Clinical Trials

There are many great opportunities to get involved in clinical research trials for cancer, and specifically for adenocarcinoma of the lung.  Clinical trials are research studies involving people. These are studies that originally began in a lab, and have taken the proper steps to be passed from animal subjects to human ones.  Cancer clinical trials are designed to use new drugs and/or surgery or radiation techniques to test ways to treat, diagnose, prevent and manage or prevent symptoms of the certain cancer under investigation.¹  Many current treatments today were past clinical trials that had been successful.  A professional in the research field will run the clinical trial very strictly.  These usually are doctors, and they are referred to as the Principle Investigator.¹  Before you get involved in a study you will be given the trial’s protocols along with a detailed outline of the plans revolving this trial.  This includes the reason the study is being done, who can join the study, how many people are needed for the study at this time, the drugs, dosage and frequency of treatments you will receive, the medical tests you will get and frequency of these tests and what information will be observed and gathered about you personally.¹  In order to be picked to be part of a clinical trial you must meet the strict criteria for the study.  In addition, the Principle Investigator will use randomization to pick his subjects, so there is an equal opportunity to be chosen to participate for all who want to enter the study. ¹ There typically are two groups involved in a clinical study, a control group, or the people receiving the new treatment and the placebo group, or the group that does not receive the new treatment.¹ There are four main phases of clinical trials, however most participants are not involved in every phase.  In addition, a participant may wait until the clinical trial has reached a certain stage before wanting to be involved. 

1.     Phase One

a.    This phase requires 15-30 people in order to get started.  The goal of this phase is to find a safe dosage and to see how the treatment should be given. In addition, this phase is used to see how the new treatment affects the human body.³

2.     Phase Two

a.    Phase two will be looking for less than 100 people to be involved in the trials.  This phase is designed to determine if the treatment has an affect on the cancer being studied.  It also will help doctors see how the treatment affects the human body. ³

3.     Phase Three

a.    The third phase of a clinical trial will need 100 to several thousand participants.  It is mainly used to compare the new treatment to the standard treatment currently used. ³

4.     Phase Four

a.    The final phase of a clinical trial requires several hundred to several thousand people.  Phase four further assesses the long-term safety and effectiveness of the new treatment. ³

There are many pros to being involved in a cancer clinical trial.  First, clinical trials offer. Clinical trials offer high-quality cancer care. If you are in a randomized
study and do not receive the new treatment being tested, you will receive the best-known standard treatment. This may be as good as, or better than, the new approach. Next, if a new treatment is proven to work and you are receiving it, you may be among the first to benefit.¹  By looking at all your treatment choices, including clinical trials, you know that are taking an active role in your care. Finally, even if you do not physically benefit from the study you will have been involved in the most crucial part of cancer research and will have helped those in the future who suffer from your same disease. ²

Of course, there are also cons to clinical trials, which I would like to discuss with you as well. New treatments under study are not always better than, or even as good as, the standard care. If you are part of the placebo group that receives the standard care instead of the new treatment being tested, it may not be as effective as the new approach.¹  Also, new treatments could have side effects that doctors do not expect or that are worse than those of the current treatments. Finally, health insurance may not cover all patient care costs in a study. The coverage varies by plan and by study. To find out
in advance what costs are likely to be covered, check with your insurance company and the billing staff at the hospital or doctor’s office. ²

Here are some links to help you find clinical studies that you may or may not want to be a part of!

http://www.cancer.gov

http://clinicaltrialslungcancer.com/?gclid=COiEyMeNrMYCFQoPaQodbkMGCA

http://www.antipdl1clinicaltrials.com/hcp/antiPDL1_clinical_trial_info/lung-cancer?cid=bio_PS_00004992_1&gclid=CKWR8sqNrMYCFQiNaQod4DoDIA

Works Cited

1. Finding a Clinical Trial. (2015, April). Retrieved June 26, 2015, from Cancer.Net website:

     http://www.cancer.net/navigating-cancer-care/how-cancer-treated/clinical-trials/

     finding-clinical-trial

2. Deciding to participate in a clinical trial. (2013, November). Retrieved June 26, 2015, from

     Cancer.Net website: http://www.cancer.net/navigating-cancer-care/how-cancer-treated/

