Page 20 - Christiana Care Focus August 2018

Cancer Care |
Lung cancer C O N T I N U E D
Dr. Kmiec also explained that gene editing with CRISPR/CAS9 may have a role in the treatment of lung cancer as an augmented therapy and may be particularly useful in the removal of the NRF2 transcription factor in cancer cells. When NRF2 is in hyper-activation the genetic pathway favors the survival of malignant cells, blocking the efficacy of cancer therapies such as chemotherapy or radiation. “We are targeting NRF2 with gene editing so these therapies can be more effective,” said Dr. Kmiec.
One of the symposium keynote speakers, Bo Lu, M.D., Ph.D., radiation oncologist, who leads the radiation oncology group’s Lung Cancer Translation Research Program at the Kimmel Cancer Center at Thomas Jefferson University, explained that there is a great deal of hope for the field of immunotherapy, with significant research taking place. Immunotherapy is an alternative to traditional chemotherapy and helps expose cancer cells that would
Botherwise send signals that they are normal cells.
y exposing cancer cells as invaders, immunotherapy drugs trigger a response to re-educate and reactivate a suppressed immune system so it can effectively eliminate cancer. In addition, immunotherapy drugs are usually
safe, easy-to-deliver, well-tolerated, and hold much promise when used in combination with other cancer therapies.
“Patients under this therapy are likely to live longer and healthier lives if they respond to the treatments, because the cancer will be under the long-term control of the body’s immune system,” said Dr. Lu.
Extinguishing smoking behavior
Both smokers and non-smokers are diagnosed with lung cancer, but smoking remains the leading cause of the disease. Still, smoking has not always been a significant public health issue.
In
because cigarettes could be mass-produced at an
the early 20th century smoking was rare, though there was a rapid increase in smoking that peaked in the early 1960s, said Dr. Siegel. There was an increase
inexpensive price, and they were sold with sophisticated marketing during a time of government endorsement and social approval.
Since the 1964 publication of the U.S. Surgeon General’s report on “Smoking and Health,” showing the link between smoking and disease, smoking has been on the decline, but 15 percent of the public — 40 million Americans — continue to smoke.
Keynote speaker Daniel Rodriguez, Ph.D., professor of public health at La Salle University, said further research is needed on what smoking means to the self-esteem and identity of those who still smoke. At the very least, he said, they need greater social support. Each year 66 percent of smokers attempt to quit, but only 5 percent remain successful three months after they have tried.
He said many factors play a role in smoking as a public health issue, including nicotine dependence, stress, mental illness, weak social support for quitting and low self-efficacy beliefs. There is also data that shows a disproportionate number of tobacco outlets in poor and minority neighborhoods, a factor in the high rates of smoking among people of low socio-economic status.
In addition, young people continue to take up smoking. And if American teenagers continue smoking at the current rate, 5.6 million of these young people are expected to die prematurely from a smoking-related illness, according to the U.S. Centers for Disease Control and Prevention.
Given these statistics, Dr. Siegel hopes the lung cancer initiative will include education to prevent smoking, community-based interventions, government policies and smoking cessation efforts. “The end game for smoking is within sight but if we do nothing further we won’t get there,” he said. “That’s why we need to continue to innovate, not only in treatment, but in terms of prevention and tobacco control.” 
Smoking has been on the decline, but 15 percent of the public — 40 million Americans — continue to smoke.
18 CHRISTIANA CARE HEALTH SYSTEM