It's classic that can be falsified. And in addition, it is discriminatory: "a tumor in the lungs? It certainly fits everything …!" Who did not hear such phrases? As it seems, 25% of lung cancer (yes, in the multiple, because they are not the same) suffers from not smoking. And in that group that did not even touch tobacco, it represents the seventh cause of death.
"People who use combustion of firewood for cooking, which are common in countries like ours, some lung cancers are diagnosed," explained the oncologist. Luis Corrales, from the Costa Rica Cancer and Control Research Center. They are also caused by radiation, breathing of chemicals and hydrocarbon gases, and asbestos (asbestos). "Corrales was one of the coaches in the academy for lung cancer journalists, carried out by Pfizer in Buenos Aires. He was responsible for presenting the panoramic of the disease in the region and the challenges which is created, which is a lot, because the lung cancer is still the most dead cancer.
In this harsh environment, there is good news to give: the available treatments allow in a good number of cases, depending on what type of cancer is being treated, more time and better quality of life.
Let's explain: smoking is not the only cause, but the main cause to avoid; it was already clear in 1950. Tobacco is not very large on oncogenesis, but it is the convergence that it causes in cells (in this case, the lungs, but not the only organ that is # 39; n the result of the results) is combustion at high temperatures and the substances at that time emit tobacco, its additives and the paper, Corrales emphasized.
"These organizations can promote the partitioning of uncontrolled cells and the development of a tumor," he said. And we are one of the first shared regional data: among Latinos, there are more deaths.
But thanks to molecular biology, he added, we know that what has been considered a long-term illness that is related to smoking is much more complicated and caused by different genetic changes.
"We can distribute lung cancers into two large groups. In the first, there are small cell lines (SCLC), more often in men, which are closely related to smoking and rapid growth, and # 39; n represent between 15% and 20% of cases ".
"For this time, it was only surgery and chemotherapy but great progress was made with immunotherapy, which is in our country in the process of being approved by the National Medicines Ministry, Food and Medical Technology (Anmat), which was highlighted in the seminar Diego Kaen, Head of Oncology Hospital School and the La Rioja National University Clinic, who managed to understand technical issues of molecular tests.
"The remaining 80%, which are non-small cells (Cpcnp), are split into adenocarcinoma (85% of cases) and others. Well, 35% of patients with adenocarcinoma do not smoke , "said Corrales. He added that 4% of these tumors develop among children under 40.
The hardest thing is early diagnosis; In fact, lung cancer is still called a "silent killer", because the symptoms are similar to some other respiratory diseases (cough for three weeks or more, chest pain, shortage of breath, flu-like conditions that take a long time to improve, even with antibiotics, bleeding of the nose) and the query takes time long to arrive. That's why it's important, before any doubt, the medical control: I hope it will tell us that it is almost only rebellious bronchitis! (See "X-rays …").
If the tumor is detected early and physically removed without spreading, it can be treated and can be improved. But they are a minority (just 10%): as stated Kaen, in Argentina, most cases are found in phase III, when it is not easy.
"But that does not mean that there are no possible solutions. Up to 2014, when the doors were opened to new paradox, we only had chemotherapy. Molecular tests of tumors now allow forming of therapeutics targeted to improve the survival of patient groups with metastatic disease, "he said.
What's involved in this goes directly to the heart of the tumor, or helps the immune system to recognize the cancer cells. And thus, instead of assaulting every cell that can be reproduced quickly, even healthy ones, such as "chemo", can prevent their growth and propagate, interfere with specific molecules, known as "molecular targets", which they encourage, Kaen explained.
"Knowing and understanding the characteristics of different tumors before starting treatment allows them to be much more effective," said Corrales. And although it is not improved, in many cases the disease can be controlled for years (in the 1980s and no treatment was tried) with much less symptoms and a good quality of life.
Therapy has to target
Knowing the tumor means, in the first place, knowing what type of tumor it is, and what the mutations associated with it are. And bear in mind, moreover, that a tumor can not be homogeneous, on the one hand, and can be cheated, on the other hand, so it needs to be controlled during the procedure to see if & # 39; n still effective (see: "Liquid Biopsy"). The good thing is, in many cases, if one treatment gives the best work, there are others trying to replace it.
"EGFR is one of the most frequent transformations of a protein that, from the surface of the cells, helps them grow and share. When EGFR is hidden, cells grow & # 39 ; n faster, "added Corrales. In these cases (more often in women, young people under 40 and non-smokers) EGFR inhibitors can be administered and the signal that can trigger the growth of the cells can be prevented. "
"In Argentina, it is seen that the EGFR mutation is between 15% and 20% of cases of this type of cancer," Kaen stressed. And one of the great benefits of these therapies is to be a pill that is taken home and normal life. "
There is another 5% of Cpcnp where the ALK gene is found to have penetrated, which produces a protein that hyperstimulate the growth of malignant cells. The available treatments (pils too) can be used even for the chemo, improving the quality of life.
The other new alternative is immunotherapy. In a normal process, T lymphocytes (type of white blood cells) identify the tumor cells and delete them. Our body does it through the time. But they've learned the system out.
"Imagine that the tumor cells have a mask that is hidden, and the lymphocytes, therefore, remain so relaxed. The procedure is blocked A receptor that makes the mask possible and makes the tumor cell visible to the immune system, "explained Corrales.
Laboratory-manufactured or manufactured substances, such as monoclonal antibodies, can be used which can work by strengthening the immune system and also by preventing or slowing the growth of cancer cells, or by preventing them from spreading into other parts of & # 39 ; r body (See: "Immunotherapy").
> Woman perspective | Second cause of death in the world
Although in general, the likelihood of a woman developing lung cancer throughout her life is 1 in 17, the figures change and the disease is increasing among the female population. In Argentina, and according to data from the National Cancer Institute (INC), the number of diseases is still much higher among men (68.45% of them and 31.55% for women), but are particularly concerned of deaths of this type of cancer in women. Globally, this is the second most common cause of death among them, especially as they make their smoking time more often. By contrast, women appear to benefit from a more obvious reduction in tumor risk after they give up smoking.
> Immunotherapy We tell you what monoclonal antibodies and how they work
They are molecules produced in the laboratory designed to act as antibodies, and can restore, improve or dissolve the immune system assault on cancer cells. I'll plan to bind the antigen that tends to be more prevalent on the surface of cancer cells than in some healthy ones. Different antibodies of this type can detect cancer cells, destroy their membranes, block their growth or attack them. They can also prevent immune system inhibitors and can take the treatment of radiation and chemistry to the tumor cell. I am administered intravenously, and the frequency depends on the type of cancer and the medication that is taken.
> X-rays do not arrive If you can not leave the pucho, ask for at least controls "Unfortunately, a huge screening strategy is not possible to detect the disease in people without symptoms," Diego Kaen acknowledged. but smokers should at least ask their GP for control. "The point is that not all controls are useful:" it is proven that radiography does not work. We need special tomography, low density, "he added, and included people with a family history in the risk population. Smoking cessation reduces premature lesions and reduces the risk, but & # 39; n continues to be important for years after giving up, so controls should be a rule even if you no longer smoke.