Expert Advice for Lung Cancer Patients Considering a Clinical Trial

Expert Advice for Lung Cancer Patients Considering a Clinical Trial from Patient Empowerment Network on Vimeo

What do lung cancer patients need to know about clinical trials? Dr. Lecia Sequist shares her perspective about the benefits of clinical trials, common misconceptions about trials, and advice to patients considering clinical trials.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…ask your doctor if you should go to another center, maybe in a bigger town or city, to ask about clinical trials there? And that’s a great reason to have a second opinion. Sometimes the latest, most active treatments are only available on a clinical trial.”

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Transcript:

Lisa Hatfield:

Dr. Sequist, why is clinical trial participation so important in lung cancer, and what advice do you have for patients who are considering a clinical trial, and especially as they’re thinking about access to that clinical trial, how can they access those trials?

Dr. Lecia Sequist:

Clinical trials can come in all flavors, in different shapes and sizes. And so it is…I think clinical trials are very important for the field of cancer, they’re how we move the field forward. When scientists invent a new treatment, it can’t come to your door step unless there are clinical trials that are done to show that it works in cancer, that it’s safe, that it’s better than the older treatments. And so clinical trials are critical to cancer treatment and the progress of cancer treatment. I think a lot of people understand that, but they also think, Well, they’re really important, but someone else can do them. I don’t want to participate in a clinical trial, I don’t want to be experimented on, I don’t want to be a lab rat. And I can definitely understand that fear. But clinical trials, again, like I said, they come in all shapes and sizes, some of them are more experimental where maybe you’re getting a drug that hasn’t been tried in that many people before, some of them are less experimental where maybe there’s a drug that’s approved and works really, really well in breast cancer. It hasn’t come to lung cancer yet because it needs a clinical trial. And you can access that treatment before everyone else if you participate in the clinical trial.

Clinical trials are not for everyone, but I think that in my opinion, most patients who are diagnosed with cancer should hear about clinical trials, should learn a little bit more about what they really mean, and then they can decide for themselves if it is something that they would like to take part in. Clinical trials aren’t available at every hospital or every clinic, that’s the other thing, is that they may not offer clinical trials where you’re being treated, but you can…

I think my activation tips around clinical trials are, one, to learn more about it because most of us don’t know that much about clinical trials. And you can start by asking your doctor, but it’s possible your doctor doesn’t know that much about clinical trials either if clinical trials aren’t done or offered at your hospital or your clinic. And so you can ask your doctor if you should go to another center, maybe in a bigger town or city, to ask about clinical trials there? And that’s a great reason to have a second opinion. Sometimes the latest, most active treatments are only available on a clinical trial. So I think another misconception people have is that, well, that’s for when everything else has been tried, it’s like the last-ditch effort. That’s definitely not true. Sometimes the best treatments that we would love to give a patient first when they’re first diagnosed, because we think it has the highest chance of working, but it’s only available on a clinical trial. So it’s not something to think about only after you’ve tried five or six other things. Clinical trials should be considered, I think for every cancer patient from day one. They may not be a good fit for every patient, but they should at least be talked about and thought about, so we can really find the best plan for you. 


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What Are the Noted Disparities in Lung Cancer Screening and Access?

What Are the Noted Disparities in Lung Cancer Screening and Access? from Patient Empowerment Network on Vimeo.

What are some lung cancer disparities in the U.S.? Dr. Lecia Sequist shares insight about disparities in lung cancer screening and care, some causes of the disparities, and ways that advocacy groups are trying to decrease disparities. 

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…be sure to ask your doctor if genetic testing has been performed on your cancer, and if not, can it be performed? It’s not always the right answer, depends on the type of cancer that you have and the stage, but if you have adenocarcinoma and an advanced cancer, like stage III or stage IV, it is the standard to get genetic testing and that should be something that can be done.”

