Philippa Cheetham, MD; Sara F. Martin, MD; and Evan C. Osmundson, MD, PhD, remark on recent improvements in managing advanced lung cancer, and offer insight regarding future therapies that show promise.
PUBLISHED November 13, 2017
Philippa Cheetham, MD: Obviously, patients are concerned about outcomes and survival, and whether they’re going to be cured or not cured. Do you think it’s fair to say that, regardless of cure, we can guarantee a patient that they don’t need to be in pain and that they don’t need to be suffering with nausea and overwhelming side effects of the disease? Have we gotten to a point, now in palliative care, where we can deal with the symptoms that have a huge impact on patient quality of life, not just life expectancy?
Sara F. Martin, MD: Yes. It’s fair to say that for most patients, or all patients, we should be able to guarantee that you’re not going to have severe, uncontrollable pain. That doesn’t mean that you might not have aches and pains. We should be able to guarantee that you’re not constantly nauseated and constantly vomiting. Those are things that we should be able to guarantee for all patients at this point in medical care.
Philippa Cheetham, MD: And where do you see the future of all these treatment armamentariums? Do you think that we still have a long way to go with lung cancer management?
Sara F. Martin, MD: In terms of symptoms for patients?
Philippa Cheetham, MD: Yes.
Sara F. Martin, MD: I think there will always be new symptoms. The immunotherapies are a great new treatment option. But they have a whole different set of symptoms that patients can develop that we didn’t see with more traditional chemotherapy. So, I think as newer agents come on the market, we’ll be faced with newer symptoms or things to manage from that treatment. It’s really about learning what those are and, then, how to manage them.
Philippa Cheetham, MD: Dr. Osmundson, we know that with the excessive use of antibiotics, there’s now a whole generation of superbugs that have morphed into being able to survive in an environment where they have developed antibiotic resistance. We’re having to develop more and more drugs to deal with that. Do you think that cancer is going to beat all of us? Do you think we’re going to start seeing more aggressive forms that may evolve into being resistant to immunotherapies? The more we throw at these tumor cells, are they likely to potentially evolve into becoming resistant where we’re just kind of chasing it further and further down the line? Or, is this all cyber talk?
Evan C. Osmundson, MD, PhD: I certainly think that with respect to any individual patient’s tumor, it’s a microevolutionary process. You challenge it with different therapies. There will be a subset of cells that will be resistant. I should say that they may or may not be resistant. So, certainly, that’s going to happen based on the kinetics of the tumor. In the long-term, though, I do think that there’s hope for potentially curing stage IV patients. I think we’ve seen it in other diseases. In particular, like head and neck cancer, for example, stage IV patients can potentially be cured. We see it in hodgkins lymphoma. In patients who are technically stage IV, we have cure ability rates greater than 90%. So, I just think that we need more research and more time. Ultimately, with the right teams and the right minds, we’ll be able to enact more cures.
Philippa Cheetham, MD: Well, maybe within a few years, the drug companies will have invented a lung cancer vaccine that we can give to all of our patients. But, in the meantime, thank you so much for all of the work that you do in taking care of patients and educating everyone who is tuning into CURE Connections® today. Thank you so much.