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Article - "The War On Lung Cancer Needs Volunteers&quot


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http://www2.tbo.com/content/2008/mar/19 ... olunteers/

The War On Lung Cancer Needs Volunteers


The Tampa Tribune

Published: March 19, 2008

President Richard Nixon declared the war on cancer in 1971.

Every day, 438 people die in this country from lung cancer. Twice as many women die from lung cancer than from breast cancer, and three times as many men die from lung cancer than from prostate cancer. Well, they are all old, smoked and knew the risk they were taking, you may think.

Not so. It is estimated that 30,000 people who have never smoked in their life will develop lung cancer in 2007, and 21,900 will die from the disease. That's 60 people every day. In addition, the majority of people diagnosed with lung cancer have quit smoking many years ago.

Progress in the development of therapy that can cure lung cancer has been slow. Yes, the outlook for people with the disease has improved over the past 30 years. Five-year survival, the chance of a person being alive five years after diagnosis and often used as a gauge for cure, has doubled in that time frame. But it is still only a dismal 15 percent.

Progress is slow. What we urgently need are new and effective therapies. What's the holdup? Why have we not made substantial progress in this war on cancer?

For one, the development of new therapies is costly, time-consuming and cumbersome. New treatments must be tested for efficacy in clinical trials. In clinical trials, new therapies are tested against the older therapies, called "standard of care."

Patients are asked to volunteer to participate in such trials, and only about 1 percent of patients with lung cancer actually participate. Given the relative lack of efficacy of our current treatments, 1 percent may come as a surprise.

Getting patients to participate in clinical trials is time-consuming and expensive. Doctors have to not only spend additional time to explain the trial but also have to jump through the hoops of a convoluted regulatory process, which is actually better described as crawling through a maze at a snail's pace.

Second, the dollar amount allocated by the National Cancer Institute, the federal agency that distributes funds to research, is a mere $1,830 per lung cancer death in this country. This is less than one-tenth the amount spent per breast cancer death, $23,470, and one-hundredth of that spent per death caused by AIDS, $164,000.

The reason for this low level of funding is a striking lack of advocacy for lung cancer. We are all aware of the pink ribbon campaign that raises awareness for breast cancer. I bet you don't know the color of the lung cancer ribbon. Or does it even have a ribbon? It is clear because lung cancer has been labeled as the "invisible" disease.

What we need is for lung cancer to become visible. How can anyone overlook 438 deaths per day from a disease, not to mention the suffering, distress and desperation that patients and family members experience?

There is an urgent need for action. People are dying, young and old, and we aren't even talking. These are our parents, brothers, sisters and children. The youngest person I have seen with lung cancer was only 22.

One of my patients said, "Research is the pathway to hope." Research and clinical trials are where new and better treatments are made; they are our Trojan horse in the fight to end death and suffering from lung cancer. Call your congressional representative. Write letters. Encourage patients to participate in clinical trials. Become an advocate. It is time for us to take destiny in our own hands.

Visit facesoflungcancer.com.

Gerold Bepler, M.D., Ph.D., is the program and division chief of the Thoracic Oncology Department at the H. Lee Moffitt Cancer Center & Research Institute in Tampa ( www.moffitt.org).

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Thanks for the article. An examination of clinical trials policies, practices, needs is due. Has there been an assessment of such? Were recommendations implemented? Next steps? Barriers to change? Do some cancer centers have greater enrollment? Any changes that might result in greater participation? Patient perspectives? Provider/care giver perspectives?(academic research centers/cancer centers affiliated with academic research centers; private oncologists; Pharmaceutical company perspective?

Perspective of past participants? Best practices?

Is there an activist agenda around clinical trials?

The article is a catalyst to examine the clinical trials policicies and practices and results. Thanks, Hank

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