NikoleV
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A series of great videos coming straight from the Targeted Therapies in Lung Cancer Conference
February 24th, 2013 - by Dr. Jack West
http://expertblog.lungevity.org/2013/02 ... ca-vids-1/
I just attended a meeting in Los Angeles, called the 13th Annual International Association for the Study of Lung Cancer (IASLC) Targeted Therapies in Lung Cancer conference. It brings together dozens of leading lung cancer researchers to provide updates to each other and a broader audience of lung cancer community members about the latest new agents and research avenues for clinical research in lung cancer. While there, I had the opportunity to sit down with many of my colleagues, who were kind enough to share their thoughts on many very current issues in the field. Here are the first few of them.
Dr. William Pao on the My Cancer Genome Project
Dr. Geoffrey Oxnard: What is an Inherited EGFR T790M Mutation, and What Does It Mean?
Dr. Lecia Sequist on Molecular Marker Testing in Advanced NSCLC: What, Who, and When?
Dr. David Spigel: What are the Most Promising Targeted Therapies for Lung Cancer in the Next Few Years?
Dr. Greg Riely: How Should We Approach Acquired Resistance to Targeted Therapies in Advanced NSCLC?
Click on the link above to view the videos listed.
We’ll be producing more of these pretty close to every day. I’ll deliver posts here with links to all of these new videos, but if you want to see them as soon as they’re out, check out my Twitter feed (@JackWestMD).
I hope you find these helpful. These are truly the people with the most cutting edge knowledge in the field of lung cancer. You’ll see that they don’t all agree on every question, but that reflects the ambiguity still within the field, even among the most knowledgeable people around.
We thank these experts for their generosity with their time and expertise in providing this information to the lung cancer community.
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Factors Leading To A Recommendation on Post-Operative Chemotherapy for Early Stage Lung Cancer: Case In Point video
February 15th, 2013 - by Dr. Jack West
http://expertblog.lungevity.org/2013/02 ... isk-tumor/
I wanted to start a new video series that will provide illustrative cases from my clinic that introduce broader teaching points. This first video covers the decision-making process that led me to recommend post-operative (adjuvant) chemotherapy for a patient who had a 3.5 cm lung adenocarcinoma resected, and who had no lymph node involvement. We typically recommend chemo only for larger node-negative lung cancers, but her particular cancer had some other features that made me concerned enough about her risk of recurrence to favor at least a good consideration of chemotherapy. Here’s my discussion of some of the variables that are relevant in this setting.
Click link above to view video.
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Thankful for Early Detection
March 1st, 2013 - by Jan Gibson
http://blog.lungevity.org/2013/03/01/th ... detection/
On March 24, 2005, at 46 years old, I was diagnosed with Non-Small Cell Adenocarcinoma Lung Cancer. There were no symptoms. Because of chest pain on my right side, I went to the emergency room on Sunday, February 20th. I was concerned about my heart. Heart disease runs in my family, and although I am very physically active, my sister had a heart attack when she was 47. I never found out what was causing my chest pains that day, but I did find out that I had a mass on my left lung. How could I have lung cancer? I don’t smoke. I never knew people could get lung cancer if they didn’t smoke.
My cousin and friend Kathi, age 46, had passed away just 2 years earlier from Small Cell Lung Cancer. This couldn’t be happening to me. How was I going to tell my children? They had just seen this same disease kill my cousin. How could I explain that mine was different? This was the beginning of a new life for me. After many tests over the next month, which included Chest X-Rays, CT scans, PET scans, Needle Guided Lung Biopsy, and a Bronchoscopy/Mediastinoscopy, it was determined that the cancer seemed to be contained within the one lung and had not spread to any lymph nodes.
On April 20, 2005 a lobectomy was performed at University of Maryland Medical Center. I had the upper lobe of my left lung removed. This was the most emotional day of my life. I wrote both of my daughter’s goodbye letters, just in case. I had a wonderful surgeon who was able to perform the lobectomy using a procedure called VATS (Video assisted thoracic surgery). The recovery was much easier because of this newer procedure. I was back at the gym in 2 weeks, walking on the treadmill and using the elliptical machines. Four weeks later, with CT scan in hand, I went back to the surgeon and he said that everything looked good. They did not recommend chemotherapy at this time. I was staged at a 1A, and was told that the benefit of chemo was not worth the risk for my stage of cancer.
I am so thankful that I caught it early, and they were able to do the VATS surgery to get it out of there. The doctor says that I am cancer free now. We never did find out why I was having chest pains on my right side that day, it had absolutely nothing to do with the cancer. The pains went away the next day, and they have never been back again.
Now, I’ve never been a religious person, but I have to say, someone was trying to tell me something. Had I not gone to the ER that day, who knows when my lung cancer would have been detected?
There needs to be more funding into the early detection of lung cancer so that more people can survive this disease.
I just feel so very fortunate that my cancer was accidentally detected early and I was able to be “cured”. I want everyone else to have the chance at early detection. It’s time to treat lung cancer with the same urgency that all other major cancers receive. I have learned so much since being diagnosed with lung cancer. I learned that lung cancer is a horrible disease that is underfunded and has a stigma attached. I learned just how much my husband, my mother, my sister and my children really love me. They were my rocks.
I can’t even begin to describe what it has meant to have my LUNGevity “LCSC friends” to talk to. They are the only ones that truly understand. I joined the LUNGevity Lung Cancer Support Community message boards 6 days before my lobectomy in 2005!
I’ve been cancer free for 8 years now. I volunteer in my community. I’ve participated in cancer events and I am a volunteer LUNGevity LifeLine Support Mentor to those who are newly diagnosed.
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Hands of Time
February 28th, 2013 - by Kenneth Lourie
http://blog.lungevity.org/2013/02/28/hands-of-time/
On the one hand, I want to take note every month on the 27th as yet one more notch on my living-with-cancer belt. On the other hand, maybe I don’t need a belt to be notching but rather a life to be living. Perhaps it’s time, nearly 44 months post-diagnosis – at press time, to stop counting backwards and try more living forwards. It’s not as if keeping a running total in my head (as I do), gets me any closer to some sort of finish line where life can begin anew. Hardly. I’m not exactly cancer-free, more like cancer-stalled. Nevertheless, my monthly total does indicate how far I’ve come, how long I’ve lived, but it doesn’t necessarily translate into how much longer I may live. In fact, it might suggest the exact opposite (only so much time left on the clock, hypothetically speaking), so why bother tracking time? Why not track the future instead? Go somewhere! Do something! Live a lot, not just a little.
Unfortunately, survivability in the terminal cancer world may simply be the means to your end. If you can’t beat it, then you can only join it. Although you hope to outlast it, stay one step ahead and try to keep it from catching you. Perhaps I should consider – and embrace – the words of the great Satchel Page: “Don’t look back. Something might be gaining on you.” Still, for me, totaling up the number of months since I received my official diagnosis/prognosis, gives me confidence that having survived this unexpectedly long (original prognosis was “13 months to two years”; median life expectancy is eight months) somehow means something positive going forward. Not that there’s any statistical relationship between the past and the future. As Starfleet Captain, Kathryn Janeway said to her first officer Commander Chacotay on an episode of Star Trek: Voyager: “I swore I’d never let myself get caught in one of these Godforsaken paradoxes. The future is the past, the past is the future. It all gives me a headache.” Certainly they weren’t discussing cancer, but for me, wondering if counting the months I’ve lived with cancer might possibly have an effect on the months I have yet to live with/hopefully without cancer is beneficial somehow to surviving, is sort of how I roll. Whereas choosing the alternative approach: not counting and/or considering anything/everything, gives me a headache.