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Transcript:

Lisa Hatfield:

Thank you. Dr. Sequist, with cancer care, there are some noted disparities, particularly with access to screening and care. What are some of those disparities with lung cancer screening and care?

Dr. Lecia Sequist:

Lung cancer, unfortunately, there are a lot of disparities around the globe, but even if we focus on the U.S., there’s a lot of regional disparities as far as who’s getting cancer, who’s getting lung cancer, where the cancer treatment centers are located, where the screening is available. Lung cancer screening is really effective as far as finding cancer in the earliest stages. It’s not equally available across the country. Some of it has to do with there are certain states that expanded their Medicaid coverage as part of the medical care reform that happened about seven, eight years ago, and there are some states that didn’t expand the Medicaid, and then that situation translated into whether lung cancer screening was easy to get started in hospitals in that state. So there are some regions of the country, and a lot of them are in the South as well as the Western U.S., where if you want to get lung cancer screening, you may have to travel more than 30 miles or even more than 50 miles in order to get lung cancer screening.

There’s lots of activists and patient advocacy groups that are working to try and fix that problem so that anyone could have access to lung cancer screening within a reasonable distance of where they live, but there’s a lot of barriers. Similarly, there are barriers to getting genetic testing performed. We know that doing genetic testing on a lung cancer, it can be really helpful, especially if you have adenocarcinoma, the most common type of lung cancer, getting genetic testing done to see if there are targeted therapies that can be used to treat the cancer is a really important step in the diagnosis, but not all patients are having that done. And as you might imagine, there’s disparities, racial disparities in who’s getting these tests ordered and who is not having that testing done. And so it is important. My activation tip for patients would be to be sure to ask your doctor if genetic testing has been performed on your cancer, and if not, can it be performed? It’s not always the right answer, depends on the type of cancer that you have and the stage, but if you have adenocarcinoma and an advanced cancer, like stage III or stage IV, it is the standard to get genetic testing and that should be something that can be done. 


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Expert Advice for Creating an Optimized Lung Cancer Treatment Plan

Expert Advice for Creating an Optimized Lung Cancer Treatment Plan from Patient Empowerment Network on Vimeo.

What lung cancer treatment factors are considered in creating a treatment plan? Dr. Lecia Sequist explains factors that play a role in an optimized treatment plan and advice to patients to help ensure their best care.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…bring someone with you when you go to the oncologist office. It’s always best to have another pair of ears listening to the information that’s being presented to you, but also to get another viewpoint about how is this treatment going to work in your life, how are we going to be able to get back and forth to the appointments? Are there other options, are there other satellite sites that the hospital might have that are easier for you to get to?”

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Transcript:

Lisa Hatfield: 

Dr. Sequist, I know there are many factors that go into developing a treatment plan for patients. How do you work with your patients to develop the best treatment plan for an individual patient?

Dr. Lecia Sequist:

That’s a great question. It really is different for every patient. But I think the general steps are for me to make sure that I understand the complete picture about the patient’s cancer. And that usually means a biopsy, several types of radiology scans. Genetic testing of the tumor is often done for lung cancer. And then I definitely talk to my colleagues who give different types of treatment. So I give drug treatments. I’m a medical oncologist. But I work with colleagues who are surgeons and I work with colleagues who are radiation oncologists. If I have any questions about some of the data, I also ask, you know, if I’m not sure about what the scans are showing, I really, it’s important to talk to radiologists who are experts in reading those scans so that we really make sure there’s no gray areas, we understand what’s happening. If I have questions about the biopsy, I talk with the pathologists. So on my end I have to talk to a lot of different colleagues to make sure that I understand the patient’s situation when it comes to their cancer. But it’s also really important to understand the patient’s situation when it comes to their life.

