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Doctor pioneers method for treating dangerous lung cancer tumor

By Associated Press

12/26/2007 4:22 AM

OKLAHOMA CITY -- A new treatment developed by an Oklahoma physician may help lung cancer patients who have trouble breathing.

Lung cancer sufferers may experience fits of coughing, shortness of breath and difficult-to-treat pneumonia because tumors block the bronchioles, which are the passages through which they receive air.

Dr. Daniel Nader, a pulmonologist at Cancer Treatment Centers of America in Tulsa, injects a small amount of the cancer drug cisplatin into the tumors, followed by targeted radiation. He said the technique, which he has performed on 14 people since 2005, has promise and he hopes his positive results continue.

To qualify for his therapy, patients must have a tumor that blocks at least 75 percent of a bronchiole. Bronchioles lead to alveoli, tiny air sacs where oxygen exchange takes place.

Although the approach only works on tumors inside the less-than-a-millimeter-wide bronchioles, it makes cancer sufferers more comfortable. The treatment may also improve survival.

Also, patients with pneumonia can’t undergo aggressive chemotherapy until the infection is cured.

“It adds something to the patient’s care that allows us to relieve their symptoms quickly and improve their quality of life,” said Nader, who directs the Lung Center at the cancer center’s Tulsa location, one of four nationwide.

“When they finish the treatment ... they’re feeling much better than they did when they got here. You really can’t get any better than that,” he said.

Nader, who has been with the cancer center since 1993, came to Tulsa because of the administration’s willingness to build a state-of-the-art brachytherapy program. He has since used the labor-intensive technique on the lungs of more than 500 people.

Finding tumors and filling them with drugs is challenging and time-consuming, as is brachytherapy, which is performed in a room lined with six inches of lead and requires three physicians and support personnel.

Research has shown chemotherapy makes tumors more sensitive to radiation, Nader said, so injecting the drugs directly into them makes sense.

“We knew we were going to kill the tumor with radiation,” he said. “We wanted to make it a more effective kill. ... It (chemotherapy) had not been used in combination with radiation therapy and brachytherapy.”

Nader presented his research at an October meeting of the American College of Chest Physicians in Chicago.

Bobby Dixon, a self-employed tractor-trailer mechanic, had an inoperable tumor blocking his lung and causing intense coughing. He didn’t know what was going on, only that antibiotics didn’t help.

“I couldn’t sleep at night. I had to take NyQuil to sleep,” he said.

When Dixon stopped smoking, the coughing went away. Only after a chance visit to a doctor to make sure everything was all right did he find out he had cancer.

“I had a tumor as big as a golf ball blocking the bronchiole tube of my right lung,” the 60-year-old Shawnee resident said.

He received Nader’s treatment, which cleared his tumor.

“When they came with that therapy, it seemed like the perfect thing,” he said.

Doctors told him he had a year to live without treatment. Dixon has 12 weeks of chemotherapy remaining.

“I feel great,” he said. “Nothing they’ve done has bothered me. I don't take this lightly; I wish they (cancer patients) could all feel like me.”

By Associated Press

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