NLST, SELECT, SPIRIT, STAR . . . read more to find out why these letters could spell better health for you or a loved one.

National Lung Screening Trial (NLST)
Lung cancer kills more Americans every year than any other kind of cancer -- mainly because doctors don't have a reliable way of finding it early, when treatment has the best chance of working.

Now, doctors at the U-M Cancer Center and other study centers across the country are testing two different methods of detecting tiny lung tumors in smokers and ex-smokers. Researchers will then track participants' health for several years, looking yearly for signs of lung cancer.

By the end of the study, they'll be able to tell whether regular chest X-rays or CT scans had any effect on the participants' lung cancer detection and mortality rates. And that might help determine whether all American smokers and ex-smokers should get their lungs scanned regularly -- or whether scientists need to keep looking for better ways of finding lung cancer in its treatable early stages.

According to Ella Kazerooni, M.D., M.S., director of thoracic radiology at the U-M Health System and a member of the U-M Cancer Center, "we're looking for men and women aged 55 to 74 years, who are current and former smokers. Former smokers must have quit within the last 15 years." Smoking is by far the biggest risk factor for lung cancer, causing 87 percent of cases.

Do you think you might be interested in this study? Find out more.

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Selenium and Vitamin E Chemoprevention Trial (SELECT)
An important National Cancer Institute study underway at the U-M Cancer Center aims to find out whether daily selenium (a micronutrient present in food and supplements) or vitamin E (alpha-tocopherol) supplements may reduce a man's chances of getting prostate cancer -- one of the most common and deadly cancers diagnosed in American men.

Risk factors for prostate cancer include: being over age 55, being African-American, or having a father or brother with prostate cancer.

The U-M is seeking African-American men at least 50 years of age, and men from ethnic and other racial groups at least 55 years old. Participants must have no prior history of prostate cancer. Men who join the trial also must not have had any other cancer, except non-melanoma skin cancer, in the last five years. They must be in generally good health.

"The men who join SELECT not only have a chance to prevent prostate cancer for themselves, but they also may help their sons and grandsons live free from the disease," says Willie Underwood, M.D., lecturer and principal investigator for the U-M effort.

SELECT will enroll more than 32,000 healthy men nationwide. Some men will take only selenium or vitamin E, and some will take both. Others will take a placebo (sugar capsule).

For more information on clinical trials, call the Cancer AnswerLine at 1-800-865-1125 or visit the Cancer Center's clinical trial's page.

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Surgical Prostatectomy versus Interstitial Radiation Intervention Trial (SPIRIT)
This year, more than 180,000 American men will be diagnosed with prostate cancer. Another 35,000 will die because of it. Now, a new study is comparing seed implant therapy to the surgical removal of the prostate, or prostatectomy, to determine which is the most effective cure.

"We know both options are effective ways to treat prostate cancer," says Martin Sanda, M.D., co-chair of the trial and associate director of the U-M Cancer Center's Prostate Cancer Program, one of a number of centers in North America taking part in the study. "What we don't know is how they will compare two, five or 10 years after treatment, in terms of their effects on survival and quality of life."

Those who are eligible to participate in the trial are randomly assigned either to have prostatectomy or to have radioactive seeds implanted as treatment for early stage prostate cancer. The researchers also are using confidential patient surveys to evaluate patients' quality of life and the presence of side effects after seed implant therapy and surgical removal of the cancer.

For more information on clinical trials, call the Cancer AnswerLine at 1-800-865-1125 or visit the Cancer Center's clinical trial's page.

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Study of Tamoxifen and Raloxifene (STAR)
The U-M Cancer Center is one of more than 400 institutions in North America participating in the STAR trial, which is comparing raloxifene to tamoxifen for the prevention of breast cancer, the second-leading cause of cancer death in American women.

Tamoxifen is a drug that blocks the effects of the hormone estrogen, which is produced by a woman's ovaries and can promote the growth of some cancers. Blocking or lowering the levels of estrogen in a woman is one way of treating breast cancer.

Like tamoxifen, raloxifene is an anti-estrogen drug; it was approved by the Food and Drug Administration in 1997 for the prevention of osteoporosis. Women taking raloxifene in osteoporosis studies have seen a reduction in the incidence of breast cancer.

"The STAR trial will try to answer the following question: 'Of two drugs that interfere with the action of estrogen in the breast, which one is better to decrease the risk and incidence of breast cancer?'," says Sofia Merajver, M.D., Ph.D., U-M's principal investigator and director of the Breast and Ovarian Cancer Risk Evaluation Program.

Sponsored by the National Surgical Adjuvant Breast and Bowel Project, the STAR trial will involve 22,000 postmenopausal women randomly assigned to take either tamoxifen or raloxifene daily for five years. Women will receive regular physical exams, mammograms and gynecological exams throughout the trial.

For more information on clinical trials, call the Cancer AnswerLine at 1-800-865-1125 or visit the Cancer Center's clinical trial's page.

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