Lung Cancer Statistics You Should Know

Lung cancer remains the deadliest cancer for both men and women in the United States.  Yet the funds for lung cancer research are the lowest in funding per cancer death.


Click on this link for a quick summary of lung cancer statistics. 


In the United States for the year 2012, 73,000 women died of lung cancer while 40,000 died of breast cancer, one of the best funded forms of cancer.  For specifics on lung cancer in women, see the statistics here. 


For specific statistics on the occurrence of lung cancer is non-smokers, see this link.


Please share this information with others.  We have got to raise awareness, break down myths, and turn these trends around.


Please help!

A Setback

Regular readers of this blog may have noticed that I haven't posted anything new since the beginning of 2014.

This year has brought  new challenges that I needed to get my head around before posting about it.  In short, the lung cancer has recurred.

In my late January CT scan, there were very small, lightly scattered cancer nodules in both lungs.  Dr. Bonomi had me double my Tarceva dosage to see if that would be sufficient to stabilize the cancer.  I was very hopeful that it would.

On March 12, six weeks later, new scans showed continued growth.  Although not at all aggressive, there were more and larger nodules than before.  The Tarceva was no longer suppressing the cancer effectively.  The cancer had developed a resistance to it.  This was not unexpected.  It is typical for cancer to eventually develop resistance to Tarceva.  Tarceva worked more than twice as long for me as is typical for this drug.  I got greedy and hoped it would last even longer.  So it goes.

Dr. Bonomi offered three options:  traditional chemotherapy, a 2nd generation targeted inhibitor (a newer drug similar to Tarceva) and clinical trials.  His personal recommendation is traditional chemotherapy.

I was able to quickly arrange for second opinions from two highly regarded lung cancer oncologists - one from Northwestern Memorial Hospital, the other an oncologist for both Evanston hospital and University of Chicago.  I had consultations with each of them yesterday.  They were consistent with Dr. Bonomi in the three options, although added information about the pros and cons of each approach.  In short:

• The 2nd generation targeted inhibitor, Afatinib (in combination with another drug called Ceduximab for increased effectiveness) was just introduced for general use about six or so months ago.  Success is 30-40% with similar but likely more severe side effects to Tarceva. 
• There is only one clinical trial in the Chicago area for which I am a potential candidate, but it is in the beginning of phase 2 and has no record yet as to likelihood of success.  A major downside for this trial is that it requires a 24-hour stay at the hospital every week to administer the drug.
• A chemotherapy cocktail of Alimta and Carboplatin with an EGFR antibody called Avastin for 4 cycles of treatment.  Each treatment is once every three weeks (equalling one cycle) for a total treatment period of 12 weeks.  After that, maintenance chemo indefinitely every three weeks.  Given my history with the EGFR mutation, the doctors say this has a 50% success rate, twice as high as those without the mutation.

The two doctors who gave me second opinions each suggested I get another biopsy now as it will probably be needed if I decide to participate in a clinical trial - now or in the future.  The approach to the biopsy was radically different between the two doctors.  One wanted to use a local anesthetic with a needle to biopsy a lymph node near my clavicle.  The other wanted to put me under general anesthesia and cut into the right lower lobe of my lung.  I don't plan to participate in a clinical trial now, based on what's available. In the future, I probably wouldn't want to participate in one unless the cancer once again progresses.  If that is the case, there should be tumors they can biopsy at that time.  Dr. Bonomi didn't think I needed one unless I want to do a clinical trial now.  He was concerned that none of my tumors that are in accessible locations are big enough (> or = 1 cm) to biopsy anyway.

Dr. Bonomi believes that it is better to try a treatment approach different from the receptor inhibiting qualities of Tarceva since the cancer now recognizes these inhibitors and has developed resistance to them.  Additionally, since I increased the Tarceva dosage, the side effects of rash, itching and stomach distress have increased.   These effects could potentially be even worse with this second generation inhibitor.  For that reason, his first choice would not be using Afatinib.

He also says some people find the side effects for chemo easier to take than those for Tarceva.  He says some people "sail through" the chemotherapy.  The most likely side effect of chemo is fatigue a couple days after treatment.  Three to four percent of patients experience nausea in spite of the anti-nausea medication that is part of the chemo cocktail.  Before each chemo treatment, they do blood work to ensure the white blood cell counts don't get too low, which would make me susceptible to serious infection.  There is a possibility of nose bleeds from the antibody (Avastin).

Based on the information from the three doctors, I think I will go with traditional chemo.  I really had hoped to avoid chemotherapy and desperately wish one of these alternatives had more to offer. But it looks like the lesser of all evils so that's the way it goes.

My Article Promoting Imerman Angels

I was asked by a friend who is the co-founder of the Women Survivors Alliance to write an article about my cancer mentor role with Imerman Angels for WSA's online magazine, The Plum.  Here is a link to that article if you are interested in reading it.  It was published on March 11.

If Only for a Second...

This is an absolutely lovely and touching video about giving cancer patients a moment of lightness while they struggle through their disease.  Click here to watch.

Decisions, Decisions

Last Thursday, I saw my neurologist.  I finally heard the words I've been waiting for...I have the option to discontinue the anti-seizure medication.  That's the good news.  With that option, she also gave me a lot of cautionary advice that if it has been the medication that has been preventing another seizure and I stop it, I may start to have seizures again and would not only have to go back on the medication, but wouldn't be allowed to drive for several months until they were sure the medication was at its full efficacy.  There is no rush to make this decision.  I can decide to begin easing off at any time, although she did suggest I wait until after the holidays.

The reason I am at risk for seizures is that even though the lesion(s) that caused them are gone, there is scar tissue there now.  Depending on the size and location of the scar tissue, it could potentially cause seizures without preventive medication.

So, what to do?  I've been wanting to get off this medication for a long time.  I hate taking drugs, which I have to do regardless, but anytime I can get off of one is great.  It is a nuisance to fill the prescription, to figure out when to take the pills when traveling across time zones and just having to take them at all.

I will mull these options over for a few weeks.  I'm leaning toward taking a walk on the wild side and going off the medication.  But we will see.  Your thoughts and suggestions are welcome if you wish to comment on this post.

Thanks.

One More Thing to be Thankful For

Although Thanksgiving has passed, I continue to be thankful for the many good things in life.  Today, yet another good thing - a clean MRI scan and normal blood work - was added to the list.

The next oncology visit is January 29, but I have an appointment with the neurologist on December 12.  I am hoping for more good things, like a reduction in the anti-seizure daily dosage.  Crossing my fingers!  If nothing changes, I won't post a message. 

Hope you all have a wonderful holiday season.  Peace and joy to all.

Excellent article & video on the scourge of lung cancer

On November 26, 2013, the Chicago Tribune ran this article about 31-year-old Meghan O'Brien, who has stage 4 lung cancer, and her battle against the stigma of lung cancer as a smoker's disease.  This stigma hurts lung cancer research and affects the type of support lung cancer fighters receive from others.  The money raised for research of lung cancer doesn't hold a candle to breast cancer.  Lung cancer is the top cancer killer and most people don't even recognize that November is lung cancer month - there are no ribbons, sports teams or merchandise calling for lung cancer support.  Meghan's story is further detailed in this video.

Please take a look at these materials and share them with others.  And one last favor, when you come across a person who has lung cancer, don't ask them if they smoked.  More and more, the answer is no, but either way it doesn't matter.  Nobody deserves this wretched disease.