Actual Cause of Death in NSCLC

mikes · Senior User Joined: 25 Jul 2005 Posts: 143

People sometimes die of complications and side-effects of their treatment.

My question is what causes death in NSCLC if the disease is not treated or only given supportive care. I suspect it may be related to areas it has spread.

Alternately, if it determined that death is not related to treament in treated cases, what is the cause of death?

I have not been able to construct a good Google query for this.

Maybe Leo can help.

gdpawel

Excellent question! Cancer treatment can damage the heart and cause deaths from heart failure. This means fewer deaths from cancer. Analysis of the records of 1.2 million cancer cases in the Surveillance, Evaluation and End Results (SEER) database showed that non-cancer deaths accounted for 21% - 37% of all deaths (average). The authors attributed this effect to the damage caused by cancer treatment (mainly radiotherapy and chemotherapy).

Dr. Fancis Giles, a professor of medicine and chief of developmental therapeutics at M.D. Anderson Cancer Center, on commenting about some of the downside of targeted therapies says, "it's still a lot better than having your heart or your brain or your liver fried because the broad-spectrum chemo, in its desire to kill everything in site, is destroying your organs."

Whether from complications and side-effects of treatment, or from the cancer itself, it is usually (in most cases) the failure of a major organ (or organs) that precipitates death.

Pre-screen testing narrows the selection to those drugs that have the highest probability to be successful. There are over 100 different therapeutic drug regimens out there (400 are in the pipeline). Any one or combination of them can help cancer patients. The system is overloaded with drugs and under loaded with wisdom and expertise for using them.

mikes · Senior User Joined: 25 Jul 2005 Posts: 143

Assuming no metastasis to a any organ (exlcuding bones), which organ is most prone to failure from NSCLC itself (if any)?

Your knowledge and help is most appreciated because this subject does not make an easy Google search.

I am sure that my wife's death was the result of her treatment just as you describe.

gdpawel · Last edited by gdpawel on Sat Sep 24, 2005 12:40 am; edited 1 time in total

It was pointed out in the January 10, 2002 issue of the New England Journal of Medicine that new chemotherapy regimens "appear" to be improving survival, but when these same regimens are tested on a wider range of cancer patients, the results have been disappointing. In other words, oncologists at a single institution may obtain a 40-50% response rate (tumor shrinkage) in a tightly controlled study, but when these same chemotherapy drugs are administered in a real world setting, the response rates decline to only 17-27%.

Chemotherapy can affect the bone marrow's ability to make cells called platelets. These blood cells help stop bleeding by making the blood clot. In this case the bone marrow does not make enough platelets. This can cause a cancer patient to bleed to death.

Researchers reported in the December, 2001 Journal of the National Cancer Institute that Taxol appears to increase the risk of radiation pneumonitis, which is a lung inflammation that occurs from radiation. They have found out that this is much more common in patients treated with Taxol, which has not been shown to have any clear benefit.

As reported in the December, 2001 Journal of the National Cancer Institute, Taxol appears to increase the risk of lung inflammation and researchers suggest using it with caution. The combination may cause more problems than it solves, like radiation pneumonitis, which is a lung inflammation that occurs from radiation. Researchers have found out that this is more common in patients who receive Taxol.

Neoadjuvant Taxol chemotherapy can cause tumor cell release that can cause brain metastases. An article in the May 2005 issue of Oncology News International (Vol. 14, No.5) reports that neoadjuvant chemotheray with paclitaxel (a taxane) causes a massive release of cancer cells into the circulation. Katharina Pachmann, M.D., of Friedrich-Schiller University in Germany said that ironically, paclitaxel produces the greatest degree of tumor shrinkage but also the greatest release of circulating tumor cells.

Dr. Pachmann said that this observaton corresponds with results found in patients, that tumor response does not mean increased survival. In three different paclitaxel-containing regimens, circulating cell numbers massively increased, whereas tumor size decreased. The results indicate that monitoring of circulating tumor cells can contribute to understanding of tumor-blood interactions and may provide a valuable tool for therapy monitoring in solid tumors.

Another study reported in the American Journal of Clinical Oncology (2002;63:6-15) by Christos Kosmas, M.D., of the Medical Onoclogy Unit at Helena-Venizelou Hospital, Greece said that Carcinomatous Meningitis (or Leptomeningeal Carcinomatous) after a major response to front-line taxane-based regimens represents a grave disease manifestation and its incidence appears increased when compared retrospectively to non-taxane-treated patients.

Results of these kinds of studies are coming out slowly and quietly (now that taxol is off-patent) and indicate that taxol-containing regimens didn't prolong survival over other more conventional and less expensive cytotoxic drugs. It may indeed give clinical response (tumor shrinkage, not cure), sometimes impressive, however, these are mostly short-lived and relapses after a response to taxanes are often dramatic.

Researchers at the University of Pittsburg Medical Center have stated that chemotherapy resistance is highly variable and individualized among NSCLC clinical cell cultures. This may account for the marginal results seen with empiric use of "first line' chemotherapy agents in the adjuvant setting. This should caution thoracic surgeons and medical oncologists against the empiric prescription of these agents. The use of viable tumor culture in assay analysis should be considered when formulation a plan of adjuvant therapy for resected NSCLC (CHEST 2004 Meeting, Abstract #1188:1)

mikes · Senior User Joined: 25 Jul 2005 Posts: 143

From your web page:

"Cancer chemotherapy and radiation therapy almost without exception, will damage some normal tissue and diminish the immune system. Radiation has been known for a long time to both enhance cancer growth and to halt cancer growth. Damaging the immune system in turn is known to foster the growth of some kinds of other cancer. We do not yet have really outstanding treatments for most cancers. Modern medicine in general and cancer treatment in particular, is very imperfect. In the hopes of curing disease or helping patients, the medical profession uses rather drastic treatments for devastating diseases they know will kill someone in a short time. Many oncologists don't make the families aware enough that these treatments are drastic and can have serious side effects. "

You hit it on the head!

BTW your email is not in your profile.

gdpawel · Last edited by gdpawel on Sat Sep 24, 2005 4:50 pm; edited 2 times in total

I sent a PM to you.

mikes · Senior User Joined: 25 Jul 2005 Posts: 143

Greg,

I "unspam-proofed" gdpawel at comcast dot com and sent you an email.

It bounced.

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