Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

ACCP: Updated lung cancer guidelines

W. Michael Alberts, MD and Frank Detterbeck, MD
Conditions
May 7, 2013
52 Shares
Share
Tweet
Share

ACCP_img_logoLung cancer causes more deaths in the United States, 160,000 estimated in 2012, than the next three most common cancers, colon, breast, and prostate, combined.

More than 1.6 million people worldwide were newly diagnosed with lung cancer, comprising 13% of all new cancer diagnoses, and 1.4 million died of lung cancer, which was 18% of all cancer deaths in 2008.  

The American College of Chest Physicians released the Diagnosis and Management of Lung Cancer, 3rd ed: ACCP Evidence-Based Clinical Practice Guidelines on Tuesday.  The guidelines represent the culmination of a multiyear rigorous process involving over 100 multidisciplinary experts in the fields of pulmonology, critical care, thoracic surgery, medical and radiation oncology, pathology, integrative medicine, primary care, health-care research, guidelines methodology, and epidemiology. The ACCP guidelines summarize the state of the art in lung cancer in 24 chapters and 278 recommendations, covering the entire scope of the field.

The new lung cancer guidelines incorporate the many clinical and methodological advances and new research in the field, providing comprehensive and evidence-based recommendations related to prevention, screening, diagnosis, staging, and medical and surgical treatments. Since the 2nd edition, the science of guideline methodology has greatly advanced, increasing the rigor of the evidence review and assessment, and providing a structured process for the development and grading of recommendations. The guidelines also showcase the importance of multidisciplinary, team-based care when it comes to effective lung cancer treatment; collaborative decisions based on collective knowledge provide the most comprehensive patient-focused care.

  • Screening. For individuals at elevated risk of developing lung cancer, the guidelines recommend offering low dose CT (LDCT) scanning to screen for lung cancer in the context of a structured, organized screening program.  The recommendation is based on a systematic review of the data, which shows an important reduction in deaths from lung cancer when screening is done in an organized program. This is a clear change from the prior edition of the guidelines released in 2007, when such evidence was not available.

Lung cancer screening is a complex interplay of an individual’s risk, how LDCT scanning is performed and interpreted, and how findings are managed. Guidance is provided for follow-up of these nodules based on size and many other factors. The guidelines call for the establishment of a registry designed to help address the large number of unanswered questions that arise as screening is implemented. Additionally, the guidelines call for establishment of quality metrics so that benefits are optimized and harms are minimized.

  • Advances in treatment. Treatment of lung cancer is progressing rapidly, with significant advances in all modalities, including surgery, radiation chemotherapy, and palliative care.  Treatment procedures detailed in the guidelines include the importance of accurate definition of the stage and the benefits of minimally invasive surgery. Today, patients with limited lung function also have treatment options such as stereotactic body radiosurgery. Molecular-based targeted chemotherapy can also shut down the cellular engine driving a tumor’s growth as dramatically as flipping a switch. The guidelines also make clear that a sophisticated approach to symptom control and palliative care can markedly improve both quality and quantity of life for individuals with lung cancer.

The data presented in the guidelines also underscore the importance of an integrated collaborative team of individuals, each with lung cancer expertise within their own specialty.

  • Treatment of tobacco use. An ounce of prevention is still best; and the science behind treatment of tobacco dependency has matured tremendously. This edition of the guidelines outlines how to select the right interventions for someone who smokes and improve the rate of successful abstinence from smoking.

Smoking is a difficult addiction to overcome; however, significant advances have increased our understanding of the physiological and biological changes that make this chronic medical condition so challenging. Today, we have multiple treatment options to help these patients.  The guidelines include a detailed summary of the scientific basis and management strategies for an up-to-date, sophisticated, and evidence-based treatment program for tobacco use.

