Lung cancer is a global “pandemic” as it is one of the most frequent and serious types of cancer with the highest mortality. The disease needs urgent management, with the need to utilize all the possibilities of science and technology, so that it becomes a chronic disease.

November has been designated as a month of information and awareness about the disease and, as experts pointed out at an event organized by Bristol Myers Squibb (BMS), under the auspices of the Hellenic Lung Cancer Society (H.L.E.K.A.P.), a one of the most important causes of the disease is smoking, with 80% of cases in the western world being related to this habit. But the disease is also diagnosed in passive smokers and non-smokers. Family history, occupational exposure to asbestos and industrial metals, air pollution and inhalation of indoor air due to burning of unsuitable materials are also risk factors.

“In Greece, approximately 9,000 new cases and approximately 7,000 deaths from lung cancer are recorded every year. The mortality rate of this disease exceeds that of breast, colon and prostate cancer combined. The disease can be present, either without or with mild symptoms, such as chest pain, hoarseness, shortness of breath, persistent cough and feeling weak. Unfortunately, only 16% of patients are detected at the initial stage of the disease, while most patients show symptoms when the disease is already in advanced stages,” said oncologist-pathologist Ilias Athanasiadis. He added that prevention and early diagnosis of the disease is one of the key tools to improve patient survival. In the general population and especially in high-risk groups, screening through diagnostic tests such as low-dose chest CT contributes to early diagnosis and therefore early treatment, with the most innovative treatment options now available thanks to scientific progress,” he concluded.

Andriani Harpidou, pulmonologist, head of the Clinical Studies department at the 3rd Pathology Clinic and Homonymous Laboratory of the Medical School of the Greek Academy of Sciences, G.N.A “Sotiria”, spoke about the new treatments, noting that: “The new, innovative treatment options offer more personalized and effective approach to treatment, improving outcomes related to patients’ overall survival and quality of life. Immuno-oncology is a revolution in treatments, thanks to its different mechanism of action, providing therapeutic solutions to patients who until now had few options. Findings from clinical studies document that immuno-oncology therapies are state-of-the-art in treating the disease in terms of patient outcomes, since the immune system is trained to fight cancer cells even after the disease has gone into remission. These treatments are expected to change the course of the disease in the coming years, in combination with local treatments, surgery and radiation therapy, as well as antibody-conjugated chemotherapy.”

Key to personalized therapy are biomarkers

Pathologist-oncologist Ioannis Bukovinas, MD, PhD, PharmaD, focused on the role of biomarkers, noting that “biomarkers are the key to personalized treatment, as they detect the special biological characteristics of the tumor, so that the patient receives the appropriate personalized treatment , which perfectly matches the stage and form of the disease, contributing to better survival rates. In addition, the use of biomarkers reduces costs from unnecessary or ineffective treatments and reduces hospitalization needs due to reduced side effects. The health system saves resources, while treatments are focused on patients who respond best.” It is critical, noted Mr. Bukovinas, to reach an understanding with the State by adopting sustainable strategies for patients’ access to free biomarker tests, through an evaluation and compensation process, similar to that of drugs, in order to achieve the holistic treatment of cancer.

Inequalities in Health

Konstantinos Syrigos, professor of Pathology and Oncology at the Medical School of the Greek Academy of Sciences, president of the Hellenic Lung Cancer Society, spoke about the inequalities and challenges, noting that “in Greece, many patients receive faulty treatment, with 15% of patients facing delays in tests and treatments and insufficient access to medicines. Many times we doctors compromise the treatment plan due to obstacles from the health system, the place of residence, the lack of social services and supportive environment and the inability to provide home care. People with a lower socioeconomic index are exposed to greater risk factors, do not participate in screening, or do not receive optimal treatment. People with psychiatric comorbidities, homeless patients and substance abusers face social stereotypes, do not seek medical care and are twice as likely to cancel a scheduled examination or treatment and up to 4 times more likely to become ill and end up due to delayed diagnosis. Similar prejudices, according to studies, are also experienced by smokers, with over 20% of society showing less compassion, recognizing reduced rights to patients who have been smokers.

The event was coordinated by Giorgos Kapetanakis, president of the Hellenic Cancer Federation, who stated that “it is a fundamental right of patients to live longer and to have the best possible quality of life. The progress of science offers us many innovative ‘weapons’. We must all together, agencies and the State, to ally, in order to enable equal access for all patients to all innovative scientific achievements, treatments, biomarkers, diagnostic tools, so that cancer is now a curable or at least controllable disease disease for the majority of patients”.