Targeted therapy and immunotherapy for lung cancer

Better options: Dr Tho says that immunotherapy and targeted therapy are more effective than chemotherapy.

TARGETED therapy and immunotherapy are generally more effective than chemotherapy in treating lung cancer, said Sunway Medical Centre consultant clinical oncologist Dr Tho Lye Mun.

“Targeted therapy and immunotherapy yield better results than chemotherapy, with lower toxicity and less side effects,” he said, adding that half his patients are undergoing these treatments.

He added that those who are suited for targeted therapy, which involves consuming pills once a day, could easily survive for another two to three years.

Immunotherapy is a treatment that helps a person’s immune system fight cancer, according to the US National Cancer Institute.

“For those who undergo immunotherapy to combat aggressive forms of lung cancer, the survival rates are about 26% at three years,” he said.

However, according to Dr Tho, the average five-year survival rates are less than 5% for those with stage IV cancer.

There are currently about 4,000 cases of lung cancer with a mortality rate of 80% in Malaysia, and it causes more deaths than breast, prostate and colon cancer combined.

He added that it is one of the most common cancers in Malaysian men, partly because men don’t immediately seek doctors when they display symptoms.

“Men tend to brush off symptoms. They tend to wait till things are very bad before they see a doctor, whereas women are more proactive in health-seeking behaviour,” he said.

Dr Tho said that the majority of lung cancer cases are diagnosed late.

“Lung cancer symptoms are not as apparent as, say, a breast lump for breast cancer. You can feel and touch a breast lump.

“Lung cancer symptoms are coughing, weight loss, chest pains, and these can be confused with a simple infection. It’s not easy to differentiate between the two unless you do further tests,” he said.

He advised that if someone coughs up blood, or has unintentional weight loss of more than 5-10%, or has persistent cough and chest pains that don’t go away with treatment, that person should see a doctor with a view of including lung cancer.

Dr Tho explained that once diagnosed, the doctors would conduct molecular testing to determine if the patient is suited for either targeted therapy or immunotherapy.

“In the past, we differentiated the types of lung cancer as two broad categories, which are small cell lung cancer and non-small cell lung cancer.

“Nowadays we look at the molecular features of the tumour. We never used to do it but now we do that routinely for all lung cancer patients,” he said.

According to Dr Tho, the most common cause of lung cancer is still smoking, and the incidence of smoking is actually rising in Asia.

“However, about half of the patients who walk in to see me either have never smoked or are not heavy smokers. In these cases, cancer could be caused by pollution, genetic factors and exposure to chemicals, such as dyes and other materials used in industries.”

He added that one’s work environment could lead to lung cancer, as some of his patients are factory workers who were exposed to hazardous materials.

Following a lung cancer diagnosis, many lifestyle adjustments have to be made.

“A lot of patients may not be able to work because of the chest pains, weight loss and coughing. It would affect a person’s finances, and ultimately his or her sense of worth.

“Men still tend to be the main breadwinner of the family, and if they cannot work and have to go to hospital for treatment, it would affect their self-esteem,” said Dr Tho.

“Cancer is a life-changing diagnosis. It doesn’t just affect the individual, it affects the whole family and extended family.”

However, Dr Tho stressed that it’s not so much about treating the physical illness, but managing the illness from a holistic point of view.

“Good health is having good relationships with your loved ones, your significant other, your family members. It’s about having peace in your heart.

“The aim is not just to prolong life, but to allow people to continue to do what they need to do, for as long as possible,” he said.