GRACE :: Lung Cancer
Denise Brock

Lung Cancer Video Library – Spanish Language: Video #40 The General Approach to Extensive Stage Small Cell Cancer

 
GRACE Cancer Video Library - Lung

 

We are pleased to continue this series of informational videos for our Spanish speaking community.  GRACE is pleased to welcome Dr. Rafael Santana-Davila, Assistant Professor with the University of Washington School of Medicine and Seattle Cancer Care Alliance.  In this 40th video for the Spanish lung cancer video library, Dr. Santana-Davila joined GRACE to discuss the general approach to extensive stage small cell lung cancer.  


 

 

 

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TRANSCRIPTS – Spanish and English
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Los Principios de Tratamiento Cuando el Cáncer de Células Pequeñas está en Estadio Extendido

The General Approach to Extensive Stage Small Cell Cancer

 

Rafael Santana-Davila, MD
Assistant Professor of Medicine
University of Washington Seattle Cancer Care Alliance
Seattle, Washington

 

Spanish TRANSCRIPT

Cuando el cáncer de células pequeñas está en estadio extendido es básicamente cuando el cáncer está en otras partes del pulmón o en otras partes del cuerpo. En este tipo de cáncer, el principio no es curar al paciente si no tratar de extender su vida y mejorar la calidad de ésta. En la mayoría de los casos el principio es quimioterapia, hay varios tipos de ésta que se pueden usar pero dependen de la conversación del doctor con el paciente para que conozca los riesgos, beneficios y los efectos adversos de cada tipo de quimioterapia. Se dan regularmente dos ciclos de quimioterapia y después se vuelven a hacer estudios de imágenes para ver cómo está respondiendo el cáncer. Lo más común es dar cuatro ciclos de quimioterapia y después de esto se puede usar radiación para consolidar las ganancias que obtuvo la quimioterapia.


  

English TRANSCRIPT

When small cells lung cancer is in extensive stage is when the cancer cells are in other parts of the lung or even in other parts of the body. In this type of cancer, the goal is not to cure the patient but to try to extend their life and improve their life quality. In most cases the treatment suggested is chemotherapy, which has different types of approaches and they all depend on the conversation the doctor and the patient have in order for the patient to understand the risks, benefits and possible side effects. Regularly, we give two cycles of chemotherapy and then we make again imaging studies to see how the cancer is responding. Four cycles of chemotherapy are the most common treatment to give and then we use radiation to concentrate the good effects chemotherapy had in the cancer cells.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #39 General Approach to Limited Stage SCLC

 
GRACE Cancer Video Library - Lung

 

We are pleased to continue this series of informational videos for our Spanish speaking community.  GRACE is pleased to welcome Dr. Rafael Santana-Davila, Assistant Professor with the University of Washington School of Medicine and Seattle Cancer Care Alliance.  In this 39th video for the Spanish lung cancer video library, Dr. Santana-Davila joined GRACE to discuss the general approach to limited stage small cell lung cancer.  


 

 

 

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TRANSCRIPTS – Spanish and English
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Enfoque General Para El Estadio Limitado de Células Pequeñas de Cancer de Pulmón

General Approach to Limited Stage Small Cells Lung Cancer

 

Rafael Santana-Davila, MD
Assistant Professor of Medicine
University of Washington Seattle Cancer Care Alliance
Seattle, Washington

 

Spanish TRANSCRIPT

Cuando el cancer de células pequeñas se encuentra en estado limitado, el tratamiento es a base de radiación y quimioterapia al mismo tiempo (quimioterapia y radiación concurrente). Regularmente es cuatro a seis semanas de radiación con dos ciclos de quimioterapia al mismo tiempo. Una vez que ha pasado esto lo que esperamos es que se haya erradicado todo el cancer dentro del pulmón y curar a las personas. En algunos casos, también se da radiación al cerebro para prevenir que el cancer lo afecte, a esto se le llama por sus siglas en inglés: PCI.


