lung cancer Archives - HHO Hunterdon Hematology Oncology

There are some unusual and interesting differences between men and women when it comes to the phenomenon of lung cancer. Not that cancer is interesting. It’s not. It’s disconcerting, to say the least. What we’re talking about are some thought-provoking differences between men and women when it comes to the rate of lung cancer and to the mechanism of how it develops, that are forcing the medical/cancer research community to reach some important conclusions about women and lung cancer treatment. Here are some important differences between men and women when it comes to lung cancer:

The rate of lung cancer among women who have never smoked is growing (15% – 20%), while the incidence of lung cancer among men who’ve never smoked is declining (10%).
The rate of lung cancer among women due to smoking is around one-half that of men.
Receptors for the female sex hormone estrogen have been detected on lung tumors among women.
Scientists studied populations of mice who underwent ovariectomies (surgical removal of ovaries). When treated with estradiol, they developed lung cancer; when treated with anti-estrogens, the process was reversed.
There is a growing body of research evidence pointing to the conclusion that combination hormone replacement therapy (HRT) may slightly increase the risk of both getting, and dying, from lung cancer.

One of the critical, fundamental differences between men and women is the presence and relative prominence of hormones; namely, estrogen and progesterone. Researchers began to wonder about whether the role of hormones might be a critical factor behind these differences in rates of cancer. The research data collected so far indicate that lung cancer in women is, at least in part, driven or conditioned or affected by the presence of female hormones.

Hormone Replacement Therapy (HRT)

In a study of 16,000 women, the Women’s Health Initiative (WHT) found that women with non-small lung cancer who are under a combined hormone replacement therapy (HRT) regimen, i.e. taking combined estrogen and progestin, are approximately 59% more likely to die from the disease. This effect was limited only to women who already had non-small cell lung cancer; it did not apply to women who did not have lung cancer or who had small-cell lung cancer.

Conclusions

Clearly, these results are very significant and important for every woman to know who has lung cancer, who has a higher risk for lung cancer (e.g. due to smoking), or who is considering HRT. The decision regarding what course to follow should be undertaken in close, intimate conversation with one’s doctor(s). There is no single “right” course of action to take, because it depends on one’s overall health, the nature of the condition being faced, and the risks of going in one direction versus another. The decision, while ultimately yours, should be an informed one, and that requires a frank, detailed discussion with your health team members. Contact us today to set up an appointment.

According to the American Cancer Society, lung cancer is the second most common cancer among men and women and the leading cause of death in the United States. In 2014, it is estimated that 224,210 people will be diagnosed with lung cancer. Hunterdon Regional Cancer Center was selected as the only cancer facility in New Jersey to offer a clinical study on a new lung cancer investigational drug called Nivolumab, which is made by Bristol-Myers Squibb.

“This clinical study uses immuno-therapy as a new approach for treating lung cancer. This therapy uses the patient’s own immune system to attack the cancer cells,” stated Myron Bednar, M.D., Medical Oncologist, Hunterdon Regional Cancer Center. Dr. Bednar further explained, “Nivolumab works by blocking the protein called PD-1. The PD-1 antibodies stop lung cancer cells from blocking the body’s natural immune response to cancer. A drug that can inhibit PD-1 may be able to treat a variety of cancers, which is very exciting.”

Patients who may be eligible for the study have been diagnosed with advanced stage lung cancer and have undergone at least one therapy prior to entering this trial. “The benefit from standard therapy is limited for this patient population. Our hope is that this drug will keep the cancer from growing and have the patient’s immune system do the work of killing the cancer cells, versus drugs that may have many side effects, said Kenneth Blankstein, Medical Oncologist at Hunterdon Regional Cancer Center. Dr. Blankstein also mentioned, “We are pleased to be able to provide this trial in our community. We are not only the only cancer facility in New Jersey testing this drug in a clinical trial, but the only one in the tri-state area. The next closest facility is in Tennessee.”

Pictured left to right: Kathy Robbins, RN, MSN, OCN, Clinical Research Nurse at Hunterdon Regional Cancer Center works closely with patients on clinical trials. Kathy talks to Daria Shepherd and provides comfort and education during her treatment at Hunterdon Regional Cancer Center.

Daria Shepherd of Kingwood Township was diagnosed with advanced stage lung cancer in December. Ms. Shepherd had gone to her family doctor because of a pain she was having on her side. An ultrasound showed that the pain was the result of a cyst on her ovary, but the test also found a spot on her lung. A chest scan and a biopsy determined it was cancer. “I started chemotherapy, but it wasn’t effective for my type of cancer, so Dr. Bednar thought I would be an ideal candidate for the Nivolumab clinical trial,” stated Ms. Shepherd. Shepherd added, “This is my second week receiving the drug and I feel good, it has not had any side effects that have interfered with my life.” In fact, Ms. Shepherd was heading out to Spruce Run to fish with her family after her treatment.

Through Hunterdon Regional Cancer Center’s partnership with Fox Chase Cancer Center in Philadelphia, physicians have access to many clinical research trials, which are administered by specially trained staff. Current trials offered at Hunterdon Regional Cancer Center include new treatment protocols for lung cancer, breast, gastrointestinal cancers, as well as lymphoma and melanoma. To learn more about clinical trials at Hunterdon Regional Cancer Center, call Kathy Robbins, RN, MSN, OCN, Clinical Research Nurse at Hunterdon Regional Cancer Center at 908-237-2330 ext. 2.