How do I stay ahead of cancer without betraying who I am or compromising my principles? As Curly Howard of The Three Stooges said while harnessed like a horse and pulling a wagon in an episode called “G.I. Wanna Go Home”: “If I’m gonna work like a horse, I’m gonna eat like one, too” (as he began eating an extra-large sandwich). However I do this (live with cancer), I have to do it my way, or at least in a way that doesn’t make me miserable. Because being miserable is all it’s cracked up to be, and having a bad attitude likely fuels the cancer that unfortunately burns inside me. But I never want to think that I’ve learned all there is to learn to help my body/my mind fight the cancer. Maybe looking forward to potential accomplishments might extend life more than taking stock of previous achievements? On the one hand, those accomplishments (still living 44 months post diagnosis) might breed a certain confidence that bodes well to be well. On the other, focusing on the past may compromise the future?
I hope this column wasn’t too confusing. If it was, welcome to my world. If it wasn’t, “You’re a better man than I am, Gunga Din,” (Cary Grant from the movie of the same name).
How do YOU stay ahead of cancer?
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“This column is my life as one of the fortunate few; a lung cancer anomaly: a stage IV lung cancer patient who has outlived his doctor’s original prognosis; and I’m glad to share it. It seems to help me cope writing about it. Perhaps it will help you relate reading about it.”
Mr. Lourie’s columns can be found at www.connectionnewspapers.com. (key word, Lourie)
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LUNGevity Foundation Expands Management Team
FOR IMMEDIATE RELEASE
Media Contact:
Victoria Shapiro
(202) 414-0774
Betsy Thurston joins LUNGevity as Vice President of Development
http://events.lungevity.org/site/PageNa ... 22213.html
WASHINGTON (February 22, 2013) – LUNGevity Foundation is pleased to announce that Betsy Thurston has joined the senior management team as Vice President of Development. In her role, Ms. Thurston will have overall responsibility for all fundraising and development activities including the development of key external alliances.
Ms. Thurston will be a part of LUNGevity’s senior management team that drives the overall strategy for the organization and represents the Foundation on a local, regional, and national basis. She brings a wealth of experience to her new role. Most recently Thurston was Vice President for Strategic Development at the Council on Competitiveness. The Council is a membership-driven organization that recruits and engages America’s most influential and innovative leaders to directly impact and influence the future competitiveness of the United States. Thurston was responsible for building and executing sustainable institutional growth through membership and development. She served in this position since 2004. Prior to the Council Thurston worked with the AFL-CIO Housing Investment Trust and the national headquarters of the American and International Federation of Red Cross Red Crescent Societies.
“We are thrilled to have someone of Betsy’s caliber join our team,” said Andrea Stern Ferris, President and Chairman of LUNGevity. “Together we will be able to accelerate our growth and make a significant difference to all those affected by lung cancer.”
About LUNGevity Foundation
The mission of LUNGevity Foundation is to have a meaningful impact on improving lung cancer survival rates, ensure a higher quality of life for lung cancer patients and provide a community for those impacted by lung cancer. It does so by supporting critical research into the early detection and successful treatment of lung cancer, as well as by providing information, resources and a support community to patients and caregivers.
LUNGevity seeks to inspire the nation to commit to ending lung cancer.
For more information about the grants or LUNGevity Foundation, please visit www.lungevity.org.
About Lung Cancer
1 in 14 Americans is diagnosed with lung cancer in their lifetime
Lung cancer is the leading cause of cancer death, regardless of gender or ethnicity
Lung cancer kills almost twice as many women as breast cancer and more than three times as many men as prostate cancer
About 55% of all new lung cancer diagnoses are among people who have never smoked or are former smokers
Only 16% of all people diagnosed with lung cancer will survive 5 years or more, BUT if it’s caught before it spreads, the chance for 5-year survival improves dramatically.
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A Pill A Day
February 22nd, 2013 - by Kenneth Lourie
http://blog.lungevity.org/2013/02/22/a-pill-a-day/
Hopefully will keep the cancer at bay. (I’d say “away,” but let’s be realistic, three and a half years past a NSCLC diagnosis, there is no way, generally speaking, that stage IV lung cancer disappears into the ether; it’s classified as stage IV for a reason. However, there are many – and varied – non-traditional and not particularly Western and/or A.M.A./American Cancer Society-approved alternatives to fight this insidious disease, many of which, about 20 or so, I have incorporated into my overall treatment regimen. Moreover, if my continuing survival reflects anything, it is an affirmation of what former N.C. State basketball coach Jim Valvano said in 1993, in one of his last public appearances before succumbing to bone cancer, on ESPN’s inaugural ESPYs Award show, as the first recipient of the “Arthur Ashe Courage and Humanitarian Award”: “Don’t give up, don’t ever give up.” And so I haven’t.)
Besides, where’s the future in giving up or giving in? That’s not to infer that the last few years haven’t been incredibly challenging, because they have. Emotionally for sure, physically not quite as much. Although chemotherapy is all it’s cracked up to be; some treatment (drugs) were definitely worse (side effects/quality of life) than others. Fortunately for me, amazingly in fact, through it all, I have been relatively asymptomatic with minimal/manageable side-effects and zero hospitalizations. Nevertheless, cancer’s reputation as a killer is well-documented and hardly the kind of diagnosis one can ever take with a grain of salt – maybe better taken with a grain of alcohol.
Every day, every doctor’s appointment, every scan, every time you have your blood drawn, every change in how you think and how you feel, relate to the undeniable fact (and believe me, I’ve tried to deny it; it’s a good defense/self-preservation mechanism) that you (meaning me) have cancer, and not just a garden variety, but rather the incurable kind, according to my oncologist: stage IV. Defined as metastasized, inoperable, with a “13-month to two-year prognosis.” (Given to me late February, 2009.)
But here I am, still. I have outlived my prognosis (but hopefully not my usefulness) by a significant – to me, length of time: years, depending how you calculate. However, does that significance move me closer than ever to the end of my writing all these lines? I don’t want to think that, but whatever cancer does to you physically, it’s equally bad – in my experience/opinion on your mind/thought process. Thinking straight, thinking clearly, thinking objectively, thinking unselfishly; all become collateral damage as a result of your cancer diagnosis. Fighting through these difficult-to-control emotions is the bane of my existence, an existence I’m lucky to still have. My next CT Scan is in September, two months after I will have been taking my daily “targeted therapy” chemotherapy-type pill. Then I’ll know how I really feel. Until then, life goes on. And so far, this pill seems not to be making a bad situation any worse; a non-side effect for which I am extremely grateful.
____________________________________________________________
“This column is my life as one of the fortunate few; a lung cancer anomaly: a stage IV lung cancer patient who has outlived his doctor’s original prognosis; and I’m glad to share it. It seems to help me cope writing about it. Perhaps it will help you relate reading about it.”
Mr. Lourie’s columns can be found at www.connectionnewspapers.com. (key word, Lourie)
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An Attitude of Gratitude
February 20th, 2013 - by admin
By Sue Bersh
http://blog.lungevity.org/2013/02/20/an ... gratitude/
“The ship of my life may or may not be sailing on calm and amiable seas. The challenging days of my existence may or may not be bright and promising. Stormy or sunny days, glorious or lonely nights, I maintain an attitude of gratitude. If I insist on being pessimistic, there is always tomorrow. Today I am blessed.” ― Maya Angelou
If I had to sum myself up in one sentence it would be: I AM GRATEFUL.
