GRACE :: Lung Cancer
Denise Brock

Denise Brock


Operations Director for GRACE, Mom to a beautiful 14 year old daughter, Velcro Australian Shepherd, 2 obnoxious but cute cats, and 1 fuzzy bunny ... and a great husband also. I came to GRACE after my best friend was diagnosed with lung cancer. She passed on July 31, 2010; she lives on in her family and friends, and in her beautiful daughter who looks more and more like her every day. We all hold her memory close. Her diagnosis was right after our trip to Italy to celebrate her 40th birthday. She stayed with us for two more years and she passed after our families returned from a boat trip to the Canadian Gulf Islands, where we made our final bittersweet memories. If she were still here today, she would be blazing the advocacy trail. This is all part of her legacy. http://www.facebook.com/deniseabrock http://www.facebook.com/cancerGRACE
Denise Brock

Lung Cancer Video Library – Spanish Language: Video #21 Treating stage IIIA N2 NSCLC

Share
 
GRACE Cancer Video Library - Lung

 

We continue to provide informational videos for our Spanish speaking community and welcome Dr. Luis Raez, MD FACP FCCP, Chief of Hematology/Oncology and Medical Director at Memorial Cancer Institute, and Clinical Associate Professor of Medicine at Florida International University.  Dr. Raez joined GRACE to discuss the basics of lung cancer.  In this 21st video for the Spanish lung cancer video library, Dr. Raez discusses treating stage llla N2 non-small cell lung cancer (NSCLC).


 

 

How Did You Like This Video?

Please feel free to offer comments and raise questions in our Discussion Forums.


 

TRANSCRIPTS – Spanish and English
download transcripts

Tratamiento para el cáncer de pulmón de células pequeñas en estadio IIIA N2

Para estadios III de cancer de pulmón, el tratamiento es más complicado, porque se trata de una multimodalidad. Idealmente en unos pacientes con estadio III, tienen que ir a una reunión multidisciplinaria donde tengamos al cirujano, al radiooncólogo y al oncólogo médico porque muchas veces los pacientes en estadio III pueden ir a cirugía y después de la cirugía se les da quimioterapia y radiación (cuando hay compromiso mediastinal o estadio N2), sino a los pacientes en estadio III solo le damos quimioterapia adyuvante después de la cirugía.

El estadio III es complicado porque a veces el paciente no puede ser operado o no estamos seguros de que pueda ser operado. A veces, hay que disminuir el tamaño del tumor por lo que se da quimioterapia primero para reducir el tamaño y ya después se va a cirugía.

Hay varias combinaciones, a veces la tercera opción es que el paciente va a cirugía porque parece operable, pero después de la cirugía descubrimos que hay enfermedad mediastinal (ganglios comprometidos), entonces no solo se le da quimioterapia después de la cirugía, pero también se le tener que dar radiación.

Esas son las tres posibilidades que hay para un estadio III, por eso lo mejor es hacer una reunión multidisciplinaria para decidir en grupo qué es lo mejor para el cancer de pulmón en este estadio.


Treatment for small cell lung cancer in IIIA N2 stage

For lung cancer in stage III, the treatment is more complicated because it is multimodality. Ideally stage III patients should go to a multidisciplinary reunion with a surgeon, radio-oncologist and the oncologist, because sometimes these patients go into surgery and then receive chemotherapy and radiation (only when the mediastinum is affected or is in N2 stage), when they could only receive adjuvant chemotherapy after surgery.

Stage III is complicated because sometimes the patient cannot go into surgery or we are not sure if he is a candidate. Sometimes, we have to reduce the size of the tumor by giving chemotherapy first and then go into surgery. 

There are several combinations, sometimes the third option is the patient going into surgery, but after the procedure we sometimes identify mediastinum affection (lymph nodes are affected), so the treatment has to be of chemotherapy and radiation.

The three options for stage III treatment are available, but it is better to make a multidisciplinary reunion to decide which is the best treatment for the patient.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #20 Treating Early Stage Non-Small Cell Lung Cancer (NSCLC)

Share
 
GRACE Cancer Video Library - Lung

 

As we continue with information for our Spanish speaking community, we welcome Dr. Luis Raez, MD FACP FCCP, Chief of Hematology/Oncology and Medical Director at Memorial Cancer Institute, and Clinical Associate Professor of Medicine at Florida International University.  Dr. Raez joined GRACE to discuss the basics of lung cancer.  In this 20th video for the Spanish lung cancer video library, Dr. Raez discusses treating early stage non-small cell lung cancer (NSCLC).


