Published on August 2, 2018
Anyone who has been diagnosed with lung cancer wants the best chance at living the longest, fullest life possible. How can patients be confident they’re getting the most effective care? What steps can people take to stay up-to-date with the evolving field of research? Lung cancer experts Dr. Edward Kim and Dr. Jeffrey Crawford share actionable insights to help guide patients through screening, developing a multi-disciplinary team, treatment decision making and more. Are there specific tips for advanced lung cancer patients? Dr. Crawford and Dr. Kim also discuss the role of molecular testing in cancer care, the efficacy of chemo versus other treatment strategies, and one of the biggest struggles patients face. Watch now to find out more.
This is a Patient Empowerment Network program produced by Patient Power. We thank Celgene and Pfizer for their support.
Transcript | Tips for Lung Cancer Patients Navigating Their Treatment Journey
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Obviously, anybody diagnosed with lung cancer or their family member, we want the longest life and the best chance right now, and yet you have an evolving field. So what would—Dr. Crawford, how would you counsel patients and family members so that with what you have available, either as approved therapies or in trials, could be available to them?
So it's important that patients get diagnosed early. It's important that patients who are eligible for CT screening and to go that so we can detect lung cancer at an earlier stage and hopefully offer them curable surgery, and then for them to get evaluated by a multidisciplinary team if they're in early stages to see is surgery alone the right thing, surgery and chemotherapy, a combination with radiation, so all those standards are still present in early-stage disease.
Now, as we may talk about, immunotherapy and targeted therapy may have a role there as well, but I think our curative strategies remain intact there. So it's very important to have availability of a multidisciplinary team that can really assess cancer at all stages.
For the advanced cancer patients then, what's particularly important is for every patient to get molecularly defined tumor testing being done. So we not only need to know the pathology, as Dr. Kim has said. We really need to know the molecular phenotype of cancer to really make the best treatment approach for patients with advanced disease. And in most patients that should happen before they ever talk about chemotherapy. We need to know are there better approaches for that patient, and we're not going to know that without these tests being done.
How about you, Dr. Kim? I mean, still chemotherapy is still around, still in combination. People understand there are side effects, not that there are not side effects with the new immunotherapies, but people would like to skip to the most effective treatment first. So what recommendations would you have for our listeners?
Yeah. You know, we're talking strictly about the advanced lung cancer patients. The new standards in non-small cell, both nonsquamous and squamous, now contain an immunotherapy combined with chemotherapy in markers that are lower selected or unselected. I agree with Jeff. You know, the biggest struggle we always want to tell our patients is be patient. Do not let the chemotherapy start without having the results of your markers.
And that's where sort of this new diagnosis of cancer comes in, the fear of it growing while you're waiting a couple of weeks for the results of these markers, but we have to reassure patients it's okay because if you just wait the extra one to two weeks.
And I understand it could take longer getting the biopsy to get enough tissue, sending it away, taking three weeks, and then your doctor, who is maybe not as sophisticated at reading these very, very, 18-page reports, take some time to evaluate it. It could be five weeks right there very easily, and we don't like to wait that long.
But if you do have a marker present, and if it is—and now almost 50 percent of the patients with non-small cell have this, have a marker, maybe we'll be able to give you something in lieu of chemotherapy that's not a pill, single-agent immunotherapy. And certainly as a default now we're seeing again new standards of care. New standards of care are combination therapy, chemotherapy with immunotherapy based on data that's been presented in the last couple months.
And so as a biomarker person I love seeing marker-enriched populations receiving less therapy, but as we begin to incorporate these drugs in our standard regimens we're seeing improvements that are undeniable and are forcing us now to readjust or new standards.