FDA Approves Merck’s WINREVAIR™ (sotatercept-csrk), a First-in-Class Treatment for Adults with Pulmonary Arterial Hypertension (PAH, WHO* Group 1)
Hurricane Disasters Associated With Treatment Delays Among Patients With Lung Cancer
Science NewsHurricanes can disrupt care for patients who need daily radiation therapy, which depends on stable electricity and safe facility access.
A new study from researchers at the American Cancer Society (ACS) found that patients with Stage 3 locally advanced non-small-cell lung cancer (NSCLC) who received radiation treatment during a hurricane disaster were more likely to experience treatment completion delays. Researchers also reported that patients treated during a hurricane were more likely to receive higher total doses of radiation and complete more fractions. These findings will be presented at the annual American Society of Clinical Oncology (ASCO) Quality Care Symposium in San Francisco, September 27–28, 2024.
Hurricanes can disrupt cancer care and adversely affect health outcomes, especially for patients needing daily radiation therapy, which depends on stable electricity and safe facility access. Among patients diagnosed with locally advanced NSCLC, disruptions in radiation can decrease survival.
In the study, researchers, led by Rand Sakka, health services research at the American Cancer Society, and to be presented by senior author Dr. Leticia Nogueira, identified patients aged 18 years old and older from the National Cancer Database who initiated radiation therapy for non-operable stage III NSCLC between 2004-2022.
Exposure was defined as a Federal Emergency Management Agency (FEMA) hurricane disaster declaration at the county of the treating facility during radiation treatment. Patients treated at the same facility, but at a time when no hurricane happened (i.E. Unexposed) were propensity score matched in a 1:1 ratio with exposed patients on age at diagnosis, sex, lymph node involvement, comorbidity score, and era (radiation start year 2004–2009, 2010–2015, 2016–2022), to account for more active hurricane seasons in recent years. Delays in radiation treatment completion were defined as greater than eight weeks between the date radiation started and ended.
The results included 6,700 matched patients, of whom 3,350 were treated at facilities exposed to hurricanes during radiation and 3,350 completed treatment at the same facilities but when no hurricane exposure happened. Patients treated during hurricanes had 2.2 higher odds of experiencing treatment delays compared to unexposed patients (12.96% of exposed patients experienced delays compared to 6.87% of unexposed patients). Exposed patients were more likely to have received higher radiation doses and completed more fractions compared to unexposed patients.
Researchers stress that as severe weather events become more common, comprehensive emergency preparedness plans that incorporate evidence-based strategies for mitigating the adverse effects of treatment delays are essential.
This news release was published by the American Cancer Society on September 23, 2024.
Navigating The Cancer Journey With Two Different Approaches
Two vastly different approaches to navigating the cancer journey may or may not be mutually exclusive.
From my lung cancer diagnosis in the summer of 2018 through treatment, remission and now a couple of years into survivorship, I have sought and appreciated a large caring support system. Early on in my treatment, I attended a support group at my church. At my initial visit, I went with a question in mind, in which several members of the group offered ideas and opinions that were helpful.
Since then, in many and varied ways, my peers have been there for me. And I, likewise, have been there for them. Since making progress in treatment, I have faithfully given of my time and resources to several relevant organizations and have felt hugely compensated in return. Then several years later, I learned of a close friend's very different choice of approaches to the cancer journey.
When diagnosed, both my friend's husband, the patient with cancer and I faced cancers which were life threatening.
My friend and her husband decided to focus on staying in the day and not getting ahead of themselves. They made sure not to overthink possible outcomes or side effects. On a day-to-day basis, they rarely discussed cancer with each other, much less with casual friends or neighbors. My friend's husband is now in remission.
Tumors were found on each of my two lungs in the Spring of 2018. Discovered as incidental findings on CT scans, then biopsied in late June, both tumors were tested and determined malignant. The first of my two surgeries took place in mid-July. The more concerning tumor, as well as lymph nodes in my chest, were removed and tested. I waited for what seemed like forever before getting the news: most of the lymph nodes were malignant. I had stage 3B non-small cell lung cancer.
I felt overwhelmed by the magnitude of the adversary I was facing, fighting the No. 1 killer of both men and women: lung cancer. As an introvert, with a supportive husband, three adult daughters and a few close friends, I feared they might not be enough. Although a person of faith since childhood, I had a hard time maintaining hope and confidence that God would pull me through. I prayed but struggled. Would God answer my prayers? I sensed I needed the prayers of as many caring and devout people as possible.
I went outside the box and let everyone that I knew know that my cancer was life threatening. I needed prayers from neighbors I knew only casually, parents of each of the students I tutored in my small business, even the checker in the supermarket. After my surgeon removed the tumor in my right lung, I had to face another significant fear.
I was terrified of receiving chemotherapy yet managed to complete my regimen. Soon after I had completed my chemo regimen, a kind woman from a local charity arrived at my front door one Saturday in mid-December 2018. She had called me a week earlier from Mrs. Claus Club and asked me if I would like to receive a gift basket of comforting items appropriate for patients with cancer. I said, "Of course," and upon arriving that weekend day, she brought me the basket and a beautiful, crocheted blanket as well. She shared with me that John, the leader of my church's support group, had given my name to her group.
