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Treatments and Clinical Trials

Treatments (chemo, radio, surgery, TT, I-O)

In most hospitals, a team of specialists will plan the treatment they feel is best for your individual situation. This multidisciplinary team of medical professionals may include:

  • A surgeon.
  • A medical oncologist(a doctor who specialises in the medical management of cancer).
  • A radiation oncologist.
  • A chest physician.
  • A nurse specialist.
  • A radiologist (or radiographer)who has been involved in the assessment of your x-rays and scans.
  • A pathologist who has been involved in the analysis of your tumor biopsy.

 What are the treatment options?

The treatment you receive will depend on the stage and type of cancer, as well as your general health. Your treatment preferences will be discussed together with your physician. You may have a combination of treatments.

  • Surgery may be possible to remove NSCLC if it is diagnosed at an early stage. The type of operation that is offered will depend on the size and location of the cancer:
    • A wedge or segment resection is the removal of a very small amount of the lung; this is sometimes offered if the cancer is at a very early stage
    • A lobectomy is the removal of one of the lobes of the lung; it is the standard surgical treatment for NSCLC
    • A pneumonectomy is the total removal of one of the lungs; it is a more complex surgical resection than lobectomy or wedge (segment) resection.
  • Chemotherapy works by disrupting the way that cancer cells grow and divide. However, these drugs can also affect normal cells. Chemotherapy can be given before or after surgery. Some people have chemotherapy at the same time as radiotherapy – this is called chemoradiotherapy. Chemotherapy may be given with a curative intent or to prolong life and control symptoms (palliative are).
  • Radiotherapy is a type of treatment that uses ionising radiation which damages the DNA of cancerous cells, causing the cells to die. It may be used instead of surgery to try to cure early-stage lung cancer. Radiotherapy can be given after chemotherapy or concurrently (chemoradiotherapy). Radiotherapy is also used to control symptoms when the cancer is more advanced or has spread to other parts of the body. There are various different techniques for delivering radiotherapy, including SABR, a type of external beam radiation therapy that delivers a high dose of radiation specifically to the tumor.
  • Targeted therapies are drugs that block specific signaling pathways in cancer cells that encourage them to grow. They are usually used to treat advanced lung cancer.

Understanding immune system

The immune system is made up of cells and organs that protect your body from outside invaders such as bacteria, viruses, fungi, and parasites (types of germs) that can cause infection and disease. The immune system also gets rid of abnormal pre-cancerous cells and cancerous cells that are growing out of control. When it works correctly, it fights off infection and keeps you healthy. However, when it does not work correctly, germs and other abnormal cells in the body can more easily cause disease.

The organs of the immune system are positioned throughout the body. They are called lymphoid organs because they are home to lymphocytes, small white blood cells that are the key players in the immune system. The system consist of: bone marrow, thymus (T lymphocytes, or just “T cells”, mature in the thymus), lymphatic vessels, spleen, tonsils, adenoids, and appendix.

Immune Cells and Their Products

Sources:

  1. http://www.thewellproject.org/hiv-information/understanding-immune-system
  2. http://www.imgt.org/textes/IMGTeducation/Tutorials/ImmuneSystem/UK/the_immune_system.pdf

Understanding immunotherapy

So, what is immunotherapy?

It’s a method of treatment that involves engaging the patient’s own immune system to fight cancerous cells.

How does immunotherapy work? 

Our immune system protects us by warding off foreign invaders such as bacteria and viruses. The immune system can also sometimes recognize cancer cells. However, since cancer cells arise from our normal cells, sometimes the cancer just isn’t different enough for the immune system to attack it. In some cases, even when recognized as foreign, cancers use other strategies to evade the immune response. Immunotherapy works to boost your body’s immune response in order to attack cancer cells and prevent them from evading our defenses.

The concept of ‘teaching’ the immune system to recognize and destroy cancer cells is in a new era. Anticancer immunotherapy is just beginning with the long term control of cancer cells. This is called Cancer Immunotherapy which uses the bodies own immune system to target and kill cancer cells. According to the American Society of Clinical Oncology (ASCO) February 2016 report, two main strategies of immunotherapy are now being explored, “the first involves unleashing the body’s natural immune response to cancer, and the second helps the immune system find and destroy cancer cells.”

Source: https://globalnews.ca/news/2581383/this-is-it-the-cancer-treatment-that-has-doctors-talking-about-a-cure/

There are several types of immunotherapy, including:

  • Monoclonal antibodies
  • Non-specific immunotherapies
  • Oncolytic virus therapy
  • T-cell therapy
  • Cancer vaccines

Resources:

  1. cancerprogress.net
  2. http://www.imgt.org/textes/IMGTeducation/Tutorials/ImmuneSystem/UK/the_immune_system.pdf
  3. https://www.curemelanoma.org/blog/article/understanding-immunotherapy-part-1-what-is-immunotherapy

 

Clinical trial – what is it?

The objective of clinical trials is to find out whether new medical approaches that are being developed are safe and effective and better than those currently being used. Most drugs or medical procedures that are available for patients today went through clinical trial testing. This phase of research is possible only if patients who have the condition that is being studied participate, so a better name for clinical trials would be “patient-assisted research studies.”

New lung cancer treatments are always tested in volunteers with the type and stage of lung cancer for which the new treatment is intended. Clinical trials are vital for adding to medical knowledge that can improve the care given to patients. The results of these research studies determine whether new treatments are approved by the FDA/ EMA for prescribing by doctors for patients outside of clinical trials.

If you are considering participating in a clinical trial, start by asking your doctor whether there is one for which you might qualify in your area. In addition, here are several resources to help you find one that may be a good match for you:

NEXT: Living with Lung Cancer