So for that, the patient is the expert and it’s really important for me to understand where they live, who do they live with, what are the things that are challenging for them at home? For example, do they have a lot of stairs to go up and they’re having trouble breathing, or do they live really far from public transportation and they don’t have a car, what are the…they might work certain days or certain hours, or they have childcare responsibilities on certain days or certain hours. So I need to have an understanding of what their life is like too, so that we can figure out what’s the best treatment that will fit into their life, and if it’s goin to not fit so nicely into their current daily routine, how can we help them temporarily change their daily routine so that they can get through the cancer treatment.

All these things are really important. And so if there’s other experts on the patient’s side too, like family members or caregivers, those…it’s really important to engage all these different people to come together to find the best plan for that patient. So my activation tip for this question is to bring someone with you when you go to the oncologist office. It’s always best to have another pair of ears listening to the information that’s being presented to you, but also to get another viewpoint about how is this treatment going to work in your life, how are we going to be able to get back and forth to the appointments? Are there other options, are there other satellite sites that the hospital might have that are easier for you to get to?

Do they have weekend hours? If weekends are easier for you to go for some treatments or tests. There are lots of different things that are out there, and it’s hard for any one person to think of all the questions. So if you bring someone with you, it’s always helpful. 


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Exciting Lung Cancer Data and Studies: A Look at Neoadjuvant Treatment

Exciting Lung Cancer Data and Studies: A Look At Neoadjuvant Treatment from Patient Empowerment Network on Vimeo.

What are new developments in lung cancer treatment? Dr. Lecia Sequist shares some new ways of sequencing treatments that have shown success, benefits of clinical trial participation, and advice for patients for empowered care. 

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…if surgery has been recommended to you for lung cancer, to ask if you should be getting any treatment before the surgery, because that’s what a lot of the newer studies are looking at.”

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Transcript:

Lisa Hatfield:

All right, Dr. Sequist, we know that the abstracts for ASCO, which is coming up in a couple months, are not published yet, but what lung cancer data or studies are coming out of major medical conferences like ASCO or there is one coming up in Florida also, but what studies are coming out that you are the most excited about?

Dr. Lecia Sequist:

I think one of the areas that’s changing the most in lung cancer recently has to do with what’s called neoadjuvant treatment. And that just means treatment that’s given before a surgery. Historically, if a lung cancer was of a size, in a location where surgery was feasible, from a technical standpoint, it was often recommended. And sometimes the cancer might have spread to the lymph nodes or maybe it spread to another part of the body and surgery wasn’t able to be done. And it was kind of just a yes/no. Yes, we can do surgery or no, it doesn’t look like we can do surgery. And that line has gotten a little bit more blurry lately, because now multiple studies are coming out showing that you can actually give treatment like drug treatments such as chemotherapy and immune therapy before surgery is done. And sometimes that can really improve the outcome of the surgery or can improve the outcome for the patient of not having a cancer come back in the future.

And so now when someone’s newly diagnosed with lung cancer, it’s not so much just a yes no. Are we going to surgery? Yes or no? A lot of times it’s more complicated based on the newer data. Is surgery an option ever? Maybe we should try some drug treatment first and surgery might be something that we can do later. It really still depends on the…every patient has a unique situation so it’s hard to paint with a broad brush. But one of the areas that’s changing the most is around surgery, around who should have surgery and should they have treatments before or after the surgery that can help the surgery work better. So my activation tip for this question is that if surgery has been recommended to you for lung cancer, to ask if you should be getting any treatment before the surgery, because that’s what a lot of the newer studies are looking at.

And to ask if there’s any research studies that you can be part of. Because the way that these advances happen is research studies are done on patients that would like to participate in research. Participating in research, I think there’s a lot of confusion around what that means. And one of the most common things I hear patients say is, “Well, I don’t want to be a lab rat.” And I can assure you that if it’s gotten to the point of a clinical trial, it’s been very well-thought about, very well-designed with your safety, you as a patient, your safety in mind, and also that you would be completely informed about what you’re saying, what you’re getting involved in. So you’re not just throwing yourself up to be a lab rat.  But if you’re interested in a research trial, your doctor can talk to you about what that would involve, how it would be different than not being in a research study. And it may be a way for you to be able to access the treatment of tomorrow today. 