 

 

How Did You Like This Video?

Please feel free to offer comments and raise questions in our Discussion Forums.


 

TRANSCRIPTS – Spanish and English
download transcripts

Tratamiento para el estadio temprano del cáncer de pulmón de células no pequeñas

A veces es difícil recordar cual es el estadio I o II y uno se puede perder hablando del estadio. En general, el estadio I y II son sencillos porque son tumores que son confinados al pulmón, son tumores que no han invadido el mediastino y son operables. Para el estadio I y II lo que haces es cirugía como primera intervención y dependiendo de los hallazgos patológicos después de la cirugía, hacemos quimioterapia porque muchas veces a pesar de que hemos resecado tumores pequeños, como del estadio IB que son tumores pequeños de 3.5 cm, hay un riesgo de recurrencia y mortalidad grande.

Desafortunadamente, incluso en la cirugía más perfecta que es el estadio IA que pueden ser tumores de 2cm de cáncer de pulmón, los pacientes no necesariamente se curan después de los 5 años. Vemos que una parte del 10 al 20% igual van a morir por la recurrencia del cáncer de pulmón, he ahí la necesidad de dar quimioterapia.

Ahora, la quimioterapia tampoco es para todos. Hay mucha evidencia clínica que para estadio II no es discusión, se da la quimioterapia de 4 ciclos de cisplatino más el agente de elección como etopósido, pemetrexed, vinorelbina, taxanes. Después de eso, solo es observación y seguimiento del paciente.

Para estadio IA, el beneficio de la quimioterapia no existe o no está documentado, por eso no hacemos quimioterapia. Por eso es un área de mucha investigación para tratar de clasificar que pacientes tienen un riesgo alto que justifique quimioterapia u otra intervención y que pacientes no. 


Treatment for early stage non-small cell lung cancer

Sometimes it’s difficult to remember which cases are stage I and which one are stage II, one can get lost talking about the stage. In general, stage I and II are simple because the tumor is not confined to the lung, they are tumors that have not invaded the mediastinum and are surgically removed. For stage I and II, what we have to is surgery as first intervention and depending on the pathological findings, we can then do a surgery. We do chemotherapy because sometimes despite the small resected tumors like in stage IB (tumors smaller than 3.5 cm), there is a high risk of recurrence and mortality.

Unfortunately, even in the most perfect surgery in stage IA, than can be tumors of over 2 cm, patients don’t necessarily heal after 5 years. We see that a part of 10 to 20% will still die for lung cancer recurrence, so we need to give chemotherapy.

Now, chemotherapy is not for everybody. There is clinical evidence that for stage II chemotherapy the option is to give 4 cycles of cisplatin and the choice agent like etoposide, pemetrexed, vinorelbine or taxanes. After that, it’s only observation and the follow up of the patient.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #19 Second Line Therapy for NSCLC and ALK +

Share
 
GRACE Cancer Video Library - Lung

 

For our 19th video in the GRACE Spanish Lung Cancer Library, Dr. Brian Hunis, Medical Director, Head and Neck Cancer Program, Memorial Cancer Institute, Miami, Florida, joined GRACE to discuss the basics of Lung Cancer for Spanish-speaking patients and caregivers.  In this video Dr. Hunis discusses second line therapy for non-small lung cell cancer patients with anaplastic lymphoma kinase (ALK) positive.


 

 

 

 


 

How Did You Like This Video?

Please feel free to offer comments and raise questions in our Discussion Forums.


 

TRANSCRIPTS – Spanish and English
download transcripts

Terapia de segunda línea para pacientes con cáncer pulmonar de células no pequeñas y con la cinasa de linfoma anaplásico (CLA) positiva.

Para los pacientes que progresaron a crizotinib, en este momento hay dos fármacos: ceritinib que se puede considerar si el paciente progresa con crizotinib, y hay otro fármaco llamado alectinib que es la tercera línea para pacientes que progresan en terapia dirigida para ALK.

Lo que uno tiene que saber, es que, por la resistencia adquirida a uno de estos fármacos, uno tiene que checar la biopsia porque puede ser que el paciente no responda a estas terapias y necesite quimioterapia.


Second line therapy for non-small lung cell cancer and with anaplastic lymphoma kinase (CLA) positive

For patients that progressed to crizotinib, in this moment there are two drugs available: ceritinib that can be considered if the patient progresses with crizotinib and the other drug is alectinib which is a third line treatment for patients that progressed with ALK targeted treatment.

