Each year Viswam Nair, MD, manages treatment plans for hundreds of patients at Stanford University. A pulmonologist with formal training in epidemiology, Dr. Nair stays current on the latest scientific breakthroughs to offer his patients the best possible outcomes.
Nevertheless, when a patient has a chest scan that shows a single pulmonary nodule, even Dr. Nair has a tough call to make—should he recommend a biopsy or surgery, or just wait and see what happens? If it is early-stage cancer, waiting could be a mistake. But if the nodule is benign or caused by an infection, the biopsy or surgery could be unnecessarily painful or expensive.
Like so many physicians, Dr. Nair often wished that there were an easier way to check if the nodule was cancerous. He considered whether easily accessible body fluids, such as blood, might be used to test for cancer. Eventually, driven by a need for better tools to help his patients, Dr. Nair applied for a LUNGevity research grant to develop noninvasive techniques for the early detection of lung cancer.
“The funding from LUNGevity in 2012 was my first substantial research grant. It gave me three years to learn about biomarkers and do the research. Now I have strong collaborators and additional funding lined up,” Dr. Nair explained. "In short, LUNGevity Foundation kept me in lung cancer research.”
Dr. Nair is interested in circulating tumor cells. These cells, originally from a primary tumor, are commonly found floating in the blood of patients with advanced-stage lung cancer.
However, patients with early-stage lung cancer can also have tumor cells circulating in their blood.
Dr. Nair wanted to use these circulating tumor cells as blood biomarkers for early-stage lung cancer, but one blood test wasn’t enough. He knew that a two-pronged approach would likely lead to more accurate diagnoses, so he looked for another approach already being used to diagnose lung cancer.
Physicians have been using an imaging technique called a PET scan to study detailed characteristics of lung nodules to help establish treatment plans. Dr. Nair set out to combine the information from the biomarkers in the blood with the results of the PET scans.
By combining these two minimally invasive techniques, Dr. Nair has been working toward developing a “one-stop shop” that tests for early-stage lung cancer without biopsy or surgery.
“We have made some progress, but this is not ready for prime time yet,” notes Dr. Nair. “The idea of combining different types of early-detection techniques into a single test is an important idea to be explored more. And I am glad that I am seeing more research happening in this area.”
With a timely boost from LUNGevity, Dr. Nair is well on his way to reaching his ultimate goal of building an early-detection program at Stanford that combines multiple techniques to give his patients the very best possible outcomes.
Juhi Kunde, MA, is a science writer for LUNGevity. 