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What Patients Are Candidates for Immunotherapy in Lung Cancer Care?

What Patients Are Candidates for Immunotherapy in Lung Cancer Care? from Patient Empowerment Network on Vimeo.

What is the role for immunotherapy in lung cancer care? Dr. Lecia Sequist explains how immunotherapy works against lung cancer and other medical conditions that may increase risk for immunotherapy as treatment for certain patients.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…talk to your doctor about whether immune therapy is a possibility for treating your cancer. And if not, just ask why not. There are lots of good reasons why it may not be recommended, but just make sure that it’s been thought about and about whether it should be part of your treatment plan or not.”

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Transcript:

Lisa Hatfield:

Dr. Sequist, is there a role for immunotherapy in lung cancer especially for newly diagnosed patients, or is that done more after a recurrence of lung cancer?

Dr. Lecia Sequist:

Yeah. There’s a big role for immunotherapy in lung cancer. Immunotherapy is a broad term. A lot of different drugs could fall into the category of being immune types of drugs. But in general, what this whole category of treatments is trying to do is to teach your body’s own immune system how to recognize the cancer and then be able to attack it. A lot of times when cancer develops, one of the ways that it’s been able to even go from one cell to a tumor that is visible or causing problems is that it’s been able to evade the immune system or sort of hide from your body’s immune system and pretend like it’s not there. And these newer immune treatments, they work in different ways. But essentially what they have in common is that they can rip off the camouflage, they can kind of expose the cancer to the immune system so that the immune system sees the cancer and starts attacking it like it should.

So there are lots of different ways that we can try to stimulate the immune system. And these drugs have gone in a short period of time from being something that was experimental and only given after everything else had failed, to now being given as soon as patients are diagnosed with lung cancer or even after a surgery. If a small tumor is taken out, sometimes we give immune therapy after a surgery or we give immunotherapy before a surgery in anticipation of it being taken out, trying to make the surgery easier or the results of the surgery even better. So immunotherapy has really changed a whole landscape of how lung cancer is treated, but immune therapy is not for everybody. So I know sometimes you might be reading on the Internet about a patient who had a really wonderful outcome with immunotherapy and you think, of course you think, well I want that drug, I want that outcome.

But there are some types of lung cancer that it doesn’t work well for. And there are some patients who might have a medical condition where the immune therapy could actually be dangerous for them. So there are a number of exceptions and not everybody should receive immune therapy. It depends on the type of cancer you have, the markers on the cancer, but also your medical background. And if you’ve had some medical conditions where the immune system is really active. Examples might be rheumatoid arthritis or Crohn’s disease, psoriasis. These are some of the common ones. But there’s a lot of different diseases that you might have had before you even had cancer where the immune treatment might be very risky for you or dangerous. So my activation tip is to talk to your doctor about whether immune therapy is a possibility for treating your cancer. And if not, just ask why not. There are lots of good reasons why it may not be recommended, but just make sure that it’s been thought about and about whether it should be part of your treatment plan or not. 


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Can Vaccines Play a Role in Preventing or Helping to Treat Lung Cancer?

Can Vaccines Play a Role in Preventing or Helping to Treat Lung Cancer? from Patient Empowerment Network on Vimeo.

What’s the latest in lung cancer research and treatment updates? Expert Dr. Lecia Sequist shares information about emerging research currently under study, new treatments that have shown success, and her perspective about second opinions for patient care.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…ask your doctor if they think a second opinion could be helpful.”

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Transcript:

Lisa Hatfield.

Dr. Sequist, fortunately, the lung cancer arsenal keeps expanding. What promising treatments do you see on the horizon or that are newly available to lung cancer patients?