What we have to know is that, for acquired resistance to one of these drugs, one has to check the biopsy because the patient might not respond to these therapies and might need chemotherapy.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #18 Acquired Resistance to Targeted Therapies: Biology and Different Clinical Patterns

Share
 
GRACE Cancer Video Library - Lung

 

For our 18th video in the GRACE Spanish Lung Cancer Library, Dr. Brian Hunis, Medical Director, Head and Neck Cancer Program, Memorial Cancer Institute, Miami, Florida, joined GRACE to discuss the basics of Lung Cancer for Spanish-speaking patients and caregivers.  In this video Dr. Hunis addresses acquired resistance to targeted therapies: biology and different clinical patterns.


 

 

 

 


 

How Did You Like This Video?

Please feel free to offer comments and raise questions in our Discussion Forums.


 

TRANSCRIPTS – Spanish and English
download transcripts

Resistencia adquirida a las terapias dirigidas: Biología y diferentes patrones clínicos.

Lamentablemente inclusive en pacientes que tienen la translocación de ALK, eventualmente los pacientes van a desarrollar una resistencia adquirida, por lo cual la medicación con crizotinib no va a funcionar mas.

Por lo general, estos son pacientes que van a tener un prelapso o una recaída en sistema nervioso central o pulmón. Esos son pacientes a los cuales que uno va a considerar terapia de segunda línea o cambiar a quimioterapia.


Acquired resistance to targeted therapies: biology and different clinical patterns.

Unfortunately, even patients with ALK translocation will eventually develop an acquired resistance, resulting in crisotinib not working anymore.

In general, these patients will have a relapse or re-fall in the central nervous system or lung. In these patients, we will consider a second line therapy or change to chemotherapy.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #17 First Line Therapy for NSCLC Patients That Have Anaplastic Lymphoma Kinase (ALK) Positive

Share
 
GRACE Cancer Video Library - Lung

 

For our 17th video in the GRACE Spanish Lung Cancer Library, Dr. Brian Hunis, Medical Director, Head and Neck Cancer Program, Memorial Cancer Institute, Miami, Florida, joined GRACE to discuss the basics of Lung Cancer for Spanish-speaking patients and caregivers.  In this video Dr. Hunis speaks about first line therapy for non-small cell lung cancer patients that have anaplastic lymphoma kinase (ALK) positive.


 

 

 

 


 

How Did You Like This Video?

Please feel free to offer comments and raise questions in our Discussion Forums.


 

TRANSCRIPTS – Spanish and English
download transcripts

Terapia de primera línea para pacientes con cáncer pulmonar de células no pequeñas que presentan la cinasa de linfoma anaplásico (CLA) positiva.

En los pacientes en los cuales uno describe que el adenocarcinoma de pulmón de células no pequeñas tiene la translocación del gen ALK, hay terapia dirigida que atacan exclusivamente a las células que expresan esa mutación. Por lo cual los efectos adversos, la toxicidad y las respuestas son muchísimo mejores.

La primera terapia para pacientes con translocación en ALK que se ha usado en el mundo es con crisotinib. Crisotinib es una píldora que se toma diariamente, es bien tolerada y con efectos muy positivos.


First line therapy for non-small cell lung cancer patients that have the anaplastic lymphoma kinase positive.

In patients that have adenocarcinoma of non-small cells and also have the ALK gene translocation, there is a targeted treatment that only attacks the cell that express this mutation. So, the side effects, toxicity and the response are better.

The first therapy for patients with the ALK translocation that has been used in the world is with crisotinib. Crisotinib is a pill that is taken daily, is well tolerated and with very positive effects.


Ask Us, Q&A
Lung/Thoracic Cancer Expert Content

Archives

Share

GRACE Cancer Video Library - Lung Cancer Videos

 

2015_Immunotherapy_Forum_Videos

 

2015 Acquired Resistance in Lung Cancer Patient Forum Videos

Share

Join the GRACE Faculty

Breast Cancer Blog
Pancreatic Cancer Blog
Kidney Cancer Blog
Bladder Cancer Blog
Head/Neck Cancer Blog
Share

Subscribe to the GRACEcast Podcast on iTunes

Share

Email Newsletter icon, E-mail Newsletter icon, Email List icon, E-mail List icon

Subscribe to
GRACE Notes
   (Free Newsletter)

Other Resources

Share

ClinicalTrials.gov


Biomedical Learning Institute

peerview_institute_logo_243