There is nothing I am more grateful for than my husband and three incredible sons – each is a dream come true. My gratitude list is a long one – so many people and experiences that have made me who I am. I have learned that even out of sadness and hurt can come blessings.
When I was 15 years old, my Grandma Harriet died of lung cancer. My twin brother and I were her only grandchildren. We spent lots of quality time with her, and she adored us. Her life ended much too early, but to this day I feel extremely connected to her, and I am grateful.
When I was a sophomore in high school, my closest friend told me she didn’t want to be my friend anymore, and I was heartbroken. A few months later I found a new group of friends who have remained my friends for life, including my friend Elyse. Out of heartbreak came lifelong friends, and I was grateful!
Seven years ago Elyse was diagnosed with lung cancer. I intimately shared in her illness and treatment and watched her hopelessly fight a disease with a 15% survival rate (not much better than when my grandma died 30 years earlier). I don’t think I will ever be able to fully share what this experience was like, but suffice to say that I was changed forever by it. And although it was devastating to watch, I am grateful for what we shared, which equated to a lifetime of love and friendship in the 2-1/2 years that Elyse battled this insidious disease.
Call it fate or karma – whatever it is – I truly believe that all of our experiences, big and small, and our relationships build on each other to put us on our destined path with the people we are meant to be with. Hopefully this path will lead us to doing good and living a life true to ourselves.
I have found my path in my involvement with LUNGevity Foundation. I am proud to be a board member, and last year I organized my first Breathe Deep fundraising event (with the help of many good friends and LUNGevity supporters) in the community where I grew up and still live today, Deerfield, IL. Over 1,300 people participated last May, and we raised an unbelievable $140,000. We engaged a community in an important cause. A few months later, Deerfield High School chose LUNGevity as the beneficiary of its annual School Chest fundraiser. These extraordinary kids raised over $135,000 in three weeks to fund lung cancer research, and they inspired many, many people to care about lung cancer. I’m not sure any LUNGevity experience will top what I was fortunate enough to share with those remarkable teenagers. I am eternally grateful!
As we plan our next event, Breathe Deep North Shore, I am grateful for a community that has opened its arms to LUNGevity. They have put the stigma aside and truly understand that lung cancer is a fight that needs to be everyone’s. Lung cancer takes more lives than breast, prostate and colon cancers combined; it is destined to touch us all. I have never been more passionate about anything in my life than this cause.
I am particularly grateful for the friends I have made on this journey, especially my friend Jill. This 43-year old, non-smoking mom of four is the new face of lung cancer. I love her and admire all that she does to advocate for herself, her family, and this cause. Jill, along with my friends Jerry, Lynda, Mary, Patti, Heather, Tracy, Barb, and others battling this disease, are the reasons I am in this fight for the long haul. They need treatment options, and they and their families deserve hope.
We all should celebrate life, especially when faced with challenges and loss. We need to be passionate about what we believe in and love hard because every day and every person in our lives truly is a gift. We need to find our destined path and make a difference in others’ lives. We should give of ourselves in a way that fulfills us and BE GRATEFUL for the things that matter most.
I am grateful to have found LUNGevity. It has helped me heal and find meaning in a terrible loss. Join me on my journey and maybe it will become yours too (or at least inspire you to find your own). If you live in the Chicago area, join us for Breathe Deep North Shore, a 5K fun run, one-mile walk and balloon launch on April 28th at Deerfield High School. Join my team, Elyse’s Legacy, Jill’s Team, Just Breathe, another team, or start your own. Register or donate today, and share in a day of meaning and hope.
WE can make a difference in the fight against lung cancer.
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If you're a current of former smoker with a concern about lung cancer, Methodist Medical Center is offering a diagnostic test that can provide peace of mind. Beginning March 1, the Methodist Cancer Institute will offer Lunch Check, a screening tool that aids doctors in detecting lung cancer at its earliest and most treatable stage. The Methodist Lung Check is a painless screening and takes only about 30 seconds. Using a Computed Tomography (CT) of the chest, physicians can detect abnormal spots or modules. Many of these are too small to show in a standard X-ray. The cost for the Methodist Lung Check is $175. While the screening cost is normally not covered by insurance, insurance usually does cover the evaluation of any abnormal findings. For more information or to see if you qualify for the screening, call the Methodist Cancer Institute at 671-8296.
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Symptoms or Just Sometimes
February 13th, 2013 - by Kenneth Lourie
http://blog.lungevity.org/2013/02/13/sy ... sometimes/
Is what I feel – wherever I feel it, cancer or middle age? Is what I feel worthy of a mention to my oncologist or merely yours truly looking for trouble? Moreover, Is the pain/discomfort I feel in my chest (between my lungs) par for the course of treatment I’m on and characteristic of the disease with which I’ve been diagnosed, or is it completely unrelated and not at all noteworthy (dare I say, normal)? Or is this a repeat of a symptom I’ve experienced previously? Once the pain represented a tumor growing in my lungs (bad news); another time, the same pain was scar tissue growing over tumors that had shrunk (great news). (Scar tissue, as my oncologist explained to me, is similar to the scab that eventually forms over a skinned knee and is a sign of healing.) In each case, however, the identical symptom had two very different causes: one good, one bad. Ergo my confusion now. Is what I feel good, bad, or shall I remain indifferent?
And if I remain indifferent, how do I remain indifferent about the most important thing in my life: my health/diagnosis/prognosis? However, stressing about unconfirmed complications seems itself an unnecessary complication and one to be avoided. Where’s the benefit in making myself sick (see 8/29/2012 column: “Diagnosed But Not Sick”) simply because I have a terminal disease? Then again, if I am to remain proactive with respect to my care and feeding, I must advocate for myself and not allow time to pass when pain and suffering need not occur. I don’t want to worry myself sick, but nor do I suppose that neglecting myself dead serves any particular purpose either. As Curly Howard of The Three Stooges said: “I’m too young to die, too handsome; well, too young, anyway.” My feelings exactly.
Not only has the same pain-in-my-chest symptom led to opposite interpretations, it has also caused me to wonder if what I’ve felt was real or imagined (see 8/22/2012 column: “Life in the Cancer Lane”) and typical of the roller-coaster existence that becomes “normal” for cancer patients. The dilemma is, I don’t want to make something out of nothing any more than I want to make nothing out of something. Nor do I ever want to be damned, but with some days/certain symptoms, I feel as if I’m damned if I do and damned if I don’t. Still, I can live with it: I have lived with it, but it certainly doesn’t make me feel like I’ve mastered it.
Even writing a column about it (cancer, and the emotional confusion it causes) seems like I’m bringing unnecessary attention to a condition (some condition) with which I’m forced to live, but a condition any cancer/terminal patient still living would be happy to endure: life. And let me be clear: I am not complaining. I am “introspecting” into the peculiarities and perplexities of living a life for which I had no preparation, no experience and zero indication – until the biopsy confirmed it, that my life, as I had previously known it and expected it to be, was officially over. Not literally, but figuratively. Yet another conundrum.
Making the best of a bad situation, that’s how I roll (I’m a Red Sox fan after all). Some days are easier than others, some symptoms/treatments/results are better than others. And some columns make more sense than others. But that’s cancer for you: an equal opportunity “screwer-upper.”
How do you handle symptoms and the anxiety that sometimes accompany them? Comment below!
