostic approaches that are available. Both psychological and psychopharmacological treatments are effective in patients with major depression, and should be undertaken at the same time. Application of effective treatment offers the real opportunity to relieve depression and improve the quality of life for patients living with cancer.
Other reviews this month
- Optimum anthracycline-based chemotherapy for early breast cancer - Repair of DNA interstrand crosslinks: molecular mechanisms and clinical relevance - Meta-analyses of randomised clinical trials in oncology - Immunotherapy of cancer with alloreactive lymphocytes