New evidenced-based guidelines from the American College of Chest Physicians (ACCP) cite there is little evidence to show  lung cancer screening impacts mortality in patients, including those who are considered at high risk for the disease.The guidelines also recommend against the use of vitamin or mineral supplements for the prevention of lung cancer, for these do little to decrease the risk of lung cancer, while beta-carotene has been associated with increased risk of lung cancer."Even in high risk populations, currently available research data do not show that lung cancer screening alters mortality outcomes," said W. Michael Alberts, MD, FCCP, chair of the ACCP lung cancer guidelines and Chief Medical Officer,H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.Their research provides 260 of the most comprehensive recommendations related to lung  cancer prevention, screening, diagnosis, staging, and medical and surgical  treatments.

Vitamin A

The guidelines also review complementary and integrative therapy for the prevention and treatment of lung cancer.  Due to the lack of supporting evidence, the guidelines recommend against the  use of LDCT, chest radiographs, or single or serial sputum cytologic evaluation for  lung cancer screening in the general population, including smokers or others at  high risk, except in the context of a well-designed clinical trial. "Population  screening for lung cancer is not recommended and may, ultimately, put the  patient at risk for further complications," said Gene L. Colice, MD, FCCP, vice  chair of the ACCP lung cancer guidelines and Director, Pulmonary, Critical  Care, and Respiratory Services, Washington Hospital Center, Washington, DC. "Nodules  are commonly found during screening; however, to determine whether they are  cancerous requires additional testing, which is fairly invasive and extensive.  This may cause the patient needless risk, both physically and psychologically."

PREVENTION
The guidelines also recommend against the preventive use of several of the following common  supplements and medications in at-risk patients or those with a history of lung cancer:Beta-carotene– The guidelines strongly recommend against the use of beta-carotene  supplements for primary, secondary, or tertiary prevention, citing the higher incidence of  lung cancer among those who use the supplement.

Vitamin A – The guidelines strongly recommend against the use of retinoids (vitamin A),  including isotretinoin, for they have not been shown to decrease the incidence  of second tumors and could increase mortality among current smokers.

Vitamin E – Vitamin E is not recommended for lung cancer prevention, as studies show no  difference in the incidence of lung cancer among those taking vitamin E compared with those not taking it.

Aspirin – Although some literature suggests that aspirin may play a protective  role regarding cancer,the guidelines do not recommend aspirin for the prevention of lung cancer, as  studies show that aspirin does not decrease the risk of lung cancer or death due to lung cancer.

INTEGRATIVE THERAPY
For the first time, the ACCP lung cancer guidelines have included  recommendations on mind-body modalities as part of a multimodality approach to reduce the anxiety,  mood disturbances, and chronic pain associated with lung cancer. Massage therapy is  recommended for patients who are experiencing anxiety or pain, while acupuncture is  recommended for patients experiencing fatigue, dyspnea, chemo-induced  neuropathy, or in cases where pain or nausea/vomiting is poorly controlled.