Dr. Lecia Sequist:

Yeah. The field is changing so fast, it almost makes your head spin. And I think it’s wonderful that there are so many options. It’s actually been a challenge for the doctors to keep on top of the latest treatments, because they’ve been coming out so fast, especially over the last five years. 

And some of the things that I’m personally excited about in lung cancer is that there may soon be an opportunity to think about vaccines that could help prevent or could help treat lung cancers. That’s something that scientists are working on that aren’t available, but it does look like it’s realistic, that it could happen. Some of the technologies that helped develop, for example, the COVID vaccine in such a short period of time might be available to personalize treatment against an individual’s tumor. So my vaccine, if I got cancer, could be different than your vaccine if you got cancer, because they’re kind of personalized.

There’s also a new type of treatment called antibody drug conjugates, which are a smarter way of delivering chemotherapy. We’ve always just given chemotherapy to the whole body, usually through a vein, through an intravenous in the arm, and it drips in and it circulates around with the bloodstream. And the good thing about that is that it can go everywhere. So if there’s a cancer cell that’s hiding somewhere too small to be seen on the scan, the chemotherapy can get there. But it does, there’s a lot of collateral damage from toxicities from delivering chemo where there is no cancer. And with these antibody drug conjugates, the idea is that there’s an antibody in the front that’s honing into some kind of target on the cancer cell. And it still goes in through the IV, but when it reaches a cancer cell and attaches, then the backend sort of drops a bomb, which is a chemotherapy on that area.

So instead of the chemo being given to the whole body, every time the front end of this thing hits cancer cells, it engages and that triggers the backend, which is the chemotherapy kind of bomb to be dropped. So there are a lot of these types of drugs where it’s more like targeted delivery of chemo. Some of them have already been approved for cancers like breast cancer, but we don’t have an approved antibody drug conjugate in lung cancer yet. But there are a couple that are moving towards potential FDA approval. So I think given how complicated the new treatments are, my activation tip for patients would be to ask your doctor if they think a second opinion could be helpful. And I think a lot of patients feel that that might be rude or their doctor might not react in a positive way to them saying, do you think I should get a second opinion?

But as a physician, I can tell you that it’s not taken that way by most doctors. And in fact, a lot of oncologists will even suggest to their patients, you know, “Hey, this is a complicated area. I would love to get input from my colleague. I’m going to  send you to a city nearby for a second opinion.” We all rely on our colleagues a lot, and not everybody can know everything about every cancer, especially with how quickly things are changing. So second opinions are not a sign that you don’t trust your doctor or you don’t like your doctor. It’s just a sign that you really want more input. The more minds, the more brains that are thinking about your cancer, the better. And don’t be afraid to ask your doctor if they think a second opinion could be helpful for your case. 


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Can Artificial Intelligence and Machine Learning Help Advance Screening for Lung Cancer?

Can Artificial Intelligence and Machine Learning Help Advance Screening for Lung Cancer? from Patient Empowerment Network on Vimeo.

How will lung cancer personalized medicine be improved with advanced technologies? Expert Dr. Lecia Sequist explains how artificial intelligence and machine learning help advance screening for lung cancer and shares advice for patients.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“… if you are 50 and you have smoked in the past, I would urge you to talk to your doctor about whether you can access lung cancer screening. But if you’re younger or you haven’t smoked in the past, you can’t access lung cancer screening right now. And we’re hoping to change that with AI that can really help figure out who is at risk of this disease.”

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What Are the Noted Disparities in Lung Cancer Screening and Access


Transcript:

Lisa Hatfield:

Dr. Sequist, technology is advancing at such a fast pace, and we’re hearing words like artificial intelligence and machine learning. And I just read an article about a team that you’ve been working with that is developing or has developed an AI model that can detect future lung cancer risk. I believe it’s based on CT scans. Can you speak to that a little bit more and also talk a little bit more about where you see this AI technology taking cancer research and predicting cancer and also any challenges that we might face with AI and machine learning in healthcare?