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“This column is my life as one of the fortunate few; a lung cancer anomaly: a stage IV lung cancer patient who has outlived his doctor’s original prognosis; and I’m glad to share it. It seems to help me cope writing about it. Perhaps it will help you relate reading about it.”
Mr. Lourie’s columns can be found at www.connectionnewspapers.com. (key word, Lourie)
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New Promising Avenue of Research for KRAS Mutation-Positive Patients with Advanced NSCLC
February 13th, 2013 - by Dr. Jack West
http://expertblog.lungevity.org/2013/02 ... ced-nsclc/
I just recorded a brief video highlighting a publication just published in Lancet Oncology that reports results from an international, multicenter randomized phase II study led by Dr. Pasi Janne of Dana Farber Cancer Institute in Boston.
(Click link above for video)
Some prior posts have touched on this study before, as an ASCO highlight from 2012, for instance, but the publication is a major milestone. Importantly, KRAS mutations are actually the most common molecular defect we see in NSCLC, but we haven’t had an actual treatment to offer such patients up to this point.
I would say that this research suggests that we could have some particularly effective treatment options to offer to KRAS mutation-positive patients in the future.
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Dr. Ramalingam on Myths & Facts, Question and Answer Session on Clinical Trials
February 8th, 2013 - by Dr. Jack West
http://expertblog.lungevity.org/2013/02 ... s-3-and-4/
Here’s the last two parts of our webinar program with Dr. Suresh Ramalingam, medical oncologist and Director of Medical Oncology at Emory University, as well as Chair of the ECOG Lung Cancer Committee. The last portion of Dr. Suresh Ramalingam’s presentation covered several persistent myths around clinical research in cancer, countered with the real facts, and then included a highlighting of patient rights in clinical trials.
Here are the video and audio versions of this last portion of his presentation, along with the transcript and figures.
(Click link above to view video and audio links)
Ramalingam Pt 3 Clin Trials in Cancer Video
Ramalingam Pt 3 Clin Trials in Cancer Audio
Ramalingam Pt 3 Clin Trials in Cancer Transcript
Ramalingam Pt 3 Clin Trials in Cancer Figures
The program closed with a question and answer session covering emerging challenges of doing trials in a new era of molecular oncology. As a large population like “advanced lung cancer” becomes divided into many subgroups, even with some small ones like the 4% with an ALK rearrangement and perhaps even 1-3% populations with others on the horizon, we face new challenges in conducting clinical trials on small and widespread populations.
How will we continue to do clinical research on these smaller, scattered populations? Dr. Ramalingam offers his insights in the Q&A portion (because there really isn’t anything visual in this part, there’s no real video to see).
(Click link above to view audio & transcript links)
Ramalingam Pt 4 QA Session Clin Trials in Cancer Audio
Ramalingam Pt 4 Clin Trials in Cancer Pt 4 Transcript
I hope this is helpful. We’ll be sharing the next program very soon.
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An Algorithm to Guide through Options for Advanced Bronchioloalveolar Carcinoma
January 25th, 2013 - by Dr. Jack West
http://expertblog.lungevity.org/2013/01 ... -algorith/
I’m editing a late draft of a chapter I’m writing for a lung cancer textbook on management of multifocal bronchioloalveolar carcinoma (BAC). This is a clinical entity and in fact a field that is really in flux. In fact, the term BAC is in the process of being re-labeled lepidic predominant adenocarcinoma (LPA) (lepidic meaning scale-like, which is the classic way that the cells are defined as spreading when looked at under a microscope). Despite the potential name change, I suspect that it will continue to be called multifocal or advanced BAC for a long time by practicing clinicians.
I found in the process of developing this chapter that I faced the challenge of there being very little actual hard data on managing multifocal BAC. Many lung cancer experts have a very similar approach, but in truth this is based more on on expertise, good judgment, and clinical experience than real published data to cite. So, with the caveat that there isn’t a lot of evidence to shape my own practice, but also noting that I see and treat a lot of BAC and am recognized for this expertise, I wanted to distill my own thought process as I shape recommendations for my patients. I don’t think anyone has ever really articulated a clear strategy in any medical paper or book chapter, so I’m hoping this will be a valuable addition to the literature.
In my review of the medical literature out there, I was struck by two points:
1) There is incredible variability in the appearance and clinical behavior of what is called advanced BAC in the clinical world. Some of it is aggressive and imminently threatening, while much of it is very slow growing and among the least threatening cases ever labeled as lung cancer. There is therefore a great potential to over-treat or under-treat patients by not recognizing the patterns of what’s going on in an individual patient and tailoring the approach to that person’s case, rather than using a “one size fits all” approach for everyone with advanced BAC.
2) People with a very slow growth rate are likely to do very, very well no matter what treatments they get, as much despite as because of those treatments. In many cases, interventions are pursued on patients who are destined to do very well, and then when their short term survival is good, the people who did that intervention write a paper saying how their approach is feasible and attractive because the patients did well — not recognizing, or at least glossing over the idea, that they were going to do very well anyway.
I would contend that in no other area of lung cancer care is it more important to distinguish between what can be done and what should be done. And the real experts know when to not intervene. However, this algorithm is designed specifically around multifocal BAC but works just as well for other slow-growing cancers.
So here is the algorithm I developed, which isn’t beautiful, but you can see that it focuses on seeing what is actually changing rather than treating reflexively based on a label on a pathology report or single a scan finding. Essentially, it argues to avoid intervening in the absence of clinically significant change (which I would consider as something that is readily apparent as progression on scans done 6 months apart or less). Then, if you see progression, clarify whether it’s limited to one lesion or progressing more diffusely in multiple areas.
Also, if patients need systemic therapy, you use the same approach that you would for another non-squamous NSCLC. BAC today should be tested for the key molecular markers that can change management, most particularly EGFR mutation and ALK rearrangement, with the decision of chemo or targeted therapy as first line treatment really dictated by the molecular profile. In essence, this is the same way we should approach an invasive lung adenocarcinoma. There is no magic different approach for BAC once you’ve decided someone should receive systemic therapy.
Finally, I’ll emphasize that the algorithm here isn’t for ALL people with multifocal BAC, but just those who have evidence of an indolent and asymptomatic (or minimally symptomatic) process, and those who have a more readily progressing disease need all of the aggressive anti-cancer treatment they can get.
But it’s really important to recognize that we treat lots of people with more therapy than is their best interests: part of that is a cultural bias among patients and doctors of ”don’t just stand there — DO SOMETHING!“, even if it’s not likely to be helpful, or at least not yet. Also, part is that the incentives, in the US health care system at least, is to give the most care that is defensible and will be paid for.
People facing this situation may or may not accept remaining untreated for months or years at a time, even recognizing in their heads that they have an indolent cancer. We know that we over-treat some other cancers, like the majority of men with prostate cancer, but lung cancer hasn’t been one that is usually thought of as requiring as much aggressive treatment as possible. The best lung cancer doctors recognize when to hold off on that instinct.
I would advise people to think about some of these slower-growing cancers like diabetes, high cholesterol, or obesity. They represent a chronic risk to survival over years and often decades, but most people don’t lose sleep over obesity or their cholesterol levels and don’t rush into a triple bypass done 10 years before it might be needed just because a paper might show that people who undergo a prophylactic cardiac bypass 10 years before they would have had a clinical issue are still doing well 3 years after the surgery.
