Lung Health

A Mediaplanet Guide to Lung Health

Lung Health

Tony Goldwyn Read how the actor’s late mother inspires his cancer advocacy

Learn where family caregivers can find essential tools and resources Discover the opportunities clinical trials offer lung cancer patients JUNE 2021 | FUTUREOFPERSONALHEALTH.COM

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New Lung Cancer Screening Guidelines, Disparities, and Need for Research Understanding how race and gender affect the development and progression of lung cancer is critical to be able to diagnose at earlier, more responsive stages. Engaging Black patients in clinical trial participation and lung cancer research will help to address these disparities.

A 2020 Lung Cancer Research Foundation (LCRF) grant recipient and oncologist at UNC School of Medicine, Dr. Marjory Charlot, commented, “I agree with others that it is unclear why Black patients with lung cancer tend to be diagnosed at a younger age. It is also unclear why Black men have disproportionate mortality from lung cancer compared to other racial and ethnic groups and women with lung cancer.”

Another 2020 LCRF-funded grant aims to develop lung cancer risk prediction tools for Black Americans and Hispanic Americans, tackling the issue of current screening guidelines and its limitations with underserved groups.

This would allow screening eligibility to be defined in a way that is fully equitable across racial and ethnic groups.

Lung Cancer Research Foundation

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Everyone Deserves to Breathe Healthy Air

Afif El-Hasan M.D., Volunteer Medical Spokesperson, American Lung Association

Too many children struggle to breathe due to polluted air and are forced to make frequent visits to the emergency room or hospital as a result. But the health impacts of air pollution don’t just harm children, and bad air quality isn’t only an issue for California.

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Breathing air pollution harms everyone’s health, even healthy adults, and more than 4 in 10 Americans are living with unhealthy air.

Some communities are disproportionately impacted by air pollution, including low-income and communities of color. In fact, people of color are three times more likely to live in areas with the worst air quality, according to the American Lung Association’s 2021 “State of the Air” report.

Those living with bad air quality face a range of serious health harms.

Air pollution can cause lasting damage to the developing lungs of children. It can cause more

frequent asthma attacks, heart attacks and strokes, lung cancer, reproductive harm, premature birth and low birth weight, and even early death.

And now, as we face a pandemic, emerging research has found that a community’s exposure to even small increases in air pollution over the long term can lead to an increase in the COVID-19 death rate. And we know that Black and Hispanic communities have been among those hit the hardest by the virus.

The disproportionate health burden from air pollution results in an economic burden too.

People living in communities with higher air pollution face more missed

days of school and work, as well as the additional financial strain of medical costs associated with more hospitalizations and trips to the emergency room.

Everyone deserves the opportunity to live a full and healthy life. Our nation must ensure clean air for everyone.

Strengthening and fully enforcing policies that reduce dangerous pollution for all communities, not just some, is essential. And as our nation addresses climate change and transitions to cleaner sources of energy and cleaner vehicles, we have an opportunity to invest in the communities most impacted. n

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The Worst Kind of Surprise

N

ot long before the pandemic hit, I received the worst kind of surprise: a stage IV lung cancer diagnosis. I was shocked.

Scared. Confused. It couldn’t be about decisions I had made, could it? I was a healthy person, I thought. I exercised.

Never smoked. Drank only in moderation. I ate lots of vegetables. And I was only 45. Cancer didn’t care.

After I hung up with the doctor, I sent a text to Janis, my wife: “Please call me.” She wrote back: “Can’t right now.

Is that ok?” Then me again: “I’ve got bad news.” She came home. We held each other and cried. We went for a walk and ended up sharing a burger but left most of it on the plate.

Sitting at the nearly empty burger bar, we tried to gather our thoughts. We would need an oncologist. We would need to decide how to talk about this with our little boys, who were five and nine. We would need to figure out who else to tell and how. We had no idea what awaited us in what would amount to a massive,

“ We had no idea what awaited us in what would amount to a massive, emotionally fraught, project management effort.”

emotionally fraught project management effort — but it was time to get started.

In the days that followed, we chose an oncologist. For my initial treatment, he pointed us to a therapy that targets a specific genetic mutation in my cancer.

And I needed to begin right away because the cancer had

spread extensively through my body: the first scan showed my insides leopard-like with all the lit-up tumors.

I then experienced the whiplash of learning that the therapy was working, at least initially, and then finding out that I had to stop taking it because it was damaging my

liver. This was just the first in a seemingly never-ending series of twists and turns that continues to this day.I don’t know what happens next.

