Dustin's Lung Cancer Battle
- Actor Dustin Diamond, 44, is currently undergoing chemotherapy to treat his stage four lung cancer.
- Diamond has been diagnosed with small cell lung cancer; lung cancer is either diagnosed as small cell or non-small cell, and the former tends to be the more aggressive kind of cancer.
- CT scans of the chest area can be used for lung cancer screenings so that the cancer can be diagnosed at an earlier stage.
Stage Four Lung Cancer Treatment Options
For people with late-stage cancer, such as Diamond, who has stage four lung cancer, treatment may be focused on maintenance and quality of life, meaning, attempting to halt the progression of the disease and maintaining the status quo.
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Some treatment paths are universal and will be used in both small cell and non-small cell lung cancer. Treatment options for lung cancer will depend on the stage and clinical characteristics of the cancer. Treatment options in stage four cancer can include chemotherapy, radiation, immunotherapy, and targeted therapy or some combination of both.
The goal of treatment of stage four lung cancer is to provide therapy that is systemic, meaning it goes everywhere in the body so that it can attack all the cells that have spread. The most common form of systemic therapies includes chemotherapy, immunotherapy, and targeted therapy. Specifically in patients with small cell lung cancer, like Diamond, treatment options for stage four lung cancer are a combination of chemotherapy and immunotherapy. For patients with non-small cell lung cancer, treatment depends on specific aspects of the tumor.
For non-small cell lung cancer, doctors have several ways to decide between using chemotherapy or other agents. When speaking about deciding between chemotherapy and targeted therapy in an earlier interview, Dr. Ronald Natale, a Medical Oncologist at Cedars-Sinai, said, “Among patients who are nonsmokers, or former very light smokers, we identify a mutation that we can target with pills in about 60% to 70% of them.” This type of treatment is called targeted therapy. “…So we’re giving chemotherapy to about 30% to 40% of patients who are nonsmokers.” This 30%-40% that Dr. Natale refers to are those patients whose tumors do not have mutations that targeted therapy can treat or are not candidates for immunotherapy. These patients will largely be treated with chemotherapy.
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Dr. Natale explained, “Among patients who are smokers, who have more complex cancers that have hundreds, sometimes thousands of mutations, don’t have a driver mutation that we can give a pill for, which is only a tiny percentage of lifelong smokers. Chemotherapy is the primary treatment in the majority of those patients.”
For people with stage four non-small cell lung cancer or metastatic lung cancer, the cancerous tumor is tested for biomarkers to see if targeted agents can be used. In addition to deciding between chemotherapy and targeted therapy, the doctor will also test the lung cancer to see if immunotherapy is a treatment option.
Lung Cancer Screening Methods
If you’ve been a smoker in the past, or are currently a smoker, it’s a good idea to get screened for lung cancer. Getting a CT scan of the chest area to screen for cancer can be beneficial, and allow doctors to catch lung cancer earlier.
Dr. Patrick Forde, a Thoracic Oncologist at Johns Hopkins Medicine, said in a previous interview, “Over the last few years, there’s been a number of studies looking at using low dose CT scans of the chest in patients who have a history of smoking to try and pick up lung cancers in earlier stage. About 70% to 80% of patients who are diagnosed with lung cancer, unfortunately, the cancer has spread outside of the lung and is not suitable for surgery.”
Dr. Forde points to studies that have already been done on these types of scans, which can provide greater insight. “And there have been a number of studies, most recently, one in the Netherlands, which looked at doing CT scans for patients who are over the age of 55 and had a significant smoking history for many years and then monitoring them on a regular basis with a low dose CT of the chest. And they were able to show a reduction in the numbers of lung cancers which had spread outside of the chest.”
“They were able to pick them up in earlier stage and potentially cure them at a higher rate than not doing screening. So that approach was recommended here in the US now. The uptake has not been high, both in diverse communities and others as well. And I think it behooves us all to try and increase the uptake of CT, in particular, given that it’s been shown to reduce lung cancer mortality. I think one problem around CT screening is availability of low dose screening programs. They may be available in high income areas but not in others. And referral patrons from primary care, for example, for CT screening, the concern is perhaps patients who are on Medicaid or don’t have insurance will not be referred for appropriate screening.”
Former & Current Heavy Smokers Should Get Lung Cancer Screenings Using CT Scan, Says Leading Expert
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