Pill Can Replace Chemo for Lung Cancer

An article appeared this week in USA Today about a new drug, Iressa. Iressa seems to do less harm to patients, but costs thousands more than standard chemotherapy.

Quotes below are excerpts from that article, based on an article published last week in the British Lancet medical journal.

"Some advanced lung cancer patients already treated with chemotherapy might be able to skip some of the bad side effects of another series of chemo by taking a pill instead, a study suggests. An international study showed patients on Iressa, an expensive, newer targeted treatment, survived about as long as those on another course of chemotherapy.

"'This will provide us with another drug in our armory,' said Dr. Michael Seckl, head of Cancer Research UK's Lung Cancer Group at Imperial College in London. Seckl was not connected to the research.

"Few treatments for lung cancer exist, and most patients die within a few years of diagnosis. Lung cancer kills about 1.4 million people every year.

"In the study, paid for by AstraZeneca, researchers studied 1,433 advanced lung cancer patients in 24 countries, who had already gone through chemotherapy. Roughly half were given Iressa, or gefitinib, once a day. The other half were on docetaxel, a chemotherapy drug given intravenously every three weeks.

"Patients on Iressa survived about 7.6 months while those on chemotherapy survived about 8 months. After one year, 32% of patients on Iressa were still alive, versus 34% of chemotherapy patients.

"'In the patients that respond, it is very dramatic,' said Seckl, who has seen patients live years on the drug. He did not work with AstraZeneca on Iressa, but has consulted with them on other drugs.

"'Though the benefits of prolonging life are modest, patients on (Iressa) get a higher quality of life,' said Chris Twelves, a professor of clinical cancer oncology at Leeds University. "That should swing the pendulum in its favor."

How to Deal with Chemo

A few months after my colonectomy, I was seen by a doctor who told me I should start on chemo immediately. I didn't like him at all -- he had the bedside manner of a cadaver -- and there were two surgeons who advised me that, in their opinion, I didn't need it. I decided not to have it. That was five years ago.

I am very aware that I may eventually need chemo. I am very well aware that the cancer may come back.

I took great interest in an article in Parade magazine a couple of weeks ago about chemo and how to deal with it, and found, even though I'm not facing this eventuality just yet, that it seemed very helpful.

7 Ways To Cope with Chemo
By Jessie Gruman
Published: September 14, 2008

The drugs used to treat cancer can have different results in different people. They can be a miracle—they cured my Hodgkin’s disease—or not. Side effects vary greatly too. Many of us approach chemo with fear, but a few steps can help you cope.

1. Learn about side effects.
Some people want to know every possible side effect of chemotherapy. Others want only a general overview so as not to become overly fearful. Both approaches are reasonable. Tell your doctor which you prefer. If you do encounter side effects, your oncology nurse, who is familiar with the drugs you’re taking, will have specific ideas and recommendations about how to ease your discomfort.

2. Manage unpredictability.
Reactions to chemotherapy are unpredictable. One day you may be fine and the next totally exhausted. The treatment you sailed through last month feels like too much today. Remember that you are receiving a powerful medical intervention and that it’s reasonable if you can’t do everything you once could. Remind others that you are not always at your best right now.

3. Adapt health behaviors.
Some people resolve to stick to a new diet or exercise regime when they begin treatment. But chemotherapy can affect both eating and physical activity: You may have no appetite, feel nauseous, or lack the energy to get to the kitchen. It helps to set modest goals. Take in enough fluids and eat a balanced diet of food. Use small spurts of energy for short walks and get plenty of sleep.

4. Cope with sadness.
Many patients are still absorbing the shock of the diagnosis when chemotherapy begins. Despair and hopelessness sit heavily on some days. It can be helpful to put these feelings into words by writing them down or talking to others. If you think your sadness will frighten or burden loved ones, confide in a trusted friend or a member of the clergy. But if you find that your sadness is unrelenting, you may want to talk with a mental-health professional who has experience with people undergoing chemotherapy.

5. Get support.
Family and friends can be a tremendous source of support. But sometimes you may feel so alone that your situation defies their understanding. Fortunately, there are many ways to connect with others who have gone through similar experiences. Local centers may provide a range of in-person opportunities to talk with others. Telephone-based or online support groups allow people to share information and encouragement.

6. Have patience.
While chemotherapy targets your cancer, it also affects your thinking, your emotions, and your energy level. Most of the immediate effects of the drugs pass within hours or days, but the fatigue and mental fogginess often linger, making it difficult to resume normal life. This can be frustrating and discouraging. Have patience. Most people find that these symptoms fade over time.

7. Find relief.
While it may be difficult to feel comfortable in your body during this time, think back: What has helped you find relief in the past? Writing your thoughts down? Prayer? Reading mystery novels? Watching sitcoms? Listening to music? Chemotherapy is new to you, but you bring experience in getting through tough times. You know best what has worked for you. Draw on your expertise about yourself to find some moments of peace.