2024-07-13 04:11:00
“Lung cancer” statistics revealed: 64 Thai people are newly ill every day, with the second highest death rate, indicating that “immunotherapy” can be used to treat both its initial and metastatic stages. Show that there is a subcutaneous injection that has passed the FDA and is used instead of mixing saline and dripping into a vein. There is no difference between drug levels – efficacy – safety. But it reduces treatment time from 1 hour to 7 minutes.
On July 12 at the InterContinental Hotel, Bangkok, at the launch event of a new innovative medicine to treat lung cancer. Professor Dr. Wiroj Sriularphong, Intern, Department of Oncology, Faculty of Medicine, Chulalongkorn University and Chairman of the Working Group on Lung Cancer for Thai People under the Oncology Society of Thailand gave a special lecture “The truth about lung cancer in Thailand: statistics and risk factors that must be for you to know”
Lung cancer is one of the worst health problems in Thailand. This is the second most common result in men and the fifth most common in women Every year there are approximately 23,494 new patients, or 64 people per day, including 15,200 males and 8,294 females, there are approximately 19,864 people died. or 54 people per day, the death rate is the second highest compared to different types of cancer, with more than 80% of lung cancer patients dying within 5 years This is the cancer with frequency high and death rate highest levels in Thailand and is a problem that the public health department should solve urgently.
The risk factors are divided into: 1. Factors that can be avoided For example, smoking is the main factor that causes lung cancer, and smoking is the cause of 85 percent of lung cancer cases. Meanwhile, e-cigarettes act like cigarettes, causing inflammation in the lungs. In the long run, there is a risk of cancer. Therefore, you should not smoke cigarettes or electronic cigarettes.
Other factors that may have an effect include air pollution such as PM 2.5 dust, which is currently being studied in relation to cancer. Because it is not inhaled and it will happen immediately, but it was found that being in an area that is high and a lot of PM 2.5 has a high chance of getting lung cancer. It must be avoided by following periods when dust levels are high. Then avoid entering that area. Or stay in the house, an air-conditioned room or in the car where PM 2.5 is very low because there is a filter to help filter when the air conditioner is on, exposure to certain substances from work such as burning coal, exposure to radon. gas. and other carcinogens such as asbestos, chromium, and radiation.
2. Unavoidable factors such as age, because people get older and have the opportunity to control the growth of body cells and decline. Increased risk of cancer As for whether lung cancer is hereditary or not? It was found that it was not genetically inherited. It was a change from the environment, but people’s families were found to have lung cancer. will receive a similar environment including different risks It can be called a mild genetic condition. Regarding the PM 2.5 factor
Professor Dr Wirot said: Symptoms of lung cancer are reasons to see a doctor Symptoms often come from the lungs, such as coughing, fatigue, shortness of breath, chest pain, or if the cancer has spread to other organs such as the brain, bones and liver, the patient will have many different symptoms. The diagnosis is important A biopsy must be done to check if it is cancer cells or not. including cancer imaging diagnosis It can be seen on a simple chest x-ray. Or check with computed tomography (CT scan) which will show more details. The Pet Scan will see how many diseases are present throughout the body.
Regarding the current treatment methods for lung cancer, there are 3 methods: 1. surgery, 2. radiation, and 3. use of drugs Currently, there are 3 types of drugs: chemotherapy, targeted drugs that can only be used for certain types of cancer that have a target. The medicine will respond to patients with specific diseases. and immunotherapy drugs
Association. Dr. Wichian Srimuninimit, Internist, Department of Oncology Siriraj Piyamaharajkarun Hospital said that there are 2 types of lung cancer: small cell lung cancer and non-small cell lung cancer There are many different ways to treat lung cancer. The choice of treatment depends on the type and stage of lung cancer. including the patient’s physical condition Most Thais only know about surgery, radiation therapy, and chemotherapy. But today, the treatment of non-small cell lung cancer has evolved to be able to treat the cancer cells more specifically. and reduce side effects from using chemotherapy in the traditional way Makes the treatment more effective. Increased survival or better control of the disease, including:
1. Specific treatment (Targeted Therapy) or treatment using targeted drugs. Most are oral medicines. By using drugs that have specific effects on cancer cells. This makes the treatment effective and has fewer side effects on normal cells. But it is necessary to take a piece of tissue and blood from the patient to check. Is there a gene mutation? If this drug were available, it would be more effective, more efficient, more responsive, disease controlled, and more durable than chemotherapy. and fewer side effects than chemotherapy drugs
2. Using immunotherapy drugs It is a new group of drugs (immunotherapy) that act to stimulate the body’s immune system. Let’s fight or eliminate cancer cells. without the ability to directly destroy cancer cells Normally, when a foreign substance enters the body, for example bacteria, viruses, cancer cells, the body will say that it is foreign and will destroy these cells. But cancer cells have mechanisms to evade immune function. By creating PD1 proteins on the immune system and PDL1 on the surface of cancer cells, this will prevent the human immune system from destroying cancer cells if PD1 and PDL1 bind to them. This causes the cancer to grow and spread to other places.