But admittedly, I’m on one side of the exam room, and the view my be different from the other chair. Could you accept surveillance scans and no treatment if you were told that you have what is technically an advanced cancer, but one that is likely slow-growing and for which early intervention offers no clear benefit over later intervention? Do you accept the premise that the treatment might be worse than the disease?
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Dr. Suresh Ramalingam Reviews the “Phases” of Clinical Research Trials and Trial Development
January 21st, 2013 - by Dr. Jack West
http://expertblog.lungevity.org/2013/01 ... s-1-and-2/
Recently, we had the privilege of featuring my friend, Dr. Suresh Ramalingam, who is the current Chair of the Lung Cancer Committee for the Eastern Cooperative Oncology Group (ECOG) as well as Professor and Chair of Medical Oncology at Emory University’s Winship Cancer Center, speaking in a webinar on the integral topic of clinical trials in cancer. He’s a great person to cover this area, because he has not only shepherded his own patients through important clinical trials, but he has also written many new studies that are shaping how we treat lung cancer now, and they have also identified promising directions for future therapies. As chair of ECOG’s Lung Cancer Committee, his guidance shapes the national priorities for lung cancer research, as ECOG studies are conducted at dozens of research centers across the US and emerge as landmarks in our understanding of cancer and the best treatments for it.
Here is the first part of his presentation, with video and audio versions of this podcast, along with the transcript and figures.
(Click on the link above to view the podcast and transcript links)
Ramalingam Clin Research in Cancer Pt 1 Video Podcast
Ramalingam Clin Research in Cancer Pt 1 Audio Podcast
Ramalingam Clin Research in Cancer Pt 1 Transcript
Ramalingam Clin Research in Cancer Pt 1 Figures
Part 2 of his presentation reviewed how we develop everything from the basic premise of what the trial will test, how we develop the statistical tests, trial documentation, and the regulatory requirements leading to a clinical trial becoming available for patient enrollment at an institution.
(Click on the link above to view the podcast & transcript links)
Ramalingam Clin Research Pt 2 Video Podcast
Ramalingam Clin Research Pt 2 Audio Podcast
Ramalingam Clin Research Pt 2 Transcript
Ramalingam Clin Research Pt 2 Figs
Part 3 will discuss a series of common myths and facts about clinical trials, as well as a discussion of patient rights for the people who enroll in trials.
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Touching For Sure, But Not Always
February 7th, 2013 - by Kenneth Lourie
http://blog.lungevity.org/2013/02/07/to ... ot-always/
Usually, but not always, when I show for my scheduled post-chemotherapy/post-scan appointment with my oncologist, I am physically examined (touching, feeling). Recently, due to some enhanced computer and facility upgrades, I was shown the actual scans, digitized. However, on more than one occasion over the last 18 months or so, after we discussed the results of my most recent CT Scan – and lab work, no physical exam was performed. Apparently, as I later learned, the good results from my scan sort of trumps any need to feel for physical manifestations. Meaning, that if the scan shows no tumor growth or movement, it stands to reason – medically speaking, that corollary-type symptoms/indications/abnormalities would not occur/be present. To simplify even more, there’s no need for a “pre-operative grope,” to quote Dr. Hawkeye Pierce from an episode of MASH, if the diagnostic test shows there’s nothing to “grope.”
On balance then, the doctor’s not examining me is good news, generally, presumably; at least that’s how he explained it to me. It’s a professional version of “Why bother?” There’s nothing to see so he doesn’t have to take a look. I can live with that. Still, I remember the first appointment I had with my oncologist when he didn’t examine me (he always asks questions though); before I sort of realized that I hadn’t been examined, I was already in my car driving home. I said aloud to my wife, Dina: “He didn’t even examine me!” I felt cheated somehow, as if I didn’t get my co-pay’s worth. I called my nurse the next day to complain and express my curiosity/anxiety about why it was that my oncologist had not touched/tested me for any physical reactions/signs as he had on all previous appointments.
My doctor did not call back if I recall, but I believe my nurse did, with some tepid reassurance. However, on my next appointment with my oncologist, we discussed the reason why I hadn’t been examined during the previous appointment. He said there is a debate within the medical profession about this very subject. If the scans are encouraging and show no appreciable tumor growth and/or movement, the patient’s body will likely not exhibit any signs to the contrary. Ergo, physically examining the patient is sort of redundant. However, my concern that something wasn’t done to me (physically examined by my doctor) is not uncommon, my doctor said, and causes patients to have a not-unexpected reaction: skepticism. The perception by us patients is that the doctors are not in fact doing everything they’re supposed to be doing, “Hippocratically” speaking. The doctors might know better, and know the facts, but when dealing with us patients, there are feelings to consider. And if the patient’s feelings are not considered during this fairly intimate doctor-patient relationship, then the facts, clear as they may be, may fall on deaf ears. This is the quandary – as it was explained to me; examine a patient who you know (from their most recent diagnostic scan) is not experiencing any negative reactions (to their disease) or, don’t examine the patient and cause a negative emotional reaction by not physically examining them. And as any of us terminal patients will attest, there’s a fine line to be straddled between positive and negative thoughts and interpretations and how they affect the patient. Maybe, reassuring the patient might be more important than following protocol?
As much as I want to be a patient patient, the longer I survive, the more impatient and paranoid I’m becoming. I want to enjoy the good news, really I do, but sometimes I can’t.
Damn cancer.
____________________________________________________________
“This column is my life as one of the fortunate few; a lung cancer anomaly: a stage IV lung cancer patient who has outlived his doctor’s original prognosis; and I’m glad to share it. It seems to help me cope writing about it. Perhaps it will help you relate reading about it.”
Mr. Lourie’s columns can be found at http://www.connectionnewspapers.com. (key word, Lourie)
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http://www.memorialcancerinstitute.com/ ... ing-99.pdf
Memorial Cancer Institute – Broward County’s leading cancer program – is on your side in the fight against lung cancer.
Lung cancer causes more deaths than the next three leading types of cancer combined.
But when caught early, it’s highly treatable. A simple CT scan has been proven to save lives.
CT screening is recommended if you:
• are age 50 or older and smoked more than 1 pack a day for 30 years
or 2 packs a day for 15 years
• currently smoke or stopped smoking within the past 15 years
• have no history of cancer, except for non-melanoma skin cancer
Call 954-276-5500 to schedule an appointment today.
If you do not have a prescription, please call 954-265-8889.
If insurance or another healthcare payor does not cover the CT Lung Screening or does not apply, then you can
have this procedure at the $99 rate. Payment must be made in advance. Rate is valid through December 31, 2013.
Price includes the performance and interpretation of the exam. Patients must have a prescription for the procedure.
The invoiced amount may constitute a net discount. If patient is a Medicare or other federal health care program
beneficiary, patient may be obligated to report this discount to the program upon request.
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Salem Cancer Institute begins new lung cancer screening program
Feb. 4, 2013 7:43 AM
http://www.statesmanjournal.com/article ... ck_check=1
Salem Cancer Institute has begun a new lung cancer screening program in an effort to detect the disease in at-risk populations earlier, increasing survival rates.
The low-dose computed tomography scan, education and results tracking program is open to people who are 55 to 74 years old, current or past smokers and have no symptoms of a lung condition or a history of lung cancer.
The program costs $99, but scholarships are available for those who can’t afford the fee. Most insurance plans don’t cover lung cancer screenings.
Lung cancer is the No. 1 cause of cancer-related deaths in the U.S., killing 166,000 people annually. More than 75 percent of lung cancer cases are caught in the late stages, when five-year survival rates drop to less than 15 percent.
