We need to change thinking about lung cancer

One of its subtypes, NDRP ALK+, doesn't fit in with our idea of lung cancer, as it's a crappy disease for non-smokers, young people and usually women. Detection of ALK mutations is a bad prognostic factor, characterized by a high risk of metastasis to the central nervous system. CNS metastasis occurs in nearly 40 percent of patients at the time of diagnosis. The cancer that develops in the brain causes pressure that impairs vision, mental performance, walking problems, headaches, nausea and changes the patient's personality. For the family and loved ones, this is especially difficult. - They feel they are losing the person they love, suddenly there is a stranger in the house, often aggressive," explains Margaret Maksymowicz, a patient and founder of the Lung Cancer Group on Facebook.

Optimal treatment

Prof. Pawel Krawczyk, head of the Immunology and Genetics Laboratory of the Department of Pneumology, Oncology and Allergology at the Medical University of Lublin, recalled that before the advent of inhibitors, lung cancer with ALK mutation was one of the worst prognosis subtypes. In the B.6 drug program, effective second-generation ALK inhibitors are available in the first line of treatment. In line II are the latest third-generation inhibitors. These have a remarkable ability to penetrate the CNS. International recommendations call for the use of Generation III inhibitors as early as in Line I. - In the case of a third-generation inhibitor in the first line, the reduction in the risk of metastasis is up to 90 percent," says Prof. Dariusz Kowalski, president of the Polish Lung Cancer Group and head of the Behavioral Unit of the Lung and Chest Cancer Clinic at the National Cancer Institute-State Research Institute in Warsaw. In addition, the response to the third-generation drug lasts longer.

Change in thinking

A straightforward patient pathway - from education to diagnosis to treatment - is the key to a good quality of life for the patient. In lung cancer, diagnosis is key. Failure to test for ALK, according to experts, can be considered a malpractice. Another problem is the circulation of collected material - These procedures can take from three months to as long as six months - such curios situations are cited by Prof. Pawel Krawczyk. Hopefully, the National Oncology Network will soon correct these shortcomings of the system. We can already change the thinking about lung cancer today. - The doctor must explain to the patient that we have different types of lung cancer and that today it is becoming a chronic disease," says Mariola Kosowicz, MD, head of the Psychooncology Outpatient Clinic at the National Cancer Institute-State Research Institute in Warsaw.