     clinical-trials/deciding-participate-clinical-trial

3. Clinical Trial Phases. (2008, April 18). Retrieved June 26, 2015, from ClinicalTrials.gov website:

     http://www.nlm.nih.gov/services/ctphases.html

4. Clinical Trial [Image]. (n.d.). Retrieved from http://gpdfoundation.com/research/ 

You are not alone

As I said in my last post, it is always important to remember that you are not the only one who has or who ever will go through life with a diagnosis of lung cancer.  Now while doing some research on the populations diagnosed with adenocarcinoma of the lung, I stumbled upon an interesting fact that I would like to share with you briefly. Globally, the incidence of lung cancer (specifically adenocarcinoma diagnoses) rose by 51 percent between 1996-2003 and this number has only continued to grow.⁵ Researchers are now beginning to question why this cancer is becoming more prevalent in developing countries.  In 2010, a study was done to test whether or not changes in cigarette design were related to the increased occurrence of adenocarcinoma.  Filtered cigarettes have shown to increase the depth of smoke inhalation and distribution of smoke to the lungs, which in turn, intensifies the exposure of lung cells to carcinogens in smoke.  This design has become more popular in the US since the 1950’s, because of the increased effects of the nicotine “buzz” one feels from smoking filtered cigarettes.  In the 1990’s tobacco companies began refining the filtered cigarette even more to provide a bigger buzz and therefor a more harmful effect.  Furthermore, when tobacco companies put the word “filtered” on cigarettes it was seen as a positive addition and made the cigarette seem healthier to consumers. ¹ 

(3)

This advertisement was one of the first ads out for filtered cigarettes. You can see why consumers would believe that a filtered cigarette is better for you, she makes them look so appealing!

I apologize for my little nerd rant, but I just thought it was a very interesting fact and another great opportunity to emphasis the importance of quitting smoking.

            There is such a large and supportive community out there for those who have been diagnosed with lung cancer. However, I want you to think about the support system you already have in place.  My support system mainly includes (but is not limited to) my family. Here we are below :)

It is important to remember the friends and family that are surrounding you right now, because they can be some of the most crucial people that help you through tough times.  However, they cannot help you if they do not know what is going on in your life, or what you need.  Coping with news of lung cancer is a long process, and many people are not ready to share their diagnosis right away. This is just fine, you are supposed to grieve in your own way. However, once you feel ready (if you ever feel ready) to share your news about lung cancer with your loved ones, CaringBridge is a non-profit website that can be a great place to start.  “In 1997, good friends of mine had a premature baby, and they asked me to let everyone know what was happening. Instead of making dozens of emotional and time-consuming phone calls, I decided to create a website. The same night their baby Brighid was born, so was the idea that became CaringBridge.”² - Sona Mehring, CaringBridge Founder and CEO.  On this website you can create a personal journal that shares updates with the people you love about your illness. You can also receive support from friends and family that read your journal entries and post advice and words of encouragement. This is also a great way for caregivers to explain what assistance they may need in giving you care, or where people can come visit you if you are in a treatment facility. Finally, it is private and ad free to ensure privacy and respect for you and your followers.²

https://www.caringbridge.org/createwebsite?vc=1&ts=1&sp=1&utm_expid=1228517-58.UEblOQD6QFKpAwYLcuGCrg.2&utm_referrer=http%3A%2F%2Fwww.caringbridge.org%2Fabout-us%2Fbenefits

Clicking on this link will lead you to the “Start a Journal” page of Caring Bridge, and I hope you will use it and find it as beneficial as my family has.  I personally had my own CaringBridge site when I was diagnosed with lymphatic cancer in 2010.  I am happy to say I’m in remission and things are going very well for me.  The posts I received on CaringBridge helped me fight on my weakest days, it helped me see how many people were truly rooting for me.  My friends and family had prayer groups and daily posts and so much advice and kind words and I honestly never could’ve gotten through treatment without them.  To this day, my CaringBridge site is the most valuable piece of my experience. Not only do my journal entries help me remember what exactly I went through, but the posts from the community also remind me of how much I am loved.

Works Cited

1. Burns, D. M., Anderson, C. M., & Gray, N. (2010, October). Do changes in cigarette design influence the rise in adenocarcinoma of the lung? San Diego, CA: UCSD School of Medicine.

2. Mehring, CaringBridge CEO, S. (n.d.). CaringBridge: About us. Retrieved June 24, 2015, from CaringBridge website:

 http://www.caringbridge.org/about-us

3. Cigarette House. (n.d.). Cheap cigarettes L&M Box Lights/Blue [Image]. Retrieved from

http://www.cigarettehouse.net/?action=description&cigarettes=L%26M%20Box%20Lights%2FBlue&prod=413