For information, call the Salem Cancer Institute at (503) 561-7726.
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LUNGevity Foundation Hosts Third Annual Hope Summit During May, Lung Cancer Hope Month
http://events.lungevity.org/site/PageNa ... 12913.html
FOR IMMEDIATE RELEASE
Media Contact:
Victoria Shapiro
(202) 414-0774
Nation’s largest lung cancer-focused nonprofit encourages lung cancer survivors to participate
WASHINGTON (January 29, 2013) – LUNGevity Foundation, the nation’s largest lung cancer-focused nonprofit, is inviting lung cancer survivors from across the nation to register for the 2013 LUNGevity Hope Summit May 3-5, 2013 in Arlington, VA. The two day conference, taking place during Lung Cancer Hope Month, is designed for lung cancer survivors of all ages and stages of disease, currently in or out of treatment.
The summit provides an opportunity for participants to celebrate lung cancer survivorship, and gives survivors the opportunity to learn, collaborate, advocate and use their voices and stories to make a difference in the fight against lung cancer.
The topics to be addressed at this year’s Hope Summit will include inspirational speakers, medical expert forums, advocacy forums, lung cancer survivor-specific sessions, and opportunities for lung cancer survivors to share and connect with other survivors. There will be sessions specifically for survivors in active treatment and others for those out of treatment to address their specific needs.
Hope Summit attendees from previous years describe the value of the summit in very personal terms:
”Being in a room with 50 or so cancer survivors is an awe-inspiring event. Being in a room with 50 or so LUNG cancer survivors is as life-changing as the disease itself. Thank you all for an amazing weekend. “ - Alan
“The LUNGevity Hope Summit gave me the powerful sense of community that I often see in other groups, such as breast cancer or HIV/AIDS survivors, which I had not experienced since my lung cancer diagnosis. Your inspirational speakers, medical experts, advocacy training, and lung cancer survivor-specific workshops will be key in empowering us as cancer survivors to connect with other survivors and share our stories” - Jose
LUNGevity designated May as Lung Cancer Hope Month to celebrate the hope for better treatments and cures for lung cancer, as well as improving lung cancer survival rates and ensuring a higher quality-of-life for lung cancer patients and their loved ones. To register for the event and to learn more, go to: www.lungevity.org/HOPESUMMIT.
LUNGevity is offering a limited number of travel grants, based on need and availability. Deadline for grant applications is March 30. LUNGevity Foundation is also offering Community Partnerships to select organizations. Please contact Katie Brown, LUNGevity Director of Support and Advocacy, at kbrown@lungevity.org with any questions related to the Hope Summit or Community Partnerships.
About LUNGevity Foundation
The mission of LUNGevity Foundation is to have a meaningful impact on improving lung cancer survival rates, ensure a higher quality of life for lung cancer patients and provide a community for those impacted by lung cancer. It does so by supporting critical research into the early detection and successful treatment of lung cancer, as well as by providing information, resources and a support community to patients and caregivers.
LUNGevity seeks to inspire the nation to commit to ending lung cancer.
For more information about the grants or LUNGevity Foundation, please visit www.lungevity.org.
About Lung Cancer
1 in 14 Americans is diagnosed with lung cancer in their lifetime
Lung cancer is the leading cause of cancer death, regardless of gender or ethnicity
Lung cancer kills almost twice as many women as breast cancer and more than three times as many men as prostate cancer
About 55% of all new lung cancer diagnoses are among people who have never smoked or are former smokers
Only 16% of all people diagnosed with lung cancer will survive 5 years or more, BUT if it’s caught before it spreads, the chance for 5-year survival improves dramatically.
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LUNGevity Foundation Launches One-of-a-Kind Lung Cancer Survivor Resource Center
http://events.lungevity.org/site/PageNa ... 913_2.html
FOR IMMEDIATE RELEASE
Media Contact:
Victoria Shapiro
(202) 414-0774
Online resource provides for critical unmet need in growing survivor community
WASHINGTON (January 29, 2013) – LUNGevity Foundation, the nation’s largest lung cancer-focused nonprofit, announces the launch today of its Survivor Resource Center to fill a growing need in the lung cancer community. As investments in research lead to progress in early detection and lung cancer treatments, more people are living longer and better with lung cancer than ever before. The Survivor Resource Center is a hub for survivors at any stage of their lung cancer journey looking for support, information about the disease, treatment options and other resources that can help make coping and living with lung cancer easier. LUNGevity’s Survivor Resource Center is the first online resource wholly devoted to lung cancer survivors.
“LUNGevity Foundation is pleased to offer the lung cancer community this vital resource. We are one of the few places lung cancer patients and their loved ones can find a community of support in their struggles with the disease,” said Andrea Stern Ferris, LUNGevity Foundation president. “As the nation’s largest private funder of lung cancer research, we are heartened that progress in treatment for the disease is helping more people survive longer and live better than ever before. LUNGevity’s Survivor Resource Center will help those affected chart the new path in survivorship.”
According to the National Cancer Institute, “Survivorship” begins at the time of diagnosis and continues during and after treatment for as long as a patient lives. Cancer survivorship includes the physical, emotional, and day-to-day issues of the cancer journey. The Survivor Resource Center arms patients with information and resources connected to their physical and emotional well being, as well as offering practical support, such as information related to receiving assistance with prescription drug costs. The Center also connects patients with peer to peer support through LUNGevity’s Lung Cancer Support Community (LCSC), the largest dedicated social network offering support to anyone touched by lung cancer.
Lung cancer survivors who helped test the Center before its launch gave their enthusiastic support:
“The Survivor Resource Center is great! This is EXACTLY what the newly diagnosed and lung cancer survivors need.” ~Heather, lung cancer survivor
“I really liked the section on asking the right questions. When a diagnosis is new to you it's hard to know what questions to ask. Also the emotional state one might be in after receiving a cancer diagnosis may make it harder to think of the questions that should be asked.” ~Barb, Lung cancer survivor
Over the course of their lives, one in 14 Americans is affected by lung cancer. Lung cancer can afflict anyone regardless of age, gender, smoking history or skin color. Fortunately, the past decade has seen significant research-based advances in early detection and therapeutics for lung cancer patients. The 2011 National Cancer Institute’s National Lung Screening Trial showed the importance of detecting lung cancer early, and for the first time established a screening approach for a high-risk population.
Progress is being made in research for the development of blood biomarkers, genome sequencing capabilities and molecular and imaging technologies to help detect the disease. Targeted therapies are greatly improving the treatment experience, including quality of life, for some lung cancer patients, and progress is being made in both immunotherapy and antiangiogenic therapy (cutting off the blood supply to lung cancer tumors).
LUNGevity has the largest grants award program for lung cancer research among lung cancer nonprofit organizations in the United States. In the past two years, LUNGevity has awarded over $5 million to the most promising lung cancer research proposals in the areas of early detection and targeted therapeutics. To help support its mission and raise awareness of the disease, the organization hosts 75 community-building and fundraising events across the country each year.
About LUNGevity Foundation
The mission of LUNGevity Foundation is to have a meaningful impact on improving lung cancer survival rates, ensure a higher quality of life for lung cancer patients and provide a community for those impacted by lung cancer. It does so by supporting critical research into the early detection and successful treatment of lung cancer, as well as by providing information, resources and a support community to patients and caregivers.
LUNGevity seeks to inspire the nation to commit to ending lung cancer.