  • Symptom management and palliation. For patients with advanced lung cancer, a major concern is palliation—easing the severity of pain and symptoms. In the past, the approach to palliative care was largely empiric, but as summarized in the guidelines, a large body of research has led to the development of a formal evidence-based approach. Many tools are available that provide effective symptom management and end-of-life care. The data also demonstrate that early inclusion of a palliative care team in the management of advanced lung cancer can meaningfully improve the quality of life for the patient.

The guidelines also review the scientific literature that has emerged on complementary therapies and integrative medicine. This includes interventions such as acupuncture, nutrition, and mind-body therapies. The guidelines outline which treatments and situations are scientifically supported for integration with standard treatments for lung cancer.

To learn more about, and to review the guidelines in their entirety, visit our Lung Cancer III page. Join in the conversation about the new guidelines on social media. Comment on the ACCP Facebook wall; follow the ACCP on Twitter, and tweet with the hashtag #LCIII; and post in the ACCP e-Community.

Lung-Cancer-1

W. Michael Alberts is chair, Lung Cancer Guidelines Panel, American College of Chest Physicians, and Frank Detterbeck is vice-chair, Lung Cancer Guidelines Panel, American College of Chest Physicians.

Prev

As I sit by my father in the hospital, there is a choice to be made

May 6, 2013 Kevin 3
…
Next

Health insurance exchanges will be hampered by choice overload

May 7, 2013 Kevin 8
…

Tagged as: Oncology/Hematology, Pulmonology

Post navigation

< Previous Post
As I sit by my father in the hospital, there is a choice to be made
Next Post >
Health insurance exchanges will be hampered by choice overload

More in Conditions

  • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

    Harvey Max Chochinov, MD, PhD
  • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

    Hoag Memorial Hospital Presbyterian
  • The rising threat of lung cancer in Asian American female nonsmokers

    Alice S. Y. Lee, MD
  • Urgent innovation needed to address growing mental health crisis among children and families

    Monika Roots, MD
  • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

    Cheryl Lazarus
  • The unjust reality of racial disparities in pediatric kidney transplants

    Lien Morcate
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • A tense family drama unfolds as a young daughter pursues unconventional career path

      Osmund Agbo, MD | Physician
    • Decoding the brain’s decision-making: insights for medical professions and strategies for success

      Harvey Castro, MD, MBA | Physician
    • Unmasking the truth: the shocking reality of the opioid epidemic and who’s really to blame

      Jay K. Joshi, MD | Physician
    • Discover your true north: Navigating life’s confusions and embracing your path to success

      Tyler Jorgensen, MD | Physician
    • A revolution in patient empowerment: Working together to save our medical system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Nails or Sliding Hip Screws to Repair Trochanteric Fractures?
  • Skipping Radiotherapy 'Seems Safe' for PMBCL Patients in Remission
  • More Anxious Kids Medicated; Apple's Mental Health Moves; OTC Video Game for ADHD
  • ADHD Meds Linked to Lower Suicide Risk in Borderline Personality Disorder
  • Promising Gene Therapy for Overactive Bladder

Meeting Coverage

  • Skipping Radiotherapy 'Seems Safe' for PMBCL Patients in Remission
  • Promising Gene Therapy for Overactive Bladder
  • Shotgun Sequencing of Small Intestine Reveals Species Tied to GI Symptom Severity
  • FGFR Inhibitor Stakes Claim to Post-Anti-PD-1 Role in Advanced Bladder Cancer
  • Multimorbidity Patterns and Healthcare Utilization in Vets With Schizophrenia
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • A tense family drama unfolds as a young daughter pursues unconventional career path

      Osmund Agbo, MD | Physician
    • Decoding the brain’s decision-making: insights for medical professions and strategies for success

      Harvey Castro, MD, MBA | Physician
    • Unmasking the truth: the shocking reality of the opioid epidemic and who’s really to blame

      Jay K. Joshi, MD | Physician
    • Discover your true north: Navigating life’s confusions and embracing your path to success

      Tyler Jorgensen, MD | Physician
    • A revolution in patient empowerment: Working together to save our medical system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

ACCP: Updated lung cancer guidelines
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...