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NCI Lecturer Urges 'Chemoprevention'

On July 29, the man who has helped put cancer prevention efforts on a "scientific and clinical foundation," according to National Cancer Institute director Dr. Andrew von Eschenbach, gave the annual Advances in Cancer Prevention Lecture. Dr. Waun Ki Hong spoke about cancer prevention research, in particular the promise of using molecular-based, targeted therapies to prevent the onset of cancer, an approach called chemoprevention.

Hong believes cancer treatment needs to migrate from the disease's advanced stage, when a patient's chances of survival are low, to its earliest stages. The first step in chemoprevention is identifying how great a patient's cancer risk is by taking into consideration family history, the results of screening for genetic risk factors and how any tumors look and behave.

Providing examples from his own research in oral and lung cancer at the University of Texas M.D. Anderson Cancer Center in Houston, where he heads the department of cancer medicine and chairs the department of thoracic, head, and neck medical oncology, Hong emphasized that "the risk model is crucial." Patients at low risk for lung cancer should make lifestyle changes like quitting smoking. However, he pointed out that because about half of lung cancer patients are former smokers — some have even quit smoking 20 years before they are diagnosed with the disease — quitting is not enough. Those at medium or high risk should receive chemoprevention, and those at high risk should be screened, with the hope that if cancer is present, it will be detected early.

But chemoprevention researchers face the same challenge as those working in general chemotherapy: developing interventions specifically targeted at tumor cells that do not harm other parts of the body. "We have to develop more effective chemoprevention approaches," Hong urged.

Hong, whom Von Eschenbach introduced as "one of the premier leaders in the cancer community," soon will start a large, 3-year lung chemoprevention study at M.D. Anderson.

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