“Immunotherapy It will act to either bind to PDL1 or bind to PD1, preventing the two of them from binding together. That person’s immune system will continue to destroy cancer cells. There are 2 types of immunotherapy drug use: used as a single drug or used in combination with other agents such as chemotherapy drugs Currently, immunotherapy has been found to have fewer side effects compared to chemotherapy. Its main use is mixed with saline and given intravenously,” said Communist Professor Dr. Wichian.
Dr. Yosawat Rungrojwattana, intern, oncology department of the Faculty of Medicine Vajira Hospital said that cancer treatment includes oral medicine. Medicines are given intravenously through an IV line and, more recently, medicines are given as injections under the skin. Which treatment method to choose? It depends on factors that doctors and patients consider together in each case, type of cancer, type of treatment, safety and convenience of the patient as well. Immunotherapy drugs are shown from the initial stages to the 2-3 stage will follow up. At this stage we hope that the results will be fully healed. For the metastatic stage, we hope to increase the quality of life and survival rate for patients. There are immunotherapy drugs and chemotherapy drugs. or the use of one drug The medicine will be given continuously. Until drug resistance or response is found, then stop. Or the maximum is 35 medication cycles or about 2 years before you can stop the medication or take a break from the medication.
“The effectiveness of immunotherapy is considered to have greatly improved since the past. Some patients live longer. The results of the treatment in terms of side effects are also less than chemotherapy. Immunotherapy is used to treat lung cancer, liver cancer, breast cancer and colon cancer, but it cannot be assumed that it can be used in all patients. A proper examination must be done to see how likely that patient is to respond to the drug initially. By checking the level of PDL1 from the biopsy, if PDL1 is high, for example more than 50%, it can be said that it is likely to respond well to immunotherapy drugs,” said Dr. Yosawat.
Dr Yosawat said: Immunotherapy drugs were initially given intravenously through an IV. But currently, in foreign countries, subcutaneous injections are used, which was recently approved by the Thai FDA. Therefore, it increases options for patients Usually, under the skin, about 1-2 milliliters can be injected If more than that, there will be swelling and pain. But immunotherapy drugs are injected under the skin. Halozyme Therapeutics’ drug delivery technology or enhancement using enzymes is used. “Dase Hyaluronic” goes in to break down hyaluronan in the subcutaneous layer. This creates a temporary gap under the skin. Therefore, the amount of drug injected can be increased. We use about 15 milliliters of immunotherapy medicine and the patient has no swelling or pain. The medicine has few side effects. This innovation is also used in diabetes medicine.
From clinical studies, it was found that subcutaneous injection compared to intravenous administration. The amount of medicine received is not reduced. blood drug levels Results of response to different drugs side effects Efficacy and safety differ. But there will be no allergic reaction to the drug when the drug is instilled through the saline tube. Drug administration can be more convenient and takes less time. Because the intravenous drip takes time to mix the medicine with 100-250 ml of saline and it takes about 1 hour to drip continuously, but the subcutaneous injection is very easy to use, taking 4 -8 minutes, 7 minutes on average go home faster Go about your daily life as you want. Helps reduce personnel workload Increase efficiency in providing better care and assistance to patients
“Oncologists can prescribe immunotherapy. But it is limited to patients who can pay themselves or to government officials who meet the criteria specified by the Comptroller General’s Department. Widespread use may have to wait for the price to come down further. Currently, immunotherapy drugs given intravenously and injected under the skin are about the same price, so subcutaneous injections are also an option. Because it will be more convenient,” said Dr. Yasawat.
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