Dr. Kenneth B. Blankstein, an oncologist in Flemington, N.J., is treating a woman for lung cancer. She responded well to the first chemotherapy drugs he prescribed. When her health was stable, he gave her a “temporary break” from chemo to spare her some of its side effects.

But when he tried to return her to the treatment, the insurer balked, saying that the “temporary break” was evidence that the treatment had failed. Despite Blankstein’s protests, the insurer said she would have to move next to Tarceva, another treatment.

“She had under a 5 percent chance of a response on Tarceva,” he said. “Yet they insisted, so we had to.”

As Blankstein expected, the patient did not respond, but instead of letting her return to the first chemo cocktail, the insurer insisted she try another drug first.

The patient ultimately switched to Medicare, which covered the first chemotherapy protocol. Her health is stable.

“The patient’s being told to use a drug we know isn’t going to work, but we have to use it anyway for someone with terminal illness? To me that’s just insane, but it’s the way they do things,” Blankstein said. “It’s taken away clinical judgment. It’s managing by algorithms.” Read the whole article.

By Martta Kelly | Special to The Star-Ledger

Lung cancer patient Daria Shepherd smiles as she looks at her daughter, Paige, Shepherd as Daria receives a new trial cancer treatment called Nivolumab at the Hunterdon Regional Cancer Center in Flemington. (Tony Kurdzuk/The Star-Ledger)

A routine ultrasound last year turned out to be something much more sinister for Daria Shepherd of Kingwood Township.

“I had this pain in my right side and I thought it was just the result of overdoing it,” said the active 47-year-old mother of two who enjoys jogging regularly with her 22-year-old daughter.

When her blood tests came back normal and physical therapy didn’t seem to be helping, her doctor ordered the ultrasound.
Shepherd wasn’t prepared for what came next.

The ultrasound showed not only a benign cyst on her right ovary but spots on her lung as well. A subsequent chest scan and biopsy determined the spots indicated advanced lung cancer.

Shepherd started chemotherapy, but it proved to be ineffective for her type of cancer. Her doctor, Myron E. Bednar, medical oncologist at Hunterdon Regional Cancer Center in Flemington, suggested she enroll in a clinical trial for a new drug called Nivolumab, which works with the patient’s own immune system to attack cancer cells. In addition, the drug doesn’t have the debilitating side effects of traditional chemotherapy, such as nausea, fatigue and hair loss.

Oncologist Myron Bednar checks on Daria Shepherd as she receives Nivolumab at the Hunterdon Regional Cancer Center. (Tony Kurdzuk/The Star-Ledger)

Lung cancer, according to the American Cancer Society, is the second most common cancer among men and women and the leading cause of death in the United States. It is estimated that this year, more than 224,000 people will be diagnosed with lung cancer.

HRCC was selected as the only cancer facility in New Jersey to offer a clinical study on Nivolumab, which is made by Bristol-Myers Squibb. The closest facility outside the tri-state area is in Tennessee. There are currently eight people in the clinical trial at HRCC.

To be eligible for the clinical trial, patients must have been diagnosed with advanced stage lung cancer and have undergone at least one therapy prior to entering the trial, Bednar said.

Nivolumab works by blocking a molecule called PD-L1, found in many cancer cells, from binding to a protein called PD-1, found on the surface of T-cells, known as the “fighter cells” of the immune system, said Kenneth B. Blankstein, an oncologist at HRCC.

If PD-L1 is allowed to bind to PD-1, T-cells become ineffective, Blankstein explained. This is how cancer cells are able to disarm T-cells and inhibit them from attacking the tumor. Since PD-1 blockers free up the immune system only around the tumor rather than throughout the whole body, they also have fewer side effects than chemotherapy.

“Drugs such as Nivolumab that inhibit PD-1 may also be able to treat a variety of cancers, including melanoma, which is very exciting.” Blankstein added.
Both Bednar and Blankstein stressed that while Nivolumab, like chemotherapy, is not a cure, it appears to improve the overall survival of cancer patients.

“We’re are optimistic about the results of the trial so far,” Bednar said. “We’ve had a 30 percent response rate, which, in this group, is significant.”

To date, Shepherd has had three infusion treatments and feels wonderful. She is scheduled to have a CAT scan every eight weeks to see how things are responding. “I have not had any side effects whatsoever,” she said. “I have been able to go on with my life and to do the things I love, such as fishing and jogging.”

Anyone interested in becoming part of this clinical trial should call Hunterdon Regional Cancer Center, (908)-788-6461, and ask to speak with Kathy Robbins, a clinical research nurse. If it is determined that you are eligible, she will set up an appointment with one of center’s four oncologists.

HHO News

The Link Between Estrogen and Lung Cancer

Hormone Replacement Therapy (HRT)

Conclusions

The Only Cancer Center in New Jersey to Offer Immunotherapy Clinical Trial for Lung Cancer

Are insurance policies saving patients money, or keeping them from the treatment they need?

Lung cancer treatment using patients’ immune system shows promise

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