I do know that I’m lucky to have a spectacular care team at NYU led by the inimitable Dr. Abraham Chachoua. And to have a wife and children and

parents and sisters and in-laws and friends and colleagues who are here in the fight with me… a fight that nevertheless feels as arduous as they come. And a fight that anyone — of any gender, any age, any race, smoker or not — can end up facing. n Michael Echenberg

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Get Tested for COPD. Your Lungs Will Thank You

If you’re often short of breath during everyday activities, your chest feels tight, or you cough a lot, you may be chalking it up to getting older, having allergies, or being a smoker.

Fortunately, there’s a way to know whether something more may be at play.

C

onsider getting a lung function test to find out if you have a serious condition called chronic obstructive pulmonary disease, or COPD. Knowing the cause of your cough and breathing problems will not only help you manage your symptoms, it’ll help you feel better, too.

COPD includes two main conditions: emphysema and chronic bronchitis. It’s usually caused by cigarette smoking or breathing in other irritants,

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such as dusts or chemical fumes. In a small fraction of people, a genetic condition called alpha-1 antitrypsin (AAT) deficiency plays a role in causing COPD. More than 16 million Americans have been diagnosed with COPD, and millions more have it but don’t know it, according to the National Heart, Lung, and Blood Institute (NHLBI).

COPD doesn’t have a cure at the moment, but if you seek advice from a healthcare provider and get diagnosed

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early, you can slow down this progressive disease. During your appointment, your provider will talk to you about your symptoms and your medical history and listen to your breathing. He or she may recommend one or more lung function tests to help diagnose COPD. Ask for a lung function test if you: • Are over age 40 • Are or were a smoker • Feel out of breath often

• Bring up a lot of mucus when you cough • Have already been diagnosed with a lung disease • Have AAT deficiency • Are concerned about your lung health Another factor to consider when assessing your lung health is COVID-19, the disease caused by the coronavirus. Unlike COPD, COVID-19 causes abrupt coughing and trouble breathing, so your healthcare provider may want to test you for it.

If you have a chronic lung disease, such as COPD, and get infected with COVID-19, you are at higher risk of getting very sick. COVID-19 can affect your respiratory tract (nose, throat, lungs), and possibly lead to pneumonia and acute respiratory disease. For more information on COVID-19, visit CDC.gov. n James P. Kiley Ph.D., Director of Division of Lung Diseases, National Heart, Lung, and Blood Institute

The Role of Family Caregivers in Treating COPD An estimated 40 million family caregivers of chronically ill patients in the United States play a key role in delivering support and care to their loved ones. But they are often overlooked and under-supported.

Chronic obstructive pulmonary disease, more commonly known as COPD, is a serious breathing disorder.

It is the fourth leading cause of death in the United States and a major cause of disability. An estimated 16 million

people in the United States live with a COPD diagnosis and millions more are believed to have early symptoms of COPD but have not yet been diagnosed. People living with COPD often require assistance in managing their medications, keeping their homes safe (especially if they require supplemental oxygen), and assisting with COPD emergencies, which can be frightening.

Very often, caregiving responsibilities fall to untrained family members.

One estimate says nearly 70 percent of people living with chronic obstructive pulmonary disease (COPD) receive unpaid care from at least one family member. Too often these family members feel overwhelmed and under-prepared for their new role.

Research shows these informal family caregivers suffer from high levels of anxiety and depression, and their own self-care suffers as a result of their new caregiving role.

Fortunately, there are tools and support solutions available. For instance, under a project funded by the Learn More Breathe Better Program of the

National Heart Lung Blood Institute, family caregivers of COPD patients were given a “toolkit” to help them learn more about each of their new caregiving responsibilities. Caregivers learned how to help manage a patient’s COPD medications, create a safe home environment, watch for symptoms of a serious COPD breathing episode, and be a part of the patient’s overall care team. Finally, caregivers were reminded of the importance of selfcare and told not to feel guilty taking some time for themselves.

Caregivers in the test group gave the toolkit high marks for helping them understand COPD and their new caregiving role. When asked for suggested improvements, one caregiver said she only wished she received the toolkit when her husband was first diagnosed with the illness. Further testing is underway to document the health benefits of the toolkit for caregivers and the patients they support. n

Joel Africk, President and CEO, Respiratory Health Association

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Tony Goldwyn On Advocating for Your Health and Asking for Help Actor, director, and producer Tony Goldwyn continues to advocate for proactive healthcare after losing his mother to adenocarcinoma, a type of lung cancer, 30 years ago.

Goldwyn described his mother as a person who, later in life, was dedicated to her health.

In fact, she did yoga four times per week for the eight years prior to her death.

But in her younger years, Goldwyn’s mother smoked regularly. According to the American Cancer Society, an estimated 80 percent of lung

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cancer deaths are attributed to smoking, though the real number may be higher.

