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Immunotherapy Drug Is Providing Exciting Results in the Treatment of Lung Cancers

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Alex was in his early 40s when he was diagnosed with Stage 4 Lung Cancer. A non-smoking, healthy man, who exercises regularly and eats relatively well is not who most people think of when they think of lung cancer.  However, people exactly like Alex are the new faces of lung cancer diagnoses. Alex is also one of a select few who qualified for a new targeted therapy drug recently approved by the FDA.

Lung cancer is the leading cause of cancer death globally, causing 1.7 million deaths a year. In the United States, it is expected to kill more than 154,000 people in 2018, but recent studies are producing credible progress in finding new drugs that, when combined with more traditional chemotherapy, are greatly improving the survival rates among lung cancer patients. The findings are dramatically changing the way physicians are treating lung cancers. “What it suggests is that chemotherapy alone is no longer a standard of care,” said Dr. Leena Gandhi, a leader of the study and director of the Thoracic Medical Oncology Program at the Perlmutter Cancer Center at New York University Langone Health.

So far, four drugs called checkpoint inhibitors, which unleash the patient’s own immune system to kill malignant cells, have been approved by the FDA. “I’ve been treating lung cancer for 25 years now, and I’ve never seen such a big paradigm shift as we’re seeing with immunotherapy,” said Dr. Roy Herbst, Chief of Medical Oncology at the Yale Cancer Center.

In the trial, patients with metastatic nonsquamous non-small cell lung cancer (NSCLC) who received the drug pembrolizumab (Keytruda) plus chemotherapy had improved overall survival and progression-free survival compared with just chemotherapy alone.  The results from the KEYNOTE-189 clinical trial were presented at the annual meeting of the American Association for Cancer Research (AACR) in Chicago on April 16 and published concurrently in the New England Journal of Medicine.

One of the main factors in the high rate of death due to lung cancer is that the disease is most often undetected until it has spread to other organs of the body. Lung cancer is the second most prevalent form of cancer in men and women and the top cancer killer among both sexes. In addition to the encouraging results from immunotherapy drugs, a newly discovered protein is showing promising results in detecting lung cancer earlier, providing new advanced treatment options to patients at the earliest stages of the disease. “The use of CKAP4 as a biomarker could change current practices regarding the treatment of lung cancer patients, and the diagnostic accuracies may be markedly improved by the combination of CKAP4 and conventional markers,” says Yuichi Sato, Division of Molecular Diagnostics, Kitasato University.

While the news of earlier discovery and new treatment options is very good, reducing risk factors for the disease remains the best approach to avoiding cancer. Exposure to tobacco smoke is one of the leading causes of lung cancer. Smoking marijuana and using electronic cigarettes may also increase the risk of lung cancer, but the actual risk is unknown. People who work with asbestos in a job such as shipbuilding, asbestos mining, insulation, or automotive brake repair and who smoke have a higher risk of developing cancer of the lungs. Exposure to radon has been associated with an increased risk of some types of cancer, including lung cancer. Having your home tested for the presence of Radon is a good and economical method for reducing the risk. Some people also have a genetic predisposition for lung cancer. People with parents, brothers, or sisters with lung cancer could have a higher risk of developing the cancer themselves.

Understanding cancer and how to treat it is constantly evolving toward the day when a cure is discovered. The cure is not here yet, but treatment options have greatly improved in recent decades. The treatments and methods used in clinical trials are promising in every environment in which they are tested. For more information on advancements in cancer detection and treatment, visit http://gettysburgcancercenter.com/.

Finding New Solutions in the Fight Against Cancer Through Research

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While the most overt cancer research news usually comes from efforts to derail the progression of the deadly disease, research into the development of alternative pathways to finding an ultimate solution to cancer often go unnoticed or fail to receive the same level of notice among the public. Advances are being made in new techniques to improve the effectiveness of traditional treatment protocols, the utilization of non-traditional or culturally specific treatment methods or identifying dietary or physical behaviors that may lead to increasing or decreasing the risk factors associated with cancer.

An innovative new treatment for an aggressive form of blood cancer has been approved by the U.S. Food and Drug Administration. According to Mounzer Agha, Director of the Mario Lemiuex Center for Blood Cancers at Hillman Cancer Center, the cell based therapy produced a 51 percent remission rate among patients with a strain of lymphoma that didn’t respond well to traditional chemotherapy or radiation. “There was no treatment that could possibly put them into remission, so to get a 50 percent remission rate with this kind of treatment is a major accomplishment,” Agha said. This is a breakthrough for patients and physicians, according to Agha. The treatment is customized to each individual’s immune system. “This type of therapy represents a paradigm shift in the treatment of blood cancer and it will completely change the landscape of how we approach and treat blood cancers in the future,” he said.