The Weapons of Mass Destruction

Now that you know what lung adenocarcinoma is, let’s discuss what may have caused the lung cancer. This is not meant to guilt trip you or point fingers, it is simply to help you understand why and to inspire a change in your lifestyle.  First and foremost it is important to remember that you are not alone. Lung adenocarcinoma is the most common type of lung cancer diagnosed world wide, and it accounts for 40% of all lung cancers diagnosed in the United States. ²  Why? Well, the American Thoracic Society published an article stating that smoking tobacco is the leading cause of adenocarcinoma in the lungs. And wouldn’t you know it, “nearly 18 of every 100 U.S. adults aged 18 years or older (17.8%) currently smoke cigarettes”, according to a census done by the CDC in January 2015.  This means an estimated 42.1 million adults in the United States currently smoke cigarettes.¹ The age one starts smoking, number of years one smokes, and the amount one smokes are all factors that can affect the development of lung cancer.³

 

I know you've probably seen a million and one commericals that promote quitting smoking, however I wanted to share this one because it was not aired in the United States and I found it to be very powerful.

            Well, you cannot rely on the tobacco companies to make quitting smoking any easier for you.  However, especially with a diagnosis of lung cancer, quitting smoking is essential to begin the healing process. The first, and most important step in quitting smoking is making the decision to quit and committing to your choice. This means you WANT to quit, and you build a support system of friends and family who share your goals and will be disciplined when it comes to ensuring you stop smoking.  There are 5 main ways to quit that I will be talking about today.

1.     Quitting cold turkey.  This means that you put down that cigarette now, and never pick one back up again, using only the strength in your mind.  No medication, no support groups – you just stop. According to an article written on WebMD, 90% of first time quitters try to kick the habit this way.  Unfortunately, the success rate of this method is very low and only 4-7% of people are actually able to stop smoking cold turkey.⁴

2.     Behavioral Replacement Therapy – This is where you will work 1 on 1 with a counselor to address the social, financial and emotional issues involved with smoking and help develop a personalized plan to quit. They can serve as a great accountability partner, who will keep you in check.  Sessions with tobacco cessation counselors can be done online, over the phone or face-to-face. You can visit this website to find an online or over the phone counselor, http://www.alerewellbeing.com/quit-for-life/ .  If you don’t like this site, there are numerous others that provide the same services. Just googling “help me quit smoking” will bring you to many sites where you can join support groups and get a counselor to help you today. You can also talk with your physician and they will be able to set you up with the right counselor to speak with in person.

3.     Nicotine Replacement Therapy – This involves using substances that have nicotine without the tobacco. This is important because nicotine is the addictive substance in cigarettes that gives you the buzz and the cravings for more. Nicotine gum, patches, inhalers, sprays, and lozenges are all nicotine replacement therapies that can help with cravings and withdrawal symptoms. They’re designed to slowly wean you off nicotine completely and have proven to have a 25% success rate.⁴ These are available over the counter, and there are many websites you can get them for free! Here are a few to help you get started:

a.    http://www.cdc.gov/tobacco/campaign/tips/quit-smoking/

b.    http://www.readytostopsmoking.org.uk/content/freestuff/Products.aspx

c.     https://www.quitnow.ca/tools-and-resources/quitting-medications/free-nicotine-products-and-drugs.php

d.    http://map.naquitline.org/reports/medication/

4.     Medication – Sometimes, using nicotine replacement therapy is not enough to help you quit. There are prescribed medications that you can receive to help you quit. You will need to visit a doctor before getting a prescription, but this is very helpful as physicians have a variety of great resources for you in addition to medication.  The two most commonly used medications are Zyban and Chantix and both have proven to work very well.⁴

5.     Combination Therapy – This therapy is the most successful therapy for those who are trying to quit smoking cigarettes.  This is a combination of any or all the therapies mentioned above, and is the most highly recommended therapy for smokers as it has a 60% success rate. ⁴

Now, although your desire to quit can be very strong, the addiction can be even stronger and it may be difficult to resist smoking. If you relapse do not feel ashamed. It is actually a very common part of the quitting process. The goal is to eventually quit, however the road to quitting is long and hard and there are bound to be a few hiccups along the way.  Just try to smoke as little as possible until you are ready to quit completely again. It may be difficult but I can assure you that quitting is worth it.

Works Cited 

1. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion.

(2015, January 23). Current Cigarette Smoking Among Adults in the United States. Retrieved June 24, 2015, from Centers for Disease Control and Prevention website:

http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/

2. What Is Non-Small-Cell Lung Cancer. (n.d.). In Lung Cancer. (Excerpted from American Cancer Society, 2014)

3. What You Need To Know About Lung Cancer [Pamphlet]. (2012). US Department of Health and Human Services/National Institutes of Health.

4. Ratini, M., DO, MS. (2014, September 16). How to quit smoking. Retrieved June 24,    2015, from WebMD website:

         http://www.webmd.com/smoking-cessation/quit-smoking?page=3