“Test, talk, and take action” a battlecry against lung cancer

Despite the scientifically established detrimental effects of habits such as smoking or excessive drinking, many Filipinos find it difficult to wean from smoking.

Photo Credit: Diego Castro Facebook page

TV and media personality Diego Castro believes though in the saying “an ounce of prevention is worth a pound of cure”. More so because his father, renowned broadcast anchor Angelo Castro Jr., passed away from lung cancer in 2012 after having been diagnosed just four years earlier. “He began smoking when he was 10 years old,” revealed Diego. “But he had already quit around 10 years prior to his diagnosis.”

As with many lung cancer patients, persistent cough was what led the elder Castro to the doctor. After having been diagnosed, he initially sought alternative treatments and remained to be in relatively good health despite having been given an initial prognosis of only a few months to live. He kept a normal life as far possible, meeting up with friends and working at his job.

Later, in an effort to eradicate any remaining malignancy in his body, Angelo submitted to medical doctors and underwent chemotherapy. Frequent trips to the hospital extended to weeks and months of stay—totaling two years. Unfortunately, the disease has progressed which led to his eventual demise.

The burden of the disease is more than just on the patient but on the family as a support system. “It was draining, physically, emotionally and financially,” shared Diego.

A voice of hope in an advocacy

Diego was later astonished to find out from the medical community that a lot has already been achieved in terms of more effective and efficient treatment options for cancer.

Diego admits such news brings a feeling of regret for missed opportunities. However, a chance to ensure that his father’s death was not in vain comes in the form of lending voice to a multi- sectoral advocacy that urges Filipinos to be more proactive in battling cancer through early diagnosis.

Hope From Within is a movement that symbolizes the optimism that novel treatments like immunotherapy bring to cancer patients, and the latest in its series of ongoing educational and informational forums focuses on the importance of early detection for malignancy.

Specifically, for lung cancer, it is important for those at high risk to get screened so that the disease can be addressed immediately, according to Dr. Ivy de Dios, oncology medical adviser of MSD in the Philippines.

“In order to benefit from the innovation of immunotherapy particularly for certain types of advanced lung cancer, it is important that it is administered as early as possible upon the onset of the disease,” explains Dr. de Dios. “That is why we are urging people to ‘Test, Talk and Take Action.’”

Those who should primarily consider getting screened are high-risk individuals such as smokers. “Any persistent cough should be looked into,” she reminded. The screening test involves a low-dose CT scan of the chest. Any mass identified for biopsy will also then be analyzed by a pathologist for particular proteins, to further determine the suitability of the patient for targeted therapies and immunotherapy.

The “talk” phase involves constant and in-depth discussion with medical professionals and experts. “Prognosis and treatment should be threshed out well between the patient and doctor,” said Dr. de Dios. Finally, “take action” not only means undergoing proper treatment, but having a positive and proactive approach to battling the disease through healthy lifestyle changes and help from support groups.

Immunotherapy a bright option

Immunotherapy involves fortifying the body’s natural healthy cells to avoid being overridden by malignant cells, and thus preventing the latter from multiplying. In many clinical studies all over the world, it has been proven to add more years of survival to cancer patients.

As opposed to chemotherapy, a traditional standard of treatment, immunotherapy presents less or little side effects. In many countries all over the world, immunotherapy drugs have already
been widely accepted to treat specific cancers such as lung cancer, melanoma, gastric, bladder, and Classical Hodgkin’s lymphoma.

Through pathology of samples from the patient, such as tissue or even body fluids, molecular testing can determine the best course of immunotherapy treatment. For instance, depending on the presence of cell protein called PD-L1 (programmed death ligand), immunotherapy drugs called immune checkpoint inhibitors such as nivolumab, atezolizumab or pembrolizumab may be administered.

Mutations in EGFR (epidermal growth factor receptor), meanwhile, may indicate a patient’s suitability for treatment using EGFR targeted therapies such as afatinib, erlotinib, or gefitinib. ALK (anaplastic lymphoma kinase) gene changes may call for treatment with drugs that target the ALK protein such as crizotinib.

In the Philippines, the innovation of immunotherapy has already arrived. Early this year, a particular immunotherapy drug—pembrolizumab—has been approved by the Philippine Food and Drug Administration as first-line treatment for PD-L1-positive non–small cell lung cancer (NSCLC). This means that those diagnosed with this particular type of lung malignancy may receive this immunotherapy drug from the onset, and avoid undergoing chemotherapy.

Pembrolizumab has been found effective as first line of treatment in NSCLC with high PD-L1 expression, and no EGFR and ALK gene mutations. It can also be given to NSCLC patients with PD-L1 expression, whose cancer starts growing again after chemotherapy or other targeted treatments.

Whereas before, being diagnosed with cancer seemed like an automatic death sentence, immunotherapy truly means renewed optimism among patients. With this breakthrough treatment, it is not difficult anymore for those facing cancer to look at the brighter side of possibilities and to rely on their own hope from within.