For Goldwyn’s mother, the symptoms came on suddenly. One day she had trouble catching her breath after going on a five-mile hike in the Berkshires, Massachusetts and Goldwyn insisted she see a doctor back in California where they lived.

When she did, her doctor discovered a baseball-size tumor on her lung.

Despite surgery and radiation treatments, the cancer continued to spread. On the night of the 1992 premiere

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for the movie “The Pelican Brief,” in which Goldwyn starred, his mother insisted he attend rather than stay at her bedside.

“She said, ‘You can’t cancel that,’” he recalled. “I literally got home from the premiere at 11 p.m., walked into her room and she was in extreme distress, and she died that night.

And I have to believe she waited up so that I wouldn’t have to pass up these types of professional opportunities.”

Being proactive about health To honor his mother’s legacy, Goldwyn wants people to

know that while getting regular health checkups may make some fearful, professional insight can be an opportunity to take proactive steps toward better health.

“Taking responsibility for our care is so critical,” Goldwyn said. “Start getting engaged with your healthcare professionals. It will save you money, it will save you time, and potentially will prevent negative outcomes.”

Asking for help In addition to speaking openly with healthcare professionals, it’s important to

recognize the support that loved ones can provide.

Goldwyn explained that his father, who also battled cancer, had trouble asking for help. “He didn’t want to be a burden to anybody, and he didn’t want to admit to himself that he needed help,” Goldwyn said. “We were a tight-knit family and we sort of shoved ourselves in there.”

He continued, “People want to be there for each other, and we must take care of the ones we love.” n

Melinda Carter

Clinical Trials: Opportunities and Options in Lung Cancer Treatment Patients with an advanced lung cancer diagnosis face many choices in their journey. One option for some patients is to enroll in a clinical trial — particularly for patients whose cancer has advanced to a stage where new treatment options are needed.

“When we talk about clinical trials to patients, we tell them it’s an opportunity to access investigational therapies while still in clinical development,” said Upal Basu Roy, Ph.D., MPH, executive director, LUNGevity Research at LUNGevity Foundation, an organization committed

to accelerate research and providing community, support, and education for those affected by lung cancer.

There are over 500 lung cancer clinical trials currently open and enrolling, according to Clinicaltrials. org. Trials vary and are based on the line of therapy

and the type of therapeutic intervention. “Some studies include a single agent treatment, or combination, and a different mode of administration, like pills or infusions,” said Dr. Roy. Studies with infusion-based products typically include a fixed number of cycles of therapy, while studies of oral therapies require continuous therapy until the disease progresses. Some treatments, including cell therapy, are administered as a one-time treatment. Most studies require a commitment of 2-5 years to allow for patient follow up.

Patients with lung cancer, particularly those who have not responded or progress in their disease following treatment, need to know what to expect with an investigational therapy. “It is critical to explain to patients upfront

how the trial is conducted,” said Dr. Roy. Cell-based therapies, for example, require more preparative work before the therapy is administered. Other therapies may require frequent office or hospital visits.

“The single most deciding factor [for patients] is the doctor offering the trial,” said Dr. Roy. “If a physician offers it, the likelihood of enrolling is incredibly high.”

Patient advocacy groups are an excellent resource for patients. LUNGevity, for example, educates patients through webinars about new treatment modalities, providing a forum for patients to hear directly from top physicians about these options.

“Ask your doctor whether it’s time to consider a clinical trial,” said Dr. Roy. n Iovance Biotherapeutics

Learn more about our investigational TIL Cell Therapy clinical trials for Lung Cancer • No randomization, no placebo • TIL therapy is derived from a patient’s own immune cells

Call 1-866-565-4410 (press option 3) Key Eligibility Criteria: There are additional eligibility criteria that must be met and can only be assessed by a study physician.

Diagnosis of Stage III or Stage IV Non-Small Cell Lung Cancer Disease progression after 1 or more lines of prior therapy which may have been a checkpoint inhibitor PDL-1 positive or negative status Tumors with EGFR, ALK, ROS mutations acceptable

For additional information Email clinical.inquiries@iovance.com or, Visit iovance.com/clinical/our-clinical-program/ Full eligibility details at clinicaltrials.gov (Search: NCT04614103, NSCLC) (Search: NCT03645929, Solid Tumor Trial with Lung Cancer Cohorts)

Fully active or able to carry out light work or activity At least one tumor that can be safely removed by surgery for TIL generation TIL Cell Therapy is an investigational therapy and has not been approved for any indication by the Food and Drug Administration (FDA) or any other regulatory agency. The safety and effectiveness of TIL Cell Therapy has not been determined.

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