In oriental medicine, treatment using acupuncture needles has been commonly practiced for thousands of years in the fields of treating musculoskeletal disorders, pain relief, and addiction relief. Recently, it has emerged as a promising treatment for brain diseases, gastrointestinal disorders, nausea, and vomiting, and studies are under way to use acupuncture to treat severe diseases. A research team lead by Professor Su-Il In, through joint research with Dr. Eunjoo Kim of Companion Diagnostics & Medical Technology Research Group at DGIST and Professor Bong-Hyo Lee’s research team from the College of Oriental Medicine at Daegu Haany University, has published a study showing that the molecular biologic indicators related to anticancer effects are changed only by the treatment of acupuncture. The research was published in the online edition of Scientific Reports, the sister journal of the globally renowned academic journal Nature. Professor Su-Il In said, “This research, which combines nanotechnology and oriental medicine technology, is a scientific study that shows the possibility of using acupuncture as a method to treat severe diseases such as cancer.”

For decades researchers have known that dietary issues can often be a factor in the incidence of cancer. In a paper published in the journal Nature Communications, researchers from VIB, a life sciences research institute, and Vrije University in Brussels found that a compound in sugar stimulates aggressive cancer cells and helps them to grow faster. Led by Johan Thevelein, a microbiologist with VIB, this research builds on what scientists already knew about the Warburg effect, where cancer cells rapidly break down sugar for energy and to fuel for further growth. While the research identifies a link between sugar and the aggressiveness of cancer cells, it doesn’t mean that eliminating sugar from one’s diet will eliminate the likelihood of getting cancer. “We have no evidence of this effect happens in healthy people,” Thevelein says, but “Reducing sugar intake during cancer treatment might help the system to overcome the cancer and it might facilitate the action of chemotherapy because it’s difficult to kill the cancer cells if they’re always activated [by sugar],” he says. “Providing sugar to cancer cells carries a greater risk of stimulating their aggressiveness.”

In Queensland, Australia scientist Georgia Chenevix-Trench has uncovered an additional 72 genetic markers that can indicate an increased likelihood that a patient may be more susceptible to getting cancer in their lifetime.  The discovery may lead to the development of a more definitive predictive test for breast cancer in women.

While most of us hope for quick and all-encompassing cure for cancer, the complexity and the infinite variety of cancer types indicate that a single solution is more than unlikely. The ultimate solutions will come from a combination a multitude of treatments and advances in early prediction and detection.

Gettysburg Cancer Center is actively involved with a consortium of doctors offering clinical trials for patients seeking alternative solutions and therapies.  For more information on the current clinical trials available, visit http://gettysburgcancercenter.com/patients/clinical-trials/.

Gene Therapy. A New Frontier in Medical Innovation

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Cancer is a disease that is experienced by young and old and by every economic and social segment of the world populace. At some point in everyone’s life, cancer will affect us individually, a member of our family or one or many of our friends and acquaintances. The American Cancer Society projects there will be 1,688,780 new cancer patients and 600,920 deaths due to cancer in 2017, for a disease that does not discriminate by race or national origin.

Cancer is where abnormal cell growths form in the body and interfere with normal, healthy body functions. Not new to the world stage, cancer dates back to ancient times. Today, after millennials of research and discovery, new treatments for a vast array of cancer types are being studied, many with promising results.  One such new treatment called chimeric antigen receptor T-cell therapy (CAR-T) involves taking samples of T-immune cells called T-cells from a patient, genetically engineering them, and putting them back in to fight the cancer. Co-developed with the drug giant Novartis, the therapy, CAR-T, genetically alters a patient’s own immune cells to target and destroy cancer cells.

“We’re entering a new frontier in medical innovation with the ability to reprogram a patient’s own cells to attack a deadly cancer,” said FDA Commissioner Dr. Scott Gottlieb. The process takes about 22 days and begins with the extraction of a patients T cells, exposing them to the vector which genetically transforms them. They’re then expanded and frozen for shipment back to the patient. During the out-of-body processing of the cells, the patient receives chemotherapy to wipe out any remaining T cells to avoid interference with the, soon to be, newly implanted cells.

