Iressa is this seeming super drug developed by the British-based company AstraZeneca. Associated Drug Co. Ltd is AstraZeneca’s representative in Malta.

The drug is a tablet to be taken once daily, which is infinitely more comfortable for the patients than chemotherapy or radiotherapy. The company’s representatives said the drug has practically no side-effects. It has been approved in 28 countries, including the United States, Japan, Canada and Australia.

At present, Iressa has been used for clinical trials and a compassionate scheme. This is open to all patients around the world. If all other treatments have failed, the lung cancer patient is eligible to apply for the drug.

At a conference held in Athens, the company’s clinical VP of oncology, Dr George Blackledge explained that a mutation identified in the non small cell lung cancer DNA is the key to the patients’ super response.

This type of cancer generally grows and spreads more slowly and the prognosis is usually very poor. The drug developed contains gefitinib that inhibits the epidermal growth factor receptor, where the mutation was identified.

Dr Blackledge said the mutation is responsible for the aggression of the cancer and is therefore the probable reason for the super response. A key protein called tyrosine kinase causes cells to proliferate and grow into cancer. This is a pivotal stage where signals are transmitted and the disease advances. The drug works by switching off signals at this stage and therefore slows and reduces the cancer growth.

Forty to 50 per cent of the patients in clinical trials who were given Iressa as a last resort showed improvement. The gefitinib in the drug succeeded in stabilising the disease and also helped shrink the tumour. Fifteen to 20 per cent of the patients were super responsive – they were dying and felt better after eight days.

These patients are the patients with the mutation. Although they are the ones who improve drastically, the drug is also beneficial to those without the mutation, the doctors explained.

Lung cancer symptoms, such as breathlessness, cough, weight loss and fatigue are difficult to control, said Jesme Baird, the director of patient care at the Roy Castle Lung Cancer Foundation in the UK.

Even patients who do not have the mutation Dr Blackledge described can benefit from Iressa. The trials have shown that the symptoms reduce and raise the patients’ quality of life.

The drug is not cheap, said Dr Blackledge, but people and insurance companies in America are willing to pay the $1,800 a month for the tablets. He said that Iressa’s development was expensive so the price is to be understood. Soon he hopes it will be on the market in Europe.

The patients in the clinical trials had a 5.5 per cent chance of surviving for a year. With this drug, one third of the patients are still alive one year on. This may seem like a small step, but thanks to this drug, lung cancer treatment has moved ahead in leaps and bounds. “It has only been two months since the discovery of the mutation. In the next two to three years, the treatment is going to transform,” Dr Blackledge said.

These are all very exciting findings since the doctors know how the treatment works. Instead of the “find and destroy” method used by chemotherapy and radiotherapy, this system works on targeting and controlling the cancerous growth, said Professor Jean Francois Morere, from the CHU Avicenne Paris University.

“In the hit parade of cancer, lung cancer is definitely top of the league.” He called it the silent serial killer because symptoms only occur in the late stages and diagnosis is therefore rarely made until the cancer is advanced.

Researchers are currently working upon developing a proper screening test for lung cancer. At present, x-rays, CT scans, sputum cytology and bronchoscopy are used instead.

Prof. Morere spoke of the history of lung cancer and said the cancer and smoking can be considered to be collateral damage from wars of the past. After 1850s Crimea war, victorious armies brought back the trend of smoking cigarettes and the year saw the development of the first manufactured cigarettes.

The first and second world wars also boosted the popularity of smoking, especially seeing that US general John Pershing had said, “to win this war, we need tobacco as much as we need bullets”.

Dr Jesme Baird said the doctors in the 1950s, 1960s and 1970s must also bear their part of the blame. In these times, physicians used to lend their names to cigarette adverts and thus promote smoking.

In the 20th century, 100 million people died as a result of smoking. If smoking habits do not change, 1,000 million people will die of lung cancer in this century, said Prof. Morere.

When showing a graph of lung cancer incidence in women, the professor said that for the first time in years, the curve is on the downslide. This hopefully shows that anti-smoking campaigns are working.

Although cigarette consumption has fallen in the last 20 years lung cancer remains the top of the league. Prof. Morere said most smokers are found in the developing world.

The causes of lung cancer can be avoided. Ninety per cent of cases are a result of smoking tobacco. Poor diet, asbestos, heavy metal exposure and radon also contribute to the disease. The fact that the cancer may have been caused by the patient himself may be a reason why the disease is not publicised and does not have much media coverage. Seven out of 10 people believe that lung cancer is a self-inflicted disease and that patients have less right to a hospital bed than patients suffering from other cancers.

Dr Baird said that lung cancer is still considered to be the “poor relation” of the cancer world, the one everyone forgets and locks away. In fact, she said that patients are known to conceal their disease and not ask for medical help immediately. It is a stigmatised disease and there is a massive unmet need for more and better treatment.

As mentioned earlier, the prognosis for lung cancer patients is usually very poor so any advancement, no matter how small, is a huge leap ahead, she said. Iressa provides the perfect testimony to this. The drug has given patients hope and if enough funding is provided the hope can be made reality for even more people suffering from this disease.

The public donating money to cancer research expect advancements in treatment. Lung cancer does not have any celebrity supporters and there are very few people speaking out about it.

Dr Baird said that sufferers are too busy fighting the disease to lend their voices to the public fight against the cancer. It is little known that many celebrities died of lung cancer – Walt Disney, John Wayne and George Harrison all suffered from the disease, yet it was not publicised. The public knows which celebrities have died of AIDS or have had some form of cancer, but lung cancer remains in the shadows.

Lung cancer claims more lives than all other cancers put together, Dr Baird said. She said that when funding for breast cancer research increased, the outcome improved.

If lung cancer research has come this far with limited funding, imagine where it can go if it had the necessary backing! This poses a challenge to those involved in lung cancer research, Dr Baird said. Although, considering, a lot has been done, there is still a long, long way to go – screening, education and the like.

Andrew Wilson of Marie Curie Cancer Care addressed the need to put a face to lung cancer. He said that due to the poor prognosis and the feelings of responsibility, lung cancer sufferers show higher levels of psychological distress than other cancer patients.

Support is vital for all cancer patients and maybe more so in the case of lung cancer sufferers. Mr Wilson told a touching story of the bad turn life took for a couple and how they dealt with it in a positive way.

A man diagnosed with lung cancer was terrified of having chemotherapy and was considering whether to seek treatment or not. Unfortunately, soon after, his wife was diagnosed with breast cancer. Instead of feeling sorry for themselves, the couple decided to be each other’s pillar of strength and go for their first chemotherapy treatment together.

Mr Wilson said the couple are making most of life and travelling very often. They send him a postcard from every place they visit. The point of this story was to show that positive thinking does contribute to recovery.

In fact a recent study of patients with melanoma (skin cancer) showed that those who were positive about treatment outcomes reduced their risk of dying by 65 per cent.

The recent advancements in the treatment for lung cancer have not only provided hope for sufferers but have also helped shed some spotlight on the cause. The media and the public needs to be more aware of this battle and should be ready to fight in the name of those who are too sick to do so.

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