It is common for Filipinos to dismiss seemingly ordinary health concerns such as body aches, colds or coughs. Seeking the advice of a health professional is often set aside due to time or financial constraints. And despite the scientifically established detrimental effects of habits such as smoking or excessive drinking, people continue to ignore or conveniently set these risks aside.
Chest x-ray of a person with lung cancer, showing the significant change of lesions using immunotherapy
As such, the saying “an ounce of prevention is worth a pound of cure” has gained a whole new meaning for people like TV and media personality Diego Castro.
His father, renowned broadcast anchor Angelo Castro Jr., passed away from lung cancer in 2012 after having diagnosed just four years earlier. “He began smoking when he was 10 years old,” revealed Diego. “But he had already quit around 10 years prior to his diagnosis.”
Host Lexi Schulze with Diego Castro during the Hope from within press conference in Manila Diamond Hotel
As with many lung cancer patients, persistent cough was what led the elder Castro to the doctor. After having been diagnosed, he initially sought alternative treatments and remained to be in relatively good health despite having been given an initial prognosis of only a few months to live. He kept a normal life as far possible, meeting up with friends and working at his job in front of the camera.
Later, in an effort to eradicate any remaining malignancy in his body, Angelo submitted to medical doctors and underwent chemotherapy. Frequent trips to the hospital extended to weeks and months of stay-totaling up to two years. Unfortunately, the disease has progressed which led to his eventual demise.
The burden of the disease is more than just on the patient but on the family as a support system. “lt was draining, physically, emotionally and financially,” shared Diego.
Hope from within
The Castro family’s story happened just a couple of years, but in such a short span of time, Diego is astonished to find out from the medical community that lot has already been achieved in terms of more effective and efficient treatment options for cancer.
Diego admits that such news brings a feeling of regret and missed opportunities. However, a chance to ensure that his father’s death was not in vain comes it the form of lending voice to a multi-sectoral advocacy that urges Filipinos to be more proactive in battling cancer through early diagnosis.
“Hope From Within” is a movement that symbolizes the optimism that novel treatments like immunotherapy bring to cancer patients, and the latest in its series of ongoing educational and informational forums focuses on the importance of early detection for malignancy.
Specifically, for lung cancer, it is important for those at high risk to get screened so that the disease can be addressed immediately, according to Dr. Ivy de Dios, oncology medical adviser of MSD in the Philippines.
From L to R: Dr. Rachel Marie Rosario, Executive Director, Philippine Cancer Society and Global Cancer Ambassador of the Philippines; Dr. Jorge Ignacio, President of the Philippine Society of Oncologists; Dr. Nelia Tan-Liu, Chairman of Cardinal Santos Medical Center’s Department of Pathology; Dr. Ramon Santos-Ocampo, Interventional Radiologist, UP Philippine General Hospital and University Hospital at StonyBrook; Ms. Ma. Fatima Girlie Lorenzo, President of Philippine Alliance of Patient Organization; MSD Philippine executive; Dr. Ma. Encarnita Limpin, Pulmonologist and Executive Director, Framework Convention and Tobacco Control Alliance Philippines (FCAP) and Action and Smoking and Health, Philippines (ASH); Dr. Jose Garcia, Vice President of the Philippine Society of Medical Oncologist; Dr. Clarito Cairo, Program Manager, Philippine Cancer Prevention and Control, Department of Health, and Diego Castro, News and Public Affairs anchor at UNTV.
“ln order to benefit from the innovation of immunotherapy particularly for certain types of advanced lung cancer, it is important that it is administered as early as possible upon the onset of the disease,” explains Dr. de Dios. “That is why we are urging people to ‘Test, Talk and Take Action.”
Those who should primarily consider getting screened are high-risk individuals such as smokers, “Any persistent cough should be looked into,” she reminded. The screening test involves a low-dose CT scan of the chest. Any mass identified for biopsy will also then be analyzed by a pathologist for particular proteins, to further determine the suitability of the patient for immunotherapy treatment.
The “talk” phase involves constant and in-depth discussion with medical professionals and experts. “Prognosis and treatment should be threshed out well between the patient and doctor,” said Dr. de Dios, Finally, “take action” not only means undergoing proper treatment, but having a positive and proactive approach to battling the disease through healthy lifestyle changes and help from support groups.
The promise of immunotherapy
Immunotherapy involves fortifying the body’s natural healthy cells to avoid being overridden by malignant cells, and thus preventing the latter from multiplying. In many clinical studies all over the world, it has been proven to add more years of survival to cancer patients.
As opposed to traditional standard-of-care treatment such as chemotherapy, immunotherapy presents less or little side effects. ln many countries all over the world, immunotherapy drugs have already been successfully in use to treat various types of cancers.
Through pathology of samples from the patient, such as tissue or even body fluids, molecular testing can determine the best course of immunotherapy treatment. For instance, depending on the presence of cell protein called PD-L1 (programmed death ligand), immunotherapy drugs called immune checkpoint inhibitors such as nivolumab, atezolizumab or pembrolizumab may be administered.
Mutations in EGFR (epidermal growth factor receptor), meanwhile may indicate a patient’s suitability for treatment using EGFR targeted therapies such as afatinib, erlotinib, or gefitinib. ALK (anaplastic lymphoma kinase) gene changes may call for treatment with drugs that target the ALK protein such as crizotinib.
ln the Philippines, the innovation of immunotherapy has already arrived. Early this year, a particular immunotherapy drug pembrolizumab has been indicated by the Philippine Food and Drug Administration as first-line treatment for non-small cell lung cancer (NSCLC). This means that those diagnosed with this particular type of lung malignancy may be administered the immunotherapy drug from the onset, and avoid undergoing chemotherapy.
Pembrolizumab has been found effective NSCLC as first treatment with high PD-L1 expression, and no EGFR and ALK gene mutations. lt can also be given to NSCLC patients with PD-L1 expression, whose cancer starts growing again after chemotherapy or other targeted treatments.
Whereas before, being diagnosed with cancer seemed like an automatic death sentence, immunotherapy truly means renewed optimism among patients. With this seeming “wonder drug,” it is not difficult anymore indeed for those facing cancer to look at the brighter side of possibilities and to rely on their own hope from within.