  

English TRANSCRIPT

When the lung cancer of small cells is in limited stage we use at the same time a radiation and chemotherapy treatment (chemotherapy and radiation concurrent). Regularly, is four to six weeks of radiation with two cycles of chemotherapy at the same time. Once this is over, we hope the cancer is eradicated in the lung and the person is cured. In some cases, we also give PCI which is radiation to the brain to prevent its damage.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #38 Different Types of Lung Cancer

 
GRACE Cancer Video Library - Lung

 

We are pleased to continue this series of informational videos for our Spanish speaking community.  GRACE is pleased to welcome Dr. Rafael Santana-Davila, Assistant Professor with the University of Washington School of Medicine and Seattle Cancer Care Alliance.  In this 38th video for the Spanish lung cancer video library, Dr. Santana-Davila joined GRACE to discuss the different types of lung cancer.  


 

 

 

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TRANSCRIPTS – Spanish and English
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Diferentes tipos de cancer de pulmón

Different types of lung cancer

 

Rafael Santana-Davila, MD
Assistant Professor of Medicine
University of Washington Seattle Cancer Care Alliance
Seattle, Washington

 

Spanish TRANSCRIPT

El cáncer de pulmón lo dividimos frecuentemente en algo que ha sido histórico desde hace mucho, que es el cáncer de células pequeñas y el de células no pequeñas. El cáncer de células pequeñas, depende de la serie y es alrededor del 10 al 20% de los casos. Mientras que el 80 al 90% de casos de cáncer es de las células no pequeñas, el cual también se divide en cáncer de células escamosas (30% de los casos) y adenocarcinoma (alrededor del 60% de los casos).

El resto, es cáncer de células grandes y otros subtipos de cáncer que no son tan comunes.

 


 

 

English TRANSCRIPT

Lung cancer is frequently divided in small cell cancer and non-small cell cancer. The small cells cancer depends on the blood count and affects about 10 to 20% of all cases. About 80 to 90% of the cases are non-small cells cancer, which is also divided in squamous cells (30%) and adenocarcinoma (in about 60% of patients).

The rest of the cases are large cells and other subtypes of cancer that are not very common.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #37 Basics of Lung Cancer Staging

 
GRACE Cancer Video Library - Lung

 

We are pleased to continue this series of informational videos for our Spanish speaking community.  GRACE is pleased to welcome Dr. Rafael Santana-Davila, Assistant Professor with the University of Washington School of Medicine and Seattle Cancer Care Alliance.  In this 37th video for the Spanish lung cancer video library, Dr. Santana-Davila joined GRACE to discuss the basics of lung cancer staging.  


 

 

 

How Did You Like This Video?

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


 

TRANSCRIPTS – Spanish and English
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Lo básico en los estadios de cancer de pulmón

Basics of lung cancer staging

 Dr. Luis Raez, MD FACP FCCP

Chief of Hematology/Oncology and Medical Director, Memorial Cancer Institute,
Clinical Associate Professor of Medicine, Florida International University

 

Spanish TRANSCRIPT

Lo principal que nos preguntamos nosotros cuando vemos a un paciente con cáncer es en que estadio esta, que es básicamente que tan avanzado está el cáncer. Cuando el cáncer esta solo en el pulmón, no se ha ido a ningún ganglio linfático ni a otra parte del cuerpo, le llamamos estadio uno. Cuando el cáncer ha avanzado a ganglios linfáticos cercanos pero no al mediastino es estadio dos y cuando avanza al mediastino es estadio tres. Por último cuando ha avanzado a otros órganos, a la región pleural del pulmón o a otras partes del pulmón, le llamamos estadio 4.

En cáncer de células pequeñas es relativamente fácil diagnosticar en que estadio está, ya que si está solo en un pulmón le llamamos estado limitado y cuando está en varias partes del pulmón o en el otro pulmón u otras partes del cuerpo le llamamos estadio avanzado. 


 

 

English TRANSCRIPT

The main question to have when we see a cancer patient is in what stage he is, which is basically how advanced the cancer is. When the cancer is located just in the lung, has not affected a lymph node or any other organ is called stage one. When the disease has affected lymph nodes close to the cancer but not the mediastinum is called stage two, while the affection of the mediastinum is stage three. Finally, when the cancer has spread to other organs, the pleura of the lung or other parts of the lung is called stage four.

In small lung cancer cells is relatively easy to diagnose the stage because when it’s only present in the lung it’s the limited stage and when it is located in several parts of the lung, or in the other lung or other organs is the advanced stage.


