About five and more chances for the healthy to avoid the disease and for the sick to live as long as possible.
Will lung cancer become a cancer priority for the Minister of Health?
Under the motto Stop Cancer! Give Lungs a Chance! The Lung Cancer Association, the Polish Amazons Social Movement and the Alivia Oncology Foundation have launched a joint educational campaign aimed at changing the perception of lung cancer, promoting prevention of the disease and optimal standards of diagnosis and treatment. The campaign is in line with the demands of the supranational organisation Lung Cancer Europe (LuCE), which advocates at European forums (including the European Parliament) for
o investment in prevention and equity in access to appropriate lung cancer diagnosis and treatment
in European countries.
Lung cancer is the most serious public health oncological problem in Poland
and in most countries of the world. Every year, 22,000 people in our country hear this diagnosis. Unfortunately, for the vast majority, the prognosis is not favourable, the disease in 70% is diagnosed at the stage of dissemination or local advancement. This means that the most effective, surgical treatment for lung cancer in the majority of cases is no longer possible. In 85% cases, the incidence of lung cancer is linked to the carcinogen smoking. The death toll taken by lung cancer is higher than that from breast, prostate and colorectal cancer combined. Scientific developments,
including, in particular, molecular/genetic studies of lung cancer have revealed that it is a highly heterogeneous disease (heterogeneous) and that we should be talking about multiple rather than a single condition. This fact has, relatively recently, radically changed the outlook for some patients, opening up the opportunity to select personalised treatment tailored to the characteristics of the disease and thus live a much longer and good quality life. The fatal image of lung cancer as a disease that kills quickly and relentlessly is no longer entirely deserved. The dynamic development of research into ways of overcoming the resistance of tumour cells to treatment, and the new drugs that have been developed, bring the goal of transforming lung cancer into a chronic disease a step closer. To quote Prof Giorgio Scagliotti of the University of Turin: "We are at the beginning of a new era for lung cancer patients!".
According to the campaign organisers Stop Cancer! Give Lungs a Chance! the situation can already be improved by taking five and more chances to inhibit lung cancer in both healthy and already sick people.
Opportunity number one for healthy people are prevention, which means, above all, giving up smoking immediately, which increases the risk of lung cancer by 15-30 times! Frequent checkups are important for people who have regular contact with carcinogenic substances (e.g. asbestos, exhaust fumes, certain chemicals), have other lung diseases or have a family history of lung cancer. In this regard, you should consult your GP.
Opportunity number two it's early diagnosis which offers the possibility of a complete cure for people who have developed lung cancer. Persistent and untreatable symptoms such as coughing, hoarseness, breathlessness, chest pain and haemoptysis may indicate the development of cancer. This should be brought to the attention of your GP.
Opportunity number three it's genetic diagnosis of disease. Every patient with non-small cell lung cancer (85% cases) should have genetic testing for specific molecular alterations responsible for the development of the disease, e.g. mutations
in the EGFR gene or rearrangements in the ALK gene, which are important in the precise choice of treatment. Such testing should be compulsory, especially as it has recently become possible for the National Health Fund to fully fund cancer genetic diagnostics. Every non-small cell lung cancer patient should demand it. Unfortunately, the available data indicate that, for extraneous reasons, this type of diagnosis is only performed in a proportion of patients.
Opportunity number four it's modern targeted treatment available. Patients whose genetic diagnosis has confirmed the existence of a mutation in the EGFR gene or a so-called ALK gene rearrangement should be included in drug programmes that use modern molecularly targeted treatment. It is important to check whether the hospital in question has such a drug programme contract and includes patients in the treatment. Sometimes hospitals prefer chemotherapy treatment to targeted treatment, for reasons described as financial.
Opportunity number five and more... this in the event of disease progression overcoming resistance to treatment
and therapy in line with European standards. Even the most effective targeted treatment can stop working. As a defence against destruction, tumour cells produce, among other things, new mutations that block the effectiveness of the previously used drug. A completely new opportunity could be created for this group of patients by pharmacological overcoming of treatment resistance.
For another group with disease progression, drugs that activate the immune system or anti-angiogenic drugs may be an opportunity. Unfortunately, neither drugs that overcome resistance to targeted therapy, nor immunocompetent or antiangiogenic drugs are yet available for Polish patients whose disease has progressed.
According to a report by the Alivia Oncology Foundation, entitled "Access of oncology patients to drug therapies in Poland against the background of current medical knowledge', out of 13 drugs registered in Europe and recommended by ESMO (European Society of Medical Oncology) for the treatment of lung cancer, only 4 innovative preparations are available in Poland with restrictions, in drug programmes. On these 4 drugs, the Ministry of Health spends only 4.5% of the amount allocated to all oncology drug programmes! In the rankings of expenditure on cancer treatment, Poland ranks behind such countries as Croatia, the Czech Republic, Estonia, Hungary, Lithuania, Slovakia and Slovenia,[1] spending around 28% of the European average on cancer treatment, with a GDP of 70% of the average of European countries.
According to the Minister of Health[2] of 3. March 2017, there are currently 5 innovative drugs for the treatment of non-small cell lung cancer awaiting reimbursement decisions. Among them, a drug that breaks resistance to targeted treatment, immunocompetent drugs and anti-angiogenic drugs.
Action organisers Stop Cancer! Give Lungs a Chance! appeal to the Minister of Health, to make lung cancer a real oncological priority in the health care system.
In particular, to:
- all patients with non-small cell lung cancer had an obligatory genetic diagnosis;
- doctors treated according to the best standards and referred patients to drug programmes;
access to modern, differentiated therapies for lung cancer improved for Polish patients, based on recommendations and guidelines