I attended an educational seminar today sponsored by MD Anderson at the Ritz-Carlton in Dallas. I had an opportunity to chat briefly with Dr. John Heymach, the oncologist to whom I give credit in my book (His Love Carries Me) for saving Chris’ life in 2010. Dr. Heymach not only changed Chris’ treatment plan from chemo to radiation when he had postobstructive pneumonia, he recognized that Chris fit the profile for having a rare ALK+ gene mutation and sent his lung biopsy tissue to be tested. The results came back positive, and MD Anderson’s clinical trial for ALK+ helped Chris achieve “no evidence of disease” within 12 weeks of starting the trial. Chris never had the opportunity to get his photo taken with Dr. Heymach, so I grabbed the chance when I got it!
MD Anderson (MDA) has been ranked the #1 cancer center in the nation for 14 of the last 17 years. Approximately 25% of their patients are misdiagnosed at other facilities but are properly diagnosed at MDA. You can do a self-referral by calling 1-844-894-7405 to make an appointment or fill out an online form at https://www.mdanderson.org/about-md-anderson/contact-us/askmdanderson/appointments.html. (Make sure they are in your insurance network.)
I found it fascinating to learn of the advances made in cancer treatment over the years. Three speakers focused on the advances for ovarian cancer, lung cancer, and radiation.
Karen Lu, M.D., is chair of Gynecologic Oncology and Reproductive Medicine at MDA. She’s widely regarded as a national expert on hereditary cancers. Of special interest is a MAGENTA study for women age 30 or older who have a personal or family history of breast cancer OR a family history of ovarian cancer (no personal history of ovarian cancer is allowed for the study). If you qualify for the study, you get free genetic testing, in the privacy of your own home, via a “spit” kit.
For more information regarding the MAGENTA study, go to:
In general, the cost of genetic testing has decreased over the years from $4,000 to $200.
The most common type of ovarian cancer starts in the fallopian tubes. They are now trying to remove the fallopian tubes first and leave the ovaries as long as possible for hormone function.
John Heymach, M.D., Ph.D., is MD Anderson’s chair of Thoracic/Head and Neck Medical Oncology and is a co-leader of the Lung Cancer “Moon Shot” at MD Anderson. He has earned national accolades and multiple honors for extraordinary achievements and ongoing efforts to provide hope to cancer patients worldwide.
According to Dr. Heymach, lung cancer is by far the leading cause of cancer deaths but is strikingly underfunded. There is still a stigma attached to lung cancer, but even patients who smoked are still worthy of treatment. The majority of lung cancer patients are ex-smokers or never-smokers. He stated that there are many survivors of breast cancer who advocate for funding for breast cancer research. There is a much smaller pool of survivors of lung cancer to advocate for funding, thus the large disparity in the allocation of funds.
MDA offers a personalized program to encourage cessation of smoking. You can ask your provider to refer you to their Tobacco Treatment Program or do a self-referral by sending an email to quitnow@mdanderson.org or call the 2-QUIT line at 713-792-7848 (local) or 866-245-0862 (toll-free).
From 1973-2000, the survival time for lung cancer patients was 6.9 to 7.3 months. Treatment caused tremendous toxicity but not significant benefit. Everyone got the same treatment (nicknamed “carpet bombing”). Today, they use “smart bombing” with immunotherapy and targeted therapy drugs (they target an exact mutation), and the average survival rate is much longer. (Sorry, I was busy jotting my notes and didn’t catch that statistic!)
There are numerous types of gene mutations in lung cancer, with the three main ones being:
KRAS – 22%
EGFR – 17%
EML4-ALK – 7% (this is what Chris had)
These mutations apply not just in lung cancer but in many other types of cancer as well.
The cost of a new drug development by Big Pharma is $2.6 billion. MDA’s Moon Shot program’s cost for drug development is less than $1 million because they take existing FDA approved drugs and try to find ways to “repurpose” them for use with various types of other cancers. Because these drugs have already been approved for use in humans, it cuts out many steps in the process as they move directly to testing to see what various types of cancer the drugs work for.
Immunotherapy re-engineers a patient’s own immune cells and then they are reinfused. The cells may come out as a “Chihuahua” but are infused back in as an “attack German Shepherd” against the cancer.
The reason the cost of drugs is so high is basically due to supply and demand. With regular medications, the FDA simply assures they are safe and effective. There are a lot of medications on the market that can be used to treat a condition.
When it comes to cancer treatments, though, there are fewer choices for patients because they only allow the most effective drugs to be used. Thus, there is less competition. Pricing is not based on the cost to produce the drugs but on what the market will bear. A drug that costs the patient $15,000/month may cost only pennies to make. Patients must advocate for change and allow a competitive market to drive down the price!
Albert Koong, M.D., Ph.D., is chair of Radiation Oncology at MD Anderson. He is an internationally recognized physician-scientist; his research centers on developing advanced radiotherapy techniques to treat gastrointestinal malignancies, especially in the pancreas and liver.
In the 1950s, radiation was conventional 2D (2-dimensional).
In the 1980s, radiation was conventional 3D (3-dimensional).
In the 2000s, IMRT radiation beams were 3D and shaped to the tumor. Usually 25-30 treatments are done. (Chris had only 15 rounds but at higher dose to quickly shrink his tumor.)
Then came SBRT/SABR, Particle Beam, and Proton Beams. Proton Beams help prevent collateral damage of surrounding tissue and organs.
Dr. Albert Koong, Dr. John Heymach, Dr. Karen Lu from MD Anderson Cancer Center
Radiation combined with immunotherapy allows “under radiated” therapy to work.
I am continually thankful to the doctors, scientists, nurses, pharmaceutical companies, and clinical trial patients who all work together to help make cancer “history.”
Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the products or services I have mentioned (other than my own book). I am disclosing this in accordance with the Federal Trade Commission's 16 CFR, Part 255: "Guides Concerning the Use of Endorsements and Testimonials in Advertising."