New generation personalized treatments give hope to lung cancer patients
Pointing out that lung cancer is the deadliest type of cancer, Gaziantep University Oncology Hospital, Medical Oncology Department Lecturer Prof. Dr. Alper Sevinç emphasized that tobacco use increases the risk of cancer and that smoking is an important factor in many diseases, especially lung cancer. prof. Dr. Alper Sevinç added that lung cancer patients have different genetic features and that treatments now target these features, adding that these targeted drugs only show their effects on diseased target cells.
Making a statement on 17 November World Lung Cancer Day and Lung Cancer Awareness Month prof. Dr. Alper Sevinç, summarized the advantages of the new generation personalized treatments as follows: “When we look specifically at the cause of lung cancer, we attribute it to smoking at a rate of 80-90%, but in 10 percent it is due to genetic reasons. Normally, we apply chemotherapy to a lung cancer case as standard, but we now apply new generation treatments instead of chemotherapy in people with genetic mutations, especially those who have lung cancer despite not smoking. Unlike conventional chemotherapy drugs, these agents act only on target tumor cells and do not destroy the body’s defense and other cells. Thus, patients can lead their normal lives with a better quality during the treatment.”
Lung cancer can be effectively treated with early detection.
Mutation: Fingerprint of lung cancer!
prof. Dr. While providing information on mutations, Alper Sevinç says: “The tumor actually leaves a mark on the patients. Just as there are factors that cause lung cancer as standard, as does smoking and alcohol, a tumor can also cause cancer by using another pathway. If the person with lung cancer is a woman, a non-smoker, and has adenocarcinoma (constitutes 40 percent of lung cancers), we know that the tumor may have genetic characteristics.
We call these genetic mutations. With the developments in recent years, we are now able to detect these genetic mutations. The tumor taken from the cancer patient is subjected to genetic or pathological examination, and after this examination, we first find that the tumor uses the ALK pathway or the EGFR pathway. Thus, we can switch to personalized treatment. For us, this stage is very important. Because if you don’t identify or fail to identify this genetic pathway, or if sufficient tumor biopsies are not found, these patients unfortunately continue to only receive chemotherapy.”
Specific treatment for genetic mutation in lung cancer
Although lung cancer is a type of cancer especially seen in men, it should be divided into two as smoking-related and non-smoking-related. Whether cancer is due to genetic mutations or not is also an important classification criterion for treatment. Stating that lung cancer is evaluated in three groups in terms of mutation, Prof. Dr. Alper Sevinç continued: “Lung cancers are examined in three main groups as tumors with EGFR mutations, tumors with ALK mutations and tumors with ROS1 mutations. However, these titles may increase every year because new types of mutations continue to be discovered every year. Today, different cancer treatments are applied for these three mutated types. Before treatment, we detect mutations with genetic methods, and then we give treatments according to these mutations.”
New methods and personalized treatment in lung cancer treatment
Stating that patients have a responsibility to detect mutations, Prof. Dr. Alper Sevinç said: “First of all, physicians should make their patients aware of this issue and an awareness should be raised. Patients should first know the existence of such a mutation so that they can request it from the physician. Second, the physician needs to need mutation detection. On the part of the physician, this request is usually made after a few features have emerged. For example, if the patient is a non-smoker, female, and has adenocarcinoma, genetic testing is usually requested. On the other hand, since these genetic mutations can occur in smokers and male patients, it should not be forgotten that all patient groups should be evaluated in this respect. A period of about 14 days is required for these genetic tests.
At what stage should the test be done?
Stating that lung cancer is basically divided into small cell lung cancer and non-small cell lung cancer, Prof. Dr. Sevinç stated that the treatments in question are valid for non-small cell lung cancers and said: “We also divide non-small cell lung cancers into squamous cell and non-squamous cell lung cancers. New treatment options have emerged in non-small cell lung cancer, but not the squamous cell non-epithelial type.
Therefore, when we come across a patient, if he/she fulfills these conditions, then it is necessary to look for the genetic mutation in the patient. However, these tests cannot be done everywhere in our country. Sometimes the patient may have to start this treatment without looking at the test. And it is interesting that chemotherapy in these patients does not work as much as it does in other patients. Therefore, these patients must be genetically tested. Many centers in our country are now looking at this EGFR mutation and ALK mutation. In fact, other genetic mutations such as ROS and c-met detected in some places can be looked at.”
Lung cancer symptoms and new treatment options in 10 questions
Smokers beware of lung cancer!
Emphasizing that the cause of lung cancer is the use of tobacco products at a rate of nearly 90 percent and that only 10 percent of genetic and other external factors are effective, Prof. Dr. Alper Sevinç said: “Tobacco users need to be treated before they develop lung cancer. Because the effect of quitting smoking after cancer has developed is very limited. In addition, it is necessary to follow up people who have smoked for 20 pack years. Low-dose lung tomography can be applied to these people”.
Ways to prevent cancer
prof. Dr. Alper Sevinç summarized the ways to prevent cancer as follows:
1- If possible, not to start smoking at all. If we have started, reduce or cut it out as soon as possible, limit alcohol.
2- One of the important issues is obesity. Obesity has become the problem of our age. We also see an increased risk of cancer in obese people. Therefore, the fight against obesity and obesity also benefits us in the fight against cancer.
3- It is necessary to get rid of the stagnant life. In other words, it is necessary to do daily sports activities, not to gain weight if we are at a normal weight, and to lose weight if there is obesity.
4- It is necessary to be protected from viral infections. It is important to be protected from diseases that cause cancer after liver infection, such as hepatitis, or that cause cervical cancer, such as HPV. Vaccination against viral infections supports cancer prevention.
5- It is necessary to take advantage of the sun correctly. We know that skin cancers are especially related to sunburns. Although skin cancers, especially deadly skin cancers and melanoma skin cancers, are seen at a lower rate in our country compared to western societies, we must be careful.
Lung cancer can lie dormant for 20 years without showing any symptoms