For more information about the grants or LUNGevity Foundation, please visit www.lungevity.org.
About Lung Cancer
1 in 14 Americans is diagnosed with lung cancer in their lifetime
Lung cancer is the leading cause of cancer death, regardless of gender or ethnicity
Lung cancer kills almost twice as many women as breast cancer and more than three times as many men as prostate cancer
About 55% of all new lung cancer diagnoses are among people who have never smoked or are former smokers
Only 16% of all people diagnosed with lung cancer will survive 5 years or more, BUT if it’s caught before it spreads, the chance for 5-year survival improves dramatically.
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LUNGevity Caregiver Award Winner Charlie Keene
January 23rd, 2013 - by Katie Brown
http://blog.lungevity.org/2013/01/23/lu ... lie-keene/
In November, during Lung Cancer Awareness Month, we announced LUNGevity’s Third Annual Lung Cancer Caregiver Contest. We were looking to honor a spectacular individual who has provided exceptional care to a lung cancer patient.
Nominations came in from all over the country, and if we could have, we would have awarded every caregiver a prize. Their stories of sacrifice and loving care moved us to tears. These caregivers are unsung heroes and rarely get recognized. It was our honor to recognize them and to award a prize to one exceptional caregiver that surpassed the criteria set before our judges: someone who advocated for their loved one’s medical needs, who is supportive and helpful with their loved one’s emotional needs, and someone who recognizes their own limitations and seeks support as needed in order to be the best caregiver possible.
We’re happy to announce this year’s winner is Mr. Charles Keene.
“Big Charlie” as he is lovingly called by his family members was nominated by his daughter in law, Margo, for providing unwavering and exceptional care of his wife, Becky, who has lung cancer. Excerpts of Margo’s nomination are below.
“…he accompanies her to every doctor’s visit…he stays by her side at home after every treatment…he supports her unconditionally and without a doubt is in this fight too.”
“Big Charlie has never wavered in his role as partner in sickness and in health and I know will stand by her side for infinity doing anything in his power to make Becky comfortable, happy and keep that bright smile on her beautiful face…”
The prize is a one-week stay at Cricket House in the historic Gettysburg area of Pennsylvania, and includes round-trip airline tickets for two. The weeklong getaway is donated by the owner of Cricket House, Debi Gemmell. Gemmell had been a caregiver for her husband, Chris, who passed away from lung cancer.
When we notified Charles “Big Charlie” Keene that he had been nominated for being an exceptional caregiver and had won, the soft spoken county commissioner was speechless. He is humble and no doubt does not need recognition for something he does naturally.
His wife Becky, who’s living with lung cancer, calls Big Charlie her best friend of 38 years.
“I can thank him every day, but it means SO much when others recognize and thank him!”
If you are a lung cancer caregiver and you need support or information, please visit our online lung cancer Caregiver Resource Center.
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LUNGevity's Hope Summit, May 2012
Tracy Anderson and her mother, Barb Miller, both stage IIIB lung cancer survivors, joined us for last year's annual Hope Summit. Here they talk about the importance of raising awareness, hope for the future and funding for early detection & new treatments.
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Nashville, TN Resident Named Winner of LUNGevity's Third Annual Caregiver Contest for Exceptional Support of Wife with Lung Cancer
http://events.lungevity.org/site/PageNa ... 12313.html
FOR IMMEDIATE RELEASE
Media Contact:
Victoria Shapiro
(202) 414-0774
Nation’s largest lung cancer-focused nonprofit encourages lung cancer survivors to participate
WASHINGTON (January 23, 2013) – LUNGevity Foundation is pleased to announce Charles Keene of Nashville, TN as the winner of its Annual Caregiver Contest, recognizing a special individual who has provided exceptional care to a lung cancer patient. Charlie was nominated for the award by his family for the care of his wife Becky, a lung cancer survivor who is still in active treatments.
Over the course of their lives, one in 14 Americans is affected by lung cancer. Lung cancer caregivers are mothers, fathers, sons, daughters, neighbors and family friends of all ages. In most cases, they have no medical background, yet they play a crucial role in helping lung cancer survivors manage their disease, often coordinating medical care and providing emotional and physical support, in addition to tending to household and professional needs. LUNGevity Foundation recognizes the vital role these caregivers play in the fight against the nation’s number one cancer killer and honors their commitment and love with its Annual Caregiver Contest.
During the month of November, Lung Cancer Awareness Month, LUNGevity asked the public to submit nominations for an incredible caregiver. Many dedicated men and women were nominated, including husbands, wives, daughters, sons-in-laws, sisters, mothers, fathers, and friends. Charlie Keene was ultimately chosen by an independent panel of judges, based on specific criteria of caregiving:
Being an advocate for their loved one’s medical needs
Being supportive and helpful with their loved one’s emotional needs
Successfully creating a support network around their patient
"Big Charlie," as he is lovingly called by his family members, was nominated by his daughter in law, Margo, for providing unwavering and exceptional care of his wife, Becky, who has lung cancer.
Margo stated in her nomination. "He (Charlie) accompanies her to every doctor's visit. He stays by her side at home after every treatment. He supports her unconditionally and without a doubt is in this fight too. Big Charlie has never wavered in his role as partner in sickness and in health and I know he will stand by her side for infinity doing anything in his power to make Becky comfortable, happy and keep that bright smile on her beautiful face."
The winner of LUNGevity’s caregiver contest wins travel and a one-week stay for two at Cricket House in historic Gettysburg, PA. Cricket House is owned by Debi Gemmell, who was also a caregiver for her husband, Chris. “LUNGevity recognizes the difficulty and hardships that lung cancer caregivers sometimes face and are thrilled to be able to partner with Debi to offer this prize to one incredible caregiver. We wish we could give every one of these hard-working and deserving caregivers and their loved ones a prize,” stated Katie Brown, Director of Support and Advocacy for LUNGevity Foundation.
LUNGevity Foundation has the largest grants award program for lung cancer research among lung cancer nonprofit organizations in the United States. As a thought leader and community hub, LUNGevity provides many resources to the lung cancer community, including the Lung Cancer Support Community, the largest dedicated social network providing support to anyone touched by lung cancer. As part of the online resources it offers, the Foundation created the Caregiver Resource Center, at www.lungevity.org/caregiver, which offers emotional support, practical advice and patient advocacy advice, and other services for caregivers. It is the first online resource wholly devoted to lung cancer caregivers.
About Cricket House
Cricket House is an award-winning historical property located in the heart of downtown Gettysburg, PA, and consisting of two charming historic buildings, the Cricket Guest House and the Main House, which has recently opened the Cricket House Spa. For more information, please visit www.crickethousegettysburg.com.
About LUNGevity Foundation
The mission of LUNGevity Foundation is to have a meaningful impact on improving lung cancer survival rates, ensure a higher quality of life for lung cancer patients and provide a community for those impacted by lung cancer. It does so by supporting critical research into the early detection and successful treatment of lung cancer, as well as by providing information, resources and a support community to patients and caregivers.
LUNGevity seeks to inspire the nation to commit to ending lung cancer.
For more information about the grants or LUNGevity Foundation, please visit www.lungevity.org.