“This is a major advance, and is ushering in a new era,” said Malcolm Smith, a pediatric oncologist at the National Institutes of Health. The treatment appears to strengthen a patient’s immune system allowing their own body to fight the cancer. The treatment is recommended for cancer patients who have run out of options for traditional therapy. The new therapy is only currently available for patients 25 years or younger. Thus far, 83 percent of patients are experiencing positive survival results.

While overtly touting the success of gene therapy, researchers are tempering their enthusiasm after experiencing some significant life threatening side effects in 47 percent of the studies participants. These side effects have resulted in brain swelling and deaths, casting a shadow over the field. Seizures and hallucinations were also relatively common, but temporary. Though concerning, the side effects have been successfully managed with drugs. Quality control and how to standardize the potency and purity of living cells extracted from each patient are also a concern. Because of the risks, the treatment is only currently available at 20 US hospitals. The individualized nature and relatively small patient population both drive up the cost of the treatment for now.

“This is a big paradigm shift, using this living drug,” says Dr. Kevin Curran, a pediatric oncologist at Memorial Sloan Kettering Cancer Center that will soon be offering the treatment. “It will provide a lot of hope. This is the beginning.”

“The approval of CAR T-cell therapy for pediatric leukemia marks an important shift in the blood cancer treatment paradigm,” says the American Society of Hematology. “We now have proof that it is possible to eradicate cancer by harnessing the power of a patient’s own immune system. This is a potentially curative therapy in patients whose leukemia is unresponsive to other treatments and represents the latest milestone in the shift away from chemotherapy toward precision medicine. Today’s approval is the result of over a decade of hematology research, including research funded by the National Institutions of Health (NIH).”

The Best in Cancer Care Across the Community

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Healthcare and access to quality healthcare is a critical issue for individuals whether healthy or recently diagnosed with a life-threatening illness.  Most patients have experienced a private medical practice being merged into a large healthcare system and often don’t understand how that will impact their care.

While large specialized health centers can promise to offer the most advanced techniques, facilities and methods, they are usually located in large urban centers, often miles and driving hours from the patient’s home, requiring long and physically taxing commutes for frequent treatments. Although staffed with caring and competent professionals these mega centers can often feel overly clinical and crowded, giving the patient a sense of being just another number among many.

The best and most advanced treatment and care is becoming less centralized, allowing for advanced specialized care to be available within the patient’s own community, providing ease of care access and reducing the personal stresses often accompanying cancer therapy.

Gettysburg Cancer Center (GCC) has been a leader in Oncology Care in the Adams County region since 1989. For more than 25 years, the highly regarded and vastly experienced medical specialists have been committed to providing cancer care in a community-based setting close to their patient’s home. The all-encompassing oncology and hematology programs provide a complete range of diagnosis, treatment, and follow-up care in an environment that recognizes the importance of treating not only the disease but the individual person behind the disease.

With Medical Oncology, Radiation Oncology, Diagnostic Imaging, access to the latest clinical trials as well as an onsite laboratory and pharmacy, Gettysburg Cancer Center truly offers comprehensive cancer care. Their compassionate and experienced staff takes pride in providing the best possible care and personal assistance to their patients and their patient’s families. Dr. Satish Shah, Principle Medical Oncologist and Hematologist at GCC says, “Our mission is to provide individualized treatment, utilizing the best technical approach.  We focus on providing the best treatment in the right environment so that our patients can focus on getting better.”

To learn more about how GCC’s is helping their cancer patients, click on http://gettysburgcancercenter.com/about-us/testimonials/.

Cancer Research: Not Always an Exact Science

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It is the question most frequently asked of doctors by patients who have just received a diagnosis of cancer, “Why me?” It is usually asked by those who thought they were living a healthy lifestyle and had little expectation of receiving the devastating news. Others may have been aware of near or distant family members who had a form of cancer.

While much progress has been made in the effort to understand multiple forms of cancer and the development of effective treatments, the answer to why some people get the disease and others do not remains predominately an elusive mystery. Cancer is known to be caused by changes, or mutations, to the DNA within cells that can cause the cell to stop its normal function and may allow a cell to become cancerous. Some faulty genes that increase the risk of cancer, known as inherited cancer genes, and genes that increase the risk of cancer called cancer susceptibility genes can be passed on from parent to child. But most of genetic mutations appear to occur after birth and aren’t inherited.

Environmental influences such as smoking, radiation, viruses, persistent exposure to cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise has been proven to provide a more definitive answer to the “Why Me?”. Even with this accepted knowledge, some people who share one or more of these environment factors appear to avoid a cancer diagnosis altogether.

