#LCSM Chat Topic 4/2/2020: #COVID19 and #LungCancer

It seems that the world has turned upside down.  At the time I write this, there have been almost 550,00 cases of COVID-19 confirmed in the world and over 85,000 in the US.  Here in New York City there have been over 23,000 cases and 365 deaths as of March 27th (https://coronavirus.jhu.edu/map.html).

The pandemic has placed enormous stress on our health care delivery system.  For lung cancer patients, it has affected healthcare providers’ ability to perform tests and radiologic procedures; provide timely diagnosis, staging, and care for early stage patients; and, in some cases, continue the treatment regimen for patients with stage IV disease.

Significantly, it has also interrupted the human interactions that many of us depend upon. Patients and doctors are for the most part unable to communicate face-to-face and are increasingly relying upon telemedicine to communicate when available.  The situation has left patients out of touch and likely very anxious. With everyone focusing their resources on COVID-19, will cancer patients be forgotten?

There is also justifiable concern among lung cancer patients that their underlying lung disease, side effects of treatment (such as lung scarring), or medications (such as those that suppress the immune system or predispose them to pneumonitis) will increase their risk of severe respiratory illness should they contract the virus.

With this in mind we will tackle the topic of COVID-19 and lung cancer in our April 2, 2020, #LCSM Chat at 8 pm Eastern time (5 pm Pacific).  Many questions are still not answerable, but we believe it is valuable for the lung cancer community to come together, share ideas, and support each other.  With that in mind, Dr. Brendon Stiles (@BrendonStilesMD) will moderate our discussion of the following questions:

  • T1: How is #COVID19 personally affecting your lung cancer care or care delivery?
  • T2: Are lung cancer patients more at risk for severe #COVID19?
  • T3: What are the risks of delaying treatment of lung cancer?
  • T4: What are your greatest #COVID19 concerns as a member of the lung cancer community?
  • T5: What can advocates and medical professionals do to help the lung cancer community?

Please join us, and bring your experiences and wisdom!  Remember to include #LCSM in ALL your tweets so the other chat participants can see them. You can read a primer on participating in the chat here.

#LCSM Chat Topic 3/5/2020: Expanding Access to Cancer Clinical Trials

Cancer research is necessary if we are to find more durable treatments for all cancers. While research has come a long way, we still have a long way to go in order to establish quality, durable treatments for many diagnosed with advanced/metastatic disease. 

Typically research begins, “at the bench” with cell lines and in organoids. Once an idea has shown some promise, it often moves on to testing in animals. When an idea, test or therapeutic shows significant promise, it must move to clinical trials. Clinical trials, allow diagnostic tests, screening methods, treatments, and patient care devices and methods to be evaluated for safety and effectiveness in humans. For many patients with advanced cancers, clinical trials may be their best care option.

We would all like research to move as swiftly as possible towards finding a cure. However, many clinical trials close without generating any useful information, or never even start, simply because they can’t enroll enough participants. This slows the pace of research considerably.  

There are many barriers to clinical trial enrollment.  In our #LCSM Chat this Thursday March 5, at 5 pm Pacific (8 pm Eastern), moderator Janet Freeman-Daily (@JFreemanDaily) and guest Stacey Tinianov (@coffeemommy) will lead our discussion of these barriers and how to address them using the following questions:

  • T1: What are the barriers to cancer clinical trial participation and enrollment?
  • T2: How might awareness of clinical trials be increased?
  • T3: How might eligibility requirements be modernized to help increase clinical trial enrollment?
  • T4: How might financial, travel, and administrative barriers to clinical trial enrollment be reduced?

Please join us, and bring your experiences and wisdom!  Remember to include #LCSM in ALL your tweets so the other chat participants can see them. You can read a primer on participating in the chat here.

#LCSM Chat 2020-02-06: Dealing with #lungcancer stigma and nihilism


All too often, lung cancer patients encounter stigma towards their disease and nihilism towards their chances of beating it. Although the causal connection between tobacco smoking and lung cancer was heavily emphasized in well intended public campaigns designed to curb cigarette use, unintended consequences arose.

Perhaps more than any other cancer, lung cancer is automatically associated with a bad personal choice – smoking. Many people believe patients could have avoided their lung cancer had they made better decisions. Such perceptions may stifle discussions about lung cancer, cause patients to refuse screening or to delay seeking medical evaluation, and often lead to self-blame and guilt among patients.

Therapeutic nihilism goes hand in hand with this stigma. For too long, survivors of lung cancer were reluctant to share their stories, perhaps in part as a result of their own burden of guilt. That, along with a survival percentage far below those of other cancers, led general physicians and the public to believe that all lung cancer patients would die soon after diagnosis. The only option was to tell the patient to “get your affairs in order.”

Fortunately, we are making progress. Advances in screening, surgical treatment, radiation therapy, molecular profiling, targeted therapy, and immunotherapy have drastically improved outcomes and quality of life for many lung cancer patients. At the same time, a growing community of lung cancer patients and advocates have raised their voices and demanded attention. They are sending a clear message: anyone with lungs can get lung cancer. The lung community has called for focused efforts promoting research, for programs highlighting survivorship, and for equal access to evidence-based care.

Despite progress, we still have much work to do. With that in mind, Dr. Brendon Stiles (@BrendonStilesMD) will lead our discussion on Thursday, February 6, at 8 pm Eastern Time, using the following questions:

  • T1 How does stigma affect lung cancer patients and research?
  • T2 Are doctors and patients still nihilistic about a new diagnosis of lung cancer?
  • T3 Are there certain groups of patients who doctors particularly stigmatize or take a nihilistic view towards?
  • T4 How can we better study the effects of stigma and nihilism on cancer patients?
  • T5 What can we as a group do to best address stigma and nihilism?

Please join us, and bring your experiences and wisdom!  Remember to include #LCSM in ALL your tweets so the other chat participants can see them. You can read a primer on participating in the chat here.

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