Lung Cancer in Non smokers a recent advances in oncology

Situation in Canada

In Canada, lung cancer has shown a rising trend in the last few years. According to the 2017 Canada Cancer statistics,  28,600 Canadians were diagnosed with lung cancer, which represented 14% of all cancer cases diagnosed this year. In the same year, 21,100 patients with lung cancer died of this disease, which represented 26% of all cancer-related mortalities in Canada. On average, 78 Canadians were diagnosed with lung cancer every day, and 58 died from this disease every day. Lung Cancer in light or non-smokers is a newly discovered patient category that showed recent advances in oncology care. 

Reference:  Canadian Cancer Society  http://www.cancer.ca/en/cancer-information/cancer-type/lung/statistics/?region=on 

 

Why do Non-smokers get lung cancer?

According to the medicine.net newsletter https://www.medicinenet.com/5_causes_of_lung_cancer_in_non-smokers/views.htm 

There are 5 main reasons why non-smokers develop lung cancer these are:

1-      Exposure to smoke from others who smoke cigarettes (passive smoking).

2-      Exposure to Radon (the radioactive substance that exists in some rocky lands/ caves)

3-      Asbestosis: asbestos exposure is one of the reasons behind the development of lung cancer. It is used deliberately in manufacturing thermal and acoustic insulating materials.

4-      Heredity: some families are more prone to develop lung cancer due to the predominance of hereditary susceptibility to that disease.

5-      Air pollution from vehicles, plants and industrial by-products such as toxic gases, vapours and fumes. 

What is the standard of care from the medical oncology side?

With the advance of molecular targeted therapies and tyrosine kinase inhibitors, the use of systemic chemotherapies for lung cancer (such as CIS platinum and Gemcitabine)  started to fade away, especially in Adenocarcinoma of the lung

So, what is new?

For the last 5 years, a scientific revolution in the field of targeted therapies for lung cancer has happened with the emergence of two main classes of Non-chemotherapy targeted agents these are:

1-      Targeted therapies for adenocarcinoma with a  wild ALK (Anaplastic Mutation Kinase) gene high control/ DFS results were achieved with Crizotinib and wild KRAS mutated tumours using EGFR blocking agent Gefitinib or Erlotinib  

2-      Immune therapy using PD 1(Programmed Death1 ) gene blockers such as Pembrolizumab showed a high DFS rate comparable to the use of systemic chemotherapy Pemetrexed Cisplatin, So for every patient with a non-light smoking history, a tissue analysis of the PD1 (Programmed death 1) gene is required to take an advantage of the immunotherapy using Pembrolizumab therapy. A triplet of Pembrolizumab, Cetuximab and cisplatin can give a better outcome, however, if patients are strongly positive for the PD1 gene, an immunotherapy with  Pembrolizumab can be sufficient.

In summary, newly diagnosed cases of non or light smokers NSCLC should be tested for EGFR, ALK, BRAF, and ROS1 gene markers, additionally, testing for the PD1 gene is an additional bonus in determining the feasibility of the immune therapy using Pembrolizumab for these patients.

http://www.cancernetwork.com/lung-cancer/newly-diagnosed-lung-cancer-which-molecular-tests-are-needed-optimal-treatment-decision-making/page/0/1 

 

Which treatment is better? chemotherapy? Or targeted therapy?

With the advent of relatively low toxic targeted therapies such as Crizotinib, Gefitinib or Erlotinib or immune therapies such as Pembrolizumab, it is very tempting for cancer patients to receive these new agents given the fact that, in many case scenarios, they show a similar response and survival rates to the standard chemotherapies with much less toxic profile. The final decision as to which systemic treatment you qualify for is based on many factors not only whether you have been diagnosed with adenocarcinoma such as your tumour genetic profile, your tolerance to these agents, as some patients may not tolerate them all, and also, the availability of these agents as not all oncology centres can afford to have them for their patients, as they are highly expensive.

What is the role of supporting your immune system during cancer treatment? 

Supporting your immune system is of paramount importance in the fight against cancer, Your immune system acts like a soldier fighting against the millions of wandering cancer cells in your body, and without an intact immune system, you could not fight lung cancer properly, and this is the defining point between those patients enjoying a good survival rates (despite having an advanced stage cancer) and those who fall into the low survival rates and having the same stage of cancer.

The question now is how to improve your immune system.

There are many ways you can follow to support your immune system such as a balanced nutritious diet, proper hydration, adequate water intake, and supporting your body with essential nutrients and vitamins that boost your immune system. So the question now is, do you know all these nutritious supplements or diets that support your immune system? If yes, this is great just do it!! And now please, don’t waste your time, it is very precious. What about if you need help? Need to know more about supporting the immune system for cancer care and improving your chances of disease control? Kindly ask us, will give you the right answer. Click this link to contact us: https://www.ontarionaturopathicclinic.ca/site/contact-naturpathic-dr-grimsby-niagara