Dr. Lecia Sequist:

Yeah. AI seems to be everywhere. You turn on the news or you look at your phone, and it’s talking about AI. And some of it seems scary, and Hollywood doesn’t help because there’s lots of movies about computers or robots kind of taking over the human race. And I think we have to separate Hollywood from real life. Artificial intelligence or machine learning, it’s a very general term. It can mean a lot of different things depending on what the context is. But it’s basically just a tool for understanding patterns. And we all understand patterns in our own life or our own house. I personally know that my dog is going to want to, as soon as we wake up in the morning, is going to want to go outside and then is going to want to have some food, and there are different patterns that you know in your daily life that you recognize, and you can anticipate what’s going to happen next.

AI is a tool that helps us anticipate what’s going to happen next for patterns that are way more complex than, yeah, your dog’s going to want to go outside and eat some food. So computers can sometimes pick up patterns that the human brain can’t really pick up, because they’re just too complicated. And that’s what we’ve found in our research. One of the vaccine things about lung cancer and trying to figure out how we can prevent lung cancer or find it at the earliest stage when it’s most curable is that it’s very hard to know who’s at risk. We know that lung cancer is one of the most common cancers out there, but knowing who is truly at risk and separating one person from the next is not so simple.

In the past, it’s mainly been, you know, determined by whether or not you ever smoke cigarettes. And it’s true that cigarette smoking is one risk factor for lung cancer, but it’s not the only one. And we don’t fully understand what all the risk factors might be, but we know that there are people who have smoked a lot in their life and never get lung cancer. And on the flip side, we know that there’s people who have never smoked or who maybe quit 30, 40 years ago and will still get lung cancer. And how do we know who’s at risk? That’s what we tried to solve with our research that I worked on with my colleagues at Mass General Hospital where I work and also at MIT, Massachusetts Institute of Technology, which is just down the road from us. And so we brought together our medical knowledge and our computer knowledge and tried to come up with a way to predict for any given individual person, are they at risk for lung cancer.

By looking at their lungs and not looking at the lungs the way a human radiologist sort of says, okay, there’s the right lung, there’s the left lung, and they’re looking for things that already exist like a tumor or a mass. The computer looks at a different type of pattern that human eyes and brains can’t really recognize and has learned the pattern, because we trained the computer with thousands and tens of thousands of scans where we knew this person went on to develop cancer and this one didn’t. And the computer learned the pattern of risk. And so using an X-ray or a CAT scan to predict future risk is something a little different. In medicine, we usually use an X-ray to say, okay, what’s happening now? Why does this patient have a fever? Why is this patient bleeding? And using an X-ray or a CAT scan in this case to predict the future is kind of a new thought for doctors. But we think that it could be a really valuable tool to help us understand who’s at risk for many different kinds of diseases. We happen to look at lung cancer, but I think you could use this idea for other diseases too.

Lisa Hatfield:

So will this AI model become mainstream anytime soon if a patient wants to access that? Or is it only being used for research purposes?

Dr. Lecia Sequist:

Well, we do before we start to offer anything mainstream or as part of routine care, we really need to understand how it can be used to help patients. So we are running some clinical trials right now to try and understand, is this a tool that could be used, for example, to give someone access to lung cancer screening? Because right now, if you want to have lung cancer screening, which is a very effective screening test to try and find cancer in people who feel completely well, trying to find cancer at the earliest stage before it has spread, can we give people access to lung cancer screening by using this AI test? Right now and if you want to get lung cancer screening, you have to be 50 or older, and you have to have smoked in the past. And if that fits your, if you are 50 and you have smoked in the past, I would urge you to talk to your doctor about whether you can access lung cancer screening. But if you’re younger or you haven’t smoked in the past, you can’t access lung cancer screening right now. And we’re hoping to change that with AI that can really help figure out who is at risk of this disease.