Why do some cancers spread and kill patients, while many remain docile?  Seeking the answer to this question has researchers redirecting their approach for answers from why some get cancer to why so many do not. Ruslan Medzhitov, an Immunobiologist at Yale, says “You can inject the same virus into different hosts and get vastly different responses.”

Diagnosis and treatment becomes art and science. Researchers continue to develop and identify predictive tests based on gene mutations and patterns of gene regulation.  These tests assist in targeting the right therapies and treatments for each patient.  Research related to the micro-environments in which the cancer lives and spreads will provide beneficial to the prevention and early detection of cancer.

The field of oncology remains focused on a holistic approach factoring in the environment, genetic factors, and physiology, in the hopes of finding a concrete, science based answer to the “Why Me?”

To learn more about the clinical trials and research that Gettysburg Cancer Center offers its patients, click here.

Great Promise Lies Ahead for New Lifesaving Technologies

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Research into the effectiveness of stem cell and immunotherapy treatments for a wide range of chronic diseases is producing optimistic, if not yet proven, results. According to the California Institute for Regenerative Medicine, “there’s no limit to the types of diseases that could be treated with stem cell research. Given that researchers may be able to study all cell types via embryonic stem cells, they have the potential to make breakthroughs in any disease.” In recent year’s stem cell-based therapies have been initiated but the results of those trials may take several years of testing and study to render the treatments safe and effective.

Physicians at Emory Orthopedics & Spine Center in Atlanta are among a select group of physicians around the country to offer Stem Cell therapy and other regenerative medical therapies for the relief of osteoarthritis (OA) pain and chronic tendonitis. The non-surgical procedure uses the patient’s own stem cells taken from the body and injected into the effected joint or tendon to repair damaged tissue. Osteoarthritis is the most common form of arthritis in the U.S., affecting nearly 27 million adults. At other medical centers around the country, skin stem cells have been used to grow skin grafts for patients with severe burns on very large areas of the body. Only a few clinical centers are able to carry out this treatment and it is usually reserved for patients with life-threatening burns. In Europe a new stem-cell-based treatment to repair damage to the cornea after an injury like a chemical burn, has received conditional marketing approval.

Blood-forming stem cells in the bone marrow were the first stem cells to be identified. This life-saving technique has helped thousand’s  worldwide who had been suffering from blood cancers, such as leukemia. In addition to their current use in cancer treatments, research suggests that bone marrow transplants will be useful in treating autoimmune diseases and in helping people tolerate transplanted organs.

Autologous, stem cells harvested from the same person who will get the transplant, and Allogeneic stem cells that come from a matched related or unrelated donor are the two main types of treatments currently approved for use. Combined with very high doses of chemotherapy, and often radiation therapy, the combined treatment has been shown to kill cancer cells in the patient’s bone marrow. Given by transfusion, the transplanted stem cells replace those that were destroyed. This application is among the most widely used stem cell treatment used to treat diseases and conditions of the blood and immune system.

In England, researchers have made exciting new findings that could offer a means of fighting resistance to treatment for people with esophageal cancer. Resistance to radiotherapy is a major stumbling block in the treatment of this cancer. The team of scientists, which incorporated specialists from Trinity, St. James’s Hospital Dublin, the Coombe Women and Infant’s University Hospital and the University of Hull in the UK, have published their significant findings in the international peer-reviewed journal Oncotarget. “This work is extremely important in understanding why tumors are inherently resistant to radiotherapy, and how they can acquire resistance. Our findings strongly suggest that it is the cancer stem cell population that we need to destroy if treatment is going to be effective in our esophageal cancer patients,” said Dr Maher.

Doctors in London say they have cured two babies of leukemia in the world’s first attempt to treat cancer with genetically engineered immune cells from a donor. The experiments, which took place at London’s Great Ormond Street Hospital, raise the possibility of off-the-shelf cellular therapy using inexpensive supplies of universal cells that could be dripped into patients’ veins on a moment’s notice. The infants, ages 11 and 16 months, each had leukemia and had undergone previous treatments that failed, according to a description of their cases published in Science Translational Medicine. Waseem Qasim, a physician and gene-therapy expert who led the tests, reported that both children remain in remission.

In the United States, China and around the world, scientists are racing to apply gene editing, stem cell and other immunotherapy treatments to provide improved treatments for cancer and other diseases. Utilizing the current path to approval it will be years before the new discoveries become commonplace, but the research must continue to advance if we are to realize the benefits of new lifesaving technologies.