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Lung-cancer treatments can improve life


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http://www.azcentral.com/community/west ... 916Z1.html

Patrick Miller

Special for The Republic

Sept. 16, 2005 12:00 AM

QUESTION: Is there new hope that lung cancer can be beaten?

ANSWER: New chemotherapy agents, surgical techniques and other treatment advances are giving many lung-cancer patients an improved quality of life. Yet the most important development against this deadly cancer comes every time an individual makes a decision to quit smoking.

For both men and women, lung cancer is the most deadly cancer, and 85 to 90 percent of cases are directly related to smoking. Other causes include radon, asbestos and other industrial materials, air pollution and secondhand smoke. advertisement

If detected early, lung cancer is treatable, but there are rarely any early signs.

Besides a "smoker's cough," other symptoms of cancer include an achy chest pain, shortness of breath, fatigue, unexplained weight loss, frequent colds, wheezing or trouble breathing. By the time these symptoms appear, however, the cancer has usually spread and the prognosis is poor. About 85 percent of patients with metastatic cancer die within five years.

Cancers that are detected before they spread can usually be removed by surgery, with a survival rate of about 75 percent.

Small-cell lung cancer, nearly always associated with smoking, is aggressive, rapidly spreading and difficult to treat. Non-small-cell lung cancer, accounting for 80 percent of all cases, may develop gradually over many years, and a long-term smoker may start to feel complacent just at the time the risk is highest.

Location as well as size is important, however. A tumor often grows against a vital blood vessel, making it difficult to remove safely. Recently, physicians have been using chemotherapy before surgery to shrink the tumor in certain patients, and studies have found that this approach can greatly improve the outcome. Other studies have found that preoperative chemotherapy, even with small tumors, can reduce the incidence of recurrence.

The more common approach is the use of chemotherapy immediately following surgical removal of the tumor.

When cancer has spread to other locations in the body, treatment typically involves chemotherapy or a combination of chemotherapy and radiation therapy.

Physicians have learned how to target radiation to increase its effectiveness and reduce complications. And new chemotherapy agents have improved the quality of life for many patients.Gefitinib, approved for treatment of lung cancer in May 2003, represents a whole new approach to chemotherapy. Taken in pill form, the drug targets and blocks an enzyme that tumor cells need in order to grow and spread. Another treatment that has shown promising results in early studies involves a combination of two very different kinds of agents:

• Bevacizumab, an antibody that works on the outside of a cancer cell to inhibit the growth of new blood vessels to nourish a tumor.

• Erlotinib, which works inside the cancer cell to block signals that promote cancer growth.

A pilot trial found this combination of drugs safe and more beneficial than expected.

Dr. Patrick Miller, a radiation oncologist, is chairman of the Cancer Committee at Sun Health Boswell Hospital.

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