Lisa Hatfield:

Thank you. I’m excited to see where this goes in the future. 


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What Do Lung Cancer Patients Need to Know to Build a Treatment Plan?

What Do Lung Cancer Patients Need to Know to Build a Treatment Plan? from Patient Empowerment Network on Vimeo.

What do lung cancer patients need to know about treatment options? Expert Dr. Lecia Sequist shares an overview of treatment classes for non-small cell lung cancer (NSCLC), advice for patients, and how each treatment class works against cancer.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…ask your doctor if immune therapy, targeted therapy, or chemotherapy are appropriate for your cancer. And if not, why not? There’s probably a good reason if they’re not recommending one of those things. But just make sure that you understand why you’re getting the treatment recommendation that you are.”

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Can Artificial Intelligence and Machine Learning Help Advance Screening for Lung Cancer

Can Artificial Intelligence and Machine Learning Help Advance Screening for Lung Cancer

Expert Advice for Lung Cancer Patients Considering a Clinical Trial

Expert Advice for Lung Cancer Patients Considering a Clinical Trial


Transcript:

Lisa Hatfield:

Okay. Dr. Sequist, what are the different treatment options for lung cancer?

Dr. Lecia Sequist: 

That’s a really important question. And there are so many treatment options. But I think a way that I often explain it to my patients is sort of thinking in broad strokes and categories. So one way to think of it is there’s three main types of doctors, types of specialists that treat lung cancer. And they each have their own type of treatment that they offer. So there are medical oncologists like myself, who give drugs or different medical treatments. Some of them come in pills, some of them come in intravenous infusions, but they’re all medications. Then there are radiation oncologists who give radiation, which is strong, but invisible X-ray beams that are focused at the cancer to try and kill the cancer cells that way. And then there are surgeons who, that’s some of the most, that’s the one that people usually can understand the easiest.

They’re going to cut out a cancer surgically. And so together, the surgeon, the radiation oncologist and the medical oncologist will work together to come up with the best treatment plan for each patient. Now within my field, which is medical oncology, again, we have lots of different types of medicines that we can give for lung cancer, but most of them fall into three main buckets or types. So one of them is traditional chemotherapy. Chemotherapy drugs, there’s a whole bunch in this bucket. There’s a lot of different chemotherapy drugs. But what they all have in common is that they’re trying to kill dividing cells. They’re counting on the fact that maybe the cancer cells in the body are dividing more often than the healthy cells. And so if it goes in there and kills all the dividing cells, you’re going to kill more cancer than healthy cells.

The second type of treatment that medical oncologists give lung cancer patients is targeted therapy. These are drugs that go after some kind of target or flag or marker on the cancer cell. So a lot of times the oncology team will want to test the cancer to see what markers exist, and then if they have a treatment that goes after those markers, that’s called targeted therapy where you’re giving someone a treatment because of the markers that are seen in their cancer. A lot of those markers are found in genetic testing, but some are found through other types of testing. And then the third bucket of cancer drug treatments is called immunotherapy. And these are treatments that are trying to convince the body’s own immune system to fight the cancer. We’re supposed to be fighting things that are foreign to our body, like infections or bacteria and cancers. But sometimes when a cancer is developed, it’s tricked the immune system into ignoring it.

And so what we try to do with immunotherapy is wake up the immune system, explain what the trick is and say, hey, this is the foreign thing that you’re supposed to go after and try and kill. And so depending on the type of cancer that someone has, where it is in their body, what markers are on the tumor, then your doctors can come up with what they think is the most aggressive or likely to work combination of radiation or chemo or drug treatments that might, that might include traditional chemotherapy or targeted therapy or immunotherapy.

So my activation tip for this question would be to ask your doctor if immune therapy, targeted therapy, or chemotherapy are appropriate for your cancer. And if not, why not? There’s probably a good reason if they’re not recommending one of those things. But just make sure that you understand why you’re getting the treatment recommendation that you are. 


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