About Lung Cancer
1 in 14 Americans is diagnosed with lung cancer in their lifetime
Lung cancer is the leading cause of cancer death, regardless of gender or ethnicity
Lung cancer kills almost twice as many women as breast cancer and more than three times as many men as prostate cancer
About 55% of all new lung cancer diagnoses are among people who have never smoked or are former smokers
Only 16% of all people diagnosed with lung cancer will survive 5 years or more, BUT if it’s caught before it spreads, the chance for 5-year survival improves dramatically
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Challenges Abound, Yet We Remain Strong
January 14th, 2013 - by Juhi Kunde
http://blog.lungevity.org/2013/01/14/ch ... in-strong/
As we are starting a fresh year, it is natural to take a step back and survey the scene – past and present. How was last year? What chaos and wonders will this year bring?
As always, I look on the past year with a general sense of bewilderment and awe. We lost Whitney Houston, Andy Griffith and Ravi Shankar. And who could have imagined the horrible tragedy in Newtown, Connecticut? The year is never what we expect it to be.
But last year, even in the middle of all that uncertainty, we found happiness, courage and hope. I would have never thought that the San Francisco Giants would win another World Series so soon. We saw a magnificent display of talent at the London Olympics and we held another peaceful (and tight) presidential election.
This year, I see the challenges piling as high as the Rocky Mountains. We have healthcare worries, economic concerns and of course, a royal baby to worry about. Plus we all have our unique personal challenges looming ahead of us. In my family, we are expecting our own baby in April and we are helping a beloved family member fight cancer.
Despite my concerns for the coming year, I am filled with feelings of hope, confidence and determination because the people around me are not drowning in their worries. They are embracing the future and facing their challenges by taking steps to alleviate problems and improve their situations. People in their fifties are going back to school, parents are homeschooling their children, and a few families have joined health clubs while cancelling cable subscriptions.
For lung cancer survivors and caregivers, similar patterns are emerging. People are listening to scientific webinars, reading about clinical trials and taking charge of their treatment plans. They are stepping forward to become their own health care advocates and to raise lung cancer awareness.
Plus, with the help of determined volunteers, passionate supporters and skilled scientists, the lung cancer movement continues to gain momentum and brings us closer to major breakthroughs in early detection and treatment.
By continuing to actively participate in our lives, we are all facing the challenges that lie before us.Let’s rely on our communities, be resilient and not let our worries drown us. By working cooperatively we may just succeed in beating the odds.
Let’s all try to make 2013 the year we hope it’ll be.
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“Mixed Response” in Lung Cancer: What Should We Do, and What’s Happening Biologically?
January 11th, 2013 - by Dr. Jack West
http://blog.lungevity.org/2013/01/11/mixe/
The topic of “mixed response” to treatment for lung cancer comes up as a rather common question. I tried to cover this in two brief videos. The first explains we mean when we refer to a mixed response, and then how we might approach this issue in the clinic.
The second video continues on that theme and covers the question of what is happening biologically when we see a mixed response, which brings up the question of whether we should do multiple biopsies, looking specifically at the areas that are progressing, and whether we should repeat biopsies at multiple intervals over the course of a patient’s disease. This isn’t the current standard, but might we learn far more about cancer biology if we were to do this?
If you or someone you care about demonstrated a mixed response while on treatment for lung cancer, would you be inclined to undergo a repeat biopsy, even if there were a good chance it wouldn’t reveal a result that changes management? And if yes, if an insurer said that it wouldn’t be covered, would you want to pay for the cost of the biopsy and testing for various molecular markers? These are the kinds of questions we faced in the times of transition in how we practice — in this case, moving into a new era of molecular oncology.
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How should we use serum tumor markers, if ever, in managing lung cancer?
January 4th, 2013 - by Dr. Jack West
http://blog.lungevity.org/2013/01/04/se ... -lc-video/
A common question that comes up in managing lung cancer is how, and perhaps even whether, we should use blood tests to make clinical decisions in the management of lung cancer? Here’s a video in which I discuss this issue of serum tumor marker testing for lung cancer, a question without a clear right answer, but perhaps some wrong ones.
What are your experiences with it? I’d underscore that if your oncologist isn’t checking for these, this isn’t a wrong answer, but do you feel that you’re missing out without it? Would you be tempted to use (and perhaps overinterpret) this information if you had it?
New lung cancer treatment trial launching at Yale-New Haven
in CLINICAL TRIALS
Posted
New lung cancer treatment trial launching at Yale-New Haven Hospital
Published: Saturday, March 02, 2013
By Ed Stannard
estannard@nhregister.com
@EdStannardNHR on Twitter
http://www.nhregister.com/articles/2013 ... 204696.txt
NEW HAVEN — A new cancer treatment that acts like a nuclear-tipped missile aimed straight at tumor cells could be a breakthrough in treating a deadly form of lung cancer.
Planned clinical trials were given a boost from the Food and Drug Administration last week, when it approved a form of the treatment, called antibody-drug conjugates or, more vividly, armed antibodies, for “a very aggressive form of breast cancer,” according to Dan Junius, CEO of ImmunoGen Inc. of Waltham, Mass., which developed the new therapy.
Now, Dr. Daniel Morgensztern, assistant professor of clinical oncology at Yale Medical School, is about to launch a clinical trial at the Smilow Cancer Hospital of a similar treatment for small-cell lung cancer. Accounting for about 13 percent of lung cancer cases, small cell is almost always caused by heavy smoking and “it’s uniformly fatal in most cases,” according to Dr. Roy Herbst, chief of medical oncology at Smilow.
The treatment of small-cell lung cancer “has not changed in about 25 years” and kills 25,000 to 30,000 people a year, he said.
The breast cancer drug is called Kadcyla and the new lung cancer drug is being created in a similar way. Herbst likens it to a rocket carrying a payload, but both the rocket and its poisonous baggage are deadly to cancer.
The “rocket” is an antibody — in breast cancer’s case Herceptin, a biologic therapy that accompanies chemotherapy. What ImmunoGen has been working on since 1996 is a way to bring an even more deadly drug into the tumor. The antibody-drug conjugates combine the two molecules with a “linker,” as Morgensztern calls it. “It allows the drug to be delivered directly to the cancer cells,” he said.
This is how it works:
The antibody binds with the cancer cell and is absorbed into it. But once inside, the antibody, the second poisonous agent and the linker break apart and the “smart bomb,” called DM1, blows up the cancer cell. “It eats its own poison,” Herbst said of the tumor.
A big advantage is that the treatment “allows the drug to be delivered directly to the cancer cells,” reducing damage to normal tissue and the side effects that come with traditional chemotherapy, Morgensztern said.
“The ability to bring a poison to a target in a tumor cell, sparing a normal cell, is phenomenal,” Herbst said.
The trick to creating the armed antibodies for different cancers is to find the toxin that will work best for each.
“We need to find that vulnerability, find what makes it unique ... target it, find it and then poison it,” Herbst said.
In clinical trials of Kadcyla, the breast cancer drug, “the patients had a meaningful improvement in overall survival,” said ImmunoGen’s Junius. “Patients had a much better tolerance of the therapy” than with the alternative used.
Junius said there are nine other antibody-drug conjugates being developed for other cancers, such as ovarian, glioblastomas, non-small cell lung cancer, non-Hodgkin’s lymphoma and a form of leukemia.
In Morgensztern’s trial, which will involve 120 patients at six sites, one-third of patients will be given six treatments of traditional therapy over six weeks. The majority will receive the antibody-drug conjugates “until the cancer stops working,” he said.
To apply to be a part of the trial, call Susan Porto at the Smilow Cancer Hospital Thoracic Oncology Program, 203-200-5864.
Call Ed Stannard at 203-789-5743.