Denise Brock

Lung Cancer Video Library – Spanish Language: Video #36 Treatment Options for Acquired Resistance to EGFR TKIs: T790M-Negative Disease

 
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 36th video for the Spanish lung cancer video library, Dr. Raez discusses treatment options for acquired resistance to EGFR TKIs: T790M-negative disease.


 

How Did You Like This Video?

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


 

TRANSCRIPTS – Spanish and English
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Opciones de tratamiento para la resistencia adquirida a los inhibidores de tirosinas cinasa del receptor del factor de crecimiento epidérmico (EGFR): enfermedad T790M negativo.

Treatment options for acquired resistance to tyrosine kinase inhibitor in the epidermal growth factor receptor (EGFR): T790 negative disease

 Dr. Luis Raez, MD FACP FCCP

Chief of Hematology/Oncology and Medical Director, Memorial Cancer Institute,
Clinical Associate Professor of Medicine, Florida International University

 

Spanish TRANSCRIPT

También cuando hablamos de resistencia a inhibidores de la tirosina cinasa, ya hablamos que para los pacientes con 790 hay un nuevo fármaco que se llama osimertinib. El problema es ¿qué hacemos con el resto de los pacientes? Como les decía 60% de los pacientes que están en inhibidores de la tirosina cinasa, van a tener la mutación 790, que, si ustedes saben la pueden encontrar en la sangre, la orina o en una nueva biopsia, y ahí vamos a poder usar el fármaco nuevo.

Pero, ¿qué hacemos con el 40% de pacientes que no podemos documentar la mutación?

Hay esperanza para estos pacientes porque sabemos hoy en día que para muchos de estos pacientes que no tienen esta mutación, el mecanismo de resistencia está a través de la vía MET. Entonces tenemos en investigación inhibidores de MET y de su vía, que podría ser una solución para salvar a estos pacientes. La otra opción es que algunos de estos pacientes, en un grupo pequeño como del 10% hacen carcinoma de pulmón de células pequeñas. En otras palabras, el tumor original que era carcinoma de células granes se transforma en carcinoma de células pequeñas, entonces estos pacientes no van a responder a ninguna terapia blanco existente porque no tenemos terapia blanco para carcinoma de células pequeñas y entonces hay que ponerlo en quimioterapia.

Por eso es tan importante hacer una biopsia, porque si no hacemos una biopsia cuando en el paciente falla el receptor de la tirosina cinasa nunca nos vamos a enterar que el paciente transformo a carcinoma de células pequeñas y nunca le vamos a dar la quimioterapia adecuada.

Al final, mientras estos descubrimientos y otros van avanzando lo que hay que hacer es poner a los pacientes en quimioterapia. Cuando un paciente falla y no podemos documentar la mutación 790, hay que ponerlo en quimioterapia o en un estudio clínico que el paciente pueda calificar.


 

English TRANSCRIPT

When we talk about tyrosine kinase inhibitors resistance, we know that for patients with the 790 mutation, we have the drug osimertinib. The problem is, what do we do with the rest of the patients? As I told you, 60% of the patients that are in tyrosine kinase inhibitors will have the 790 mutation that if we can find them in the blood, urine or in a new biopsy, we will be able to use the new drug.

But, what do we do with the 40% of patients in which we cannot verify the mutation?

There is hope for these patients because nowadays we know that most patients without this mutation have their resistance mechanism via de MET pathway. We have MET and their pathway inhibitors that could be the solution for these patients. The other option is that some patients, in a group of around 10%, make small cell lung cancer. In other words, the original large cell lung cancer transformed into small cell lung cancer. These patients will not respond to any existing targeted therapy because we don’t have a small cell cancer treatment, so we have to put them in chemotherapy. 

That is why it is so important to make a biopsy, because if we don’t make a biopsy when the patients fails with the tyrosine kinase inhibitors, then we will never know that the patient probably transformed into a small cell lung cancer and we will never give him the right therapy.

At the end, while these findings and more research is progressing, what we have to do is put the patients in chemotherapy. When a patient fails with the treatment and we cannot verify 790 mutation, we have to put him in chemotherapy or in a suitable clinical trial.


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