From early in treatment, I had received many helpful messages from the American Lung Association (ALA), and as a result, I decided to make what, for me, was a large donation to the organization. A few days later, I received a call from the local office of the national organization. I was asked how I wanted my contribution to be used to benefit ALA. I chose the association's Lung Force Walk and eventually would lead a team, which I named Sue's Prayer Army, in ALA's primary fundraiser for Lung Cancer Activities.
St. Peregrine's Club, my church's cancer support group, named in honor of the Patron Saint of those suffering from cancer and other life-threatening diseases, did not meet for almost one-and-a-half years during the COVID-19 pandemic. The group had always met in person, and most members thought it should remain in person. That was especially unfortunate for me, because I had just reached remission and was longing for normalcy. I suffered from a PTSD-like emotional reaction, wishing I could return to my precancer life. Life from March 2000 through June 2021 turned out to be anything but normal.
Although after cancer is, for most of us, is not the same as before, I would gone on to find my new normal. Three of our group members I now consider friends one of them I call a best friend.
Then, while I was in remission in early 2023, I learned that two first cousins of mine, who each lived in different states than I, had recently been diagnosed with life-threatening cancers. I made contact with each of them after decades since last seeing either of them. I have been able to support both. I've felt rewarded with two renewed family connections. In June of this year, 10 members of my mother's side of my family were reunited in central Pennsylvania, two months after my cousin was deemed in remission.
I now consider him and his wife more new friends!
I celebrated reaching the five-year mark cancer free in June 2023, spoke that year at the Lung Force Walk, in appreciation of ALA and the years of joy and fulfillment I had experienced because of my involvement with the organization. It was also the fifth year of Sue's Prayer Army's participation. We raised our most ever, $3,500.
I feel so sure my life has been better because of the give and take of a community of individuals who have chosen to find the positive in the cancer journey, when it would be easier and more natural to be negative.
And yet, as I continued to read my friends message asking me to wait to hear from her and her husband, and to allow them to take the lead in any conversation, to let them live in the moment. I wondered about even more lifestyle choices during a cancer journey. While reading the note, I couldn't help but think about my meditation practice, which I'd started using early in the process of my diagnosis to increase calmness in my mind, body and soul. The approach my friend described made sense to me. In avoiding the inner dialog in one's mind, it would likely allow them to be free to experience less sadness and more joy, as well as making it more possible to talk and listen to God in prayer. Although all good things, my friend's plan left me feeling lonely.
Although, of course, I have honored their request, the social involvement of sharing my cancer journey has given me a powerful sense of belonging, a source of inspiration and stronger faith than I would have otherwise believed. I feel totally fulfilled by my private meditation practice as well.
I can't help but wonder whether these vastly different approaches to a trek through cancer treatment, remission and survivorship has to be mutually exclusive.
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Medical Tests Show Alice Guo Has Possible 'lung Infection,' Says PNP
Former Bamban, Tarlac Mayor Alice Guo was found to have a suspected lung infection, according to the Philippine National Police (PNP).
In an interview outside the Pasig City Jail on Monday, PNP spokesperson Colonel Jean Fajardo said Guo underwent a medical examination before leaving the custodial facility.
Results indicated a possible 'left lung infection' although these were subject to confirmatory tests. Guo was later on found to be negative of tuberculosis.
Fajardo said Guo underwent medical and physical examination by the PNP General Hospital and forensic group as a matter of procedure before she was turned over to the custody of the Bureau of Jail Management and Penology (BJMP).
"During the medical examination, the doctor found a probable infection in her left lung," Fajardo told reporters.
"So BJMP, upon receiving Alice Guo, will now have the disposition on how to treat this possible infection," she added.
Citing information from the PNP General Hospital, Fajardo said Guo probably developed lung infection on Friday or over the weekend. Doctors attributed it to stress and fatigue.
The former mayor attended marathon hearings in both the Senate and the House of Representatives last week in relation to her alleged involvement in the Philippine Offshore Gaming Operators (POGOs) and escape in July.
Meanwhile, BJMP spokesperson Jayrex Bustinera said Guo will temporarily stay at an isolation facility, where three tuberculosis patients are currently recovering.
"It's a small isolation cell around 10 square meters. The doctor's advice is to co-confirm the findings with his X-ray and to undergo Gene-Xpert testing, the other test is negative," Bustinera disclosed.
"Gene-Xpert lab test will be administered within the day. This test is made to confirm tuberculosis impression in the X-ray result of Alice Guo. If the result is negative for TB, she will be housed in Cell No. 3, which currently houses 43 persons deprived of liberty (PDL)," he added.
Guo will eventually join 40 other detainees in a cell upon her recovery from the said lung infection.
Bustinera said Guo was already wearing BJMP pants, a yellow PDL shirt, and a mask.
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