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Wednesday, May 25, 2005 | ||
Living with lung cancerJennings struggle brings old issue back to limelight By Patricia Anstett ABC anchorman Peter Jennings announcement that he was diagnosed with lung cancer underscores the hopes and obstacles that surround the nations leading cancer killer. Lung cancer too often is found late, when it is no longer curable. Statements that Jennings would undergo chemotherapy instead of surgery or radiation, which typically are performed first to remove or shrink tumors, and a decline in Jennings health and voice indicate that he most likely has metastatic lung cancer the most advanced kind, specialists say. Jennings has not disclosed the extent of his cancer. Fewer than one in five people are alive five years after a lung cancer diagnosis. Still, new chemotherapy options are extending the lives of those with the most advanced tumors. And among those whose cancer is found earlier, there are more examples of people beating the odds. Just ask Edna Sanders, 70, of Detroit. She is approaching the 10th anniversary of living with lung cancer discovered in July 1995. It is one kind of non-small-cell lung cancer, the most common type. Jennings also has non-small-cell lung cancer. Sanders outlived her own daughter, who died of lung cancer in 1998, just five months after her diagnosis. Shes my superwoman, thats for sure, Dr. Antoinette Wozniak said of Sanders. Wozniak is Sanders longtime oncologist at the Barbara Ann Karmanos Cancer Institute in Detroit. Jennings treatment plan no surgery or radiation and his fatigued appearance and hoarse voice suggest he has metastatic, or stage 4, lung cancer, the most advanced kind, according to Dr. Jack Ruckdeschel, chief operating officer of the Karmanos Cancer Institute, and Dr. Gregory Kalemkerian, codirector of thoracic oncology at the University of Michigans Comprehensive Cancer Center in Ann Arbor, Mich. Not doing surgery is common, Kalemkerian said. Only 25 percent of all lung cancer patients are candidates for surgery, he said, because the tumors have advanced beyond the lungs. Thirty-five percent of lung cancer patients are diagnosed with stage 3 disease, when it has spread to lymph nodes on one or both lungs, and 40 percent have stage 4 disease, in which it has spread to another organ such as the brain. The reason for these late diagnoses is that theres no good detection test, including X-rays. A study is under way to determine the accuracy of a new detection test: spiral CT scanning, or computerized tomography. It uses a computer to improve the accuracy of images CT scans take of internal body structures. The technology is spreading, though costs range widely (from $300 to $1,000) and insurance coverage varies. We are on the cusp of some fairly significant advances in detection, Ruckdeschel said. The spiral CT and tests springing from it will be a major advance in finding this disease earlier. Recently, George Smith, 69, of Lansing, Mich., underwent a spiral CT scan at Karmanos to help his doctors plan his cancer treatment. A 40-year smoker, Smith has stage 3B non-small-cell lung cancer and does not want to have chemotherapy. He hopes to limit the spread of his cancer with vitamins and a healthy diet, he said. His brother died of lung cancer in November. Like many smokers, Smith started as a teen, stealing cigarettes from his mothers purse. In the Air Force, he often got free cigarettes from visiting American Red Cross and United Services Organization crews. He tried to stop smoking several times, but balked at the cost of stop-smoking treatments. At leading cancer programs, teams specialize in lung cancer and meet regularly to discuss cases. At Karmanos, for example, two of the five authors of the leading lung cancer textbook, Lung Cancer, Principles and Practice (Lippincott Williams & Wilkins, $199), are part of the institutes lung cancer team. They are Dr. Harvey Pass, a thoracic surgeon specializing in lung cancer, and Dr. Andrew Turrisi, a top radiation oncologist. The team also includes Ruckdeschel and Wozniak, both lung cancer chemotherapy specialists. U-M has a similar team that includes Kalemkerian, a nationally recognized lung cancer chemotherapy specialist and author of a chapter on cellular markers associated with non-small-cell lung cancer, in the Lippincott textbook. I see 300 people a year with lung cancer, and thats it, Kalemkerian said. Leading centers have early access to cutting-edge drugs being tested in clinical studies, including several that have gained federal approval in the past two or three years. They are the first generation of specifically targeted chemotherapy for lung cancer, Ruckdeschel said. Lung cancer patients have a few other drugs that work to inhibit an enzyme associated with fueling cancer growth. One is Tarceva, a pill found to extend survival several months in patients whose cancer has returned after at least one chemotherapy regimen. Kalemkerian prescribed Tarceva for Debbie Verhines, 50. The federally approved drug costs about $2,125 a month. Insurance coverage varies. In July, Verhines was diagnosed with metastatic lung cancer, even though she never smoked. Im probably one of the most boring people youd met, said Verhines. She survived ovarian cancer in 1998 only to be shocked to learn she had lung cancer. These are the cards you are dealt, she said. Every day is a gift. The biggest thing to me is my relationship with my husband, letting him know how much I care about him, and to spend more time with friends. Sanders advice to anchorman Jennings is to stay positive. Dont take to your bed, she said. The bed makes you weak. Keep moving. Dont give up. You can have a happy illness or a sad one. Sanders, who smoked for nearly 50 years, enjoys a Karmanos support group called Tough Broads. The retired Detroit neighborhood services worker takes the bus to her medical appointments, donning one of her snazzy hats to cover hair thinned by repeated chemotherapy. Im a witness, she said. You can live with this thing. | ||
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