It’s Not About Mistrust- Why Oncologist Want a Review of the Cancer Diagnosis? - PathSOS
When Arvind scheduled his oncology doctor’s appointment, he’d already been to a number of different doctors. It had taken months for his local doctors to figure out that the ulcer in his mouth was not a simple sore. As his visit with the oncologist neared, he was eager to get some clear guidance and form a treatment plan. But when he got there, Arvind, then 30, met a doctor he felt was cold and impersonal and simply too busy! “He just said, ‘ Go do all the things on your bucket list,’” said Arvind, a father of two. So many questions, and no answers, just a big list of investigations and complicated treatments. Arvind, came out of the doctor’s office with his wife, knowing they needed to seek another opinion – just to be sure and find those answers they were seeking. Yet some patients may feel reluctant to turn to another doctor, sometimes for fear of offending/challenging their original doctor. Most so not know how to go about getting another opinion. Dr Abha Malik, an oncopathologist, says that she wants patients to realize that most of oncologists view second opinions as important and often necessary. Infact it is a standard of care in the leading centers of the world. “Some patinets are hesitant to seek a second opinion because they think they will offend their doctor and it may interfere with their subsequent doctor-patient relationship,” said Dr Malik. Some patients, especially older ones, may not ask for a second opinion because they feel they should not cheat on their doctors. “But in reality it’s not cheating,” she said. “It’s your life and it’s better to get an unbiased perspective from multiple carers.” It may even be advisable for patients to seek another opinion in diseases like cancer. People who are facing a cancer diagnosis should feel at ease with their treatment decisions, she said. And it may mean getting a second opinion or even changing hospitals or doctors. “You need to gather all the information you may need to make a sound decision and be comfortable with your cancer care treatment team. This is really serious and impacts your life and so you deserve the opportunity to get atleast a couple of opinions.” After their visit, Arvind and his wife and his wife reached out to friends and family members in hopes of a recommendation. They searched on internet and stumbled upon PathSOS, an online cancer second opinion consultation service. Arvind contacted them via net and was promptly called up by their patient coordinator who asked him to submit all his medical records online and his biopsy slides for pathology and treatment review. The slides were reviewed by a highly subspecialized oncopathologist who made some important changes in the diagnostic report that altered his staging and treatment options. Following which the radiation oncologist and surgical oncologist in the virtual team looked at his case that led to a comprehensive case review and treatment planning. With this expert review report, Arvind and his wife were much more sure about their options. Also the reporting format of PathSOS doctors was much more integrated that helped them get a better overview. Some of the PathSOS experts that looked at Arvind’s case, were international experts that he could never have thought of getting a consultation from, since travel overseas is an expensive and complex affair. “PathSOS review gave me the confidence about my diagnosis and helped me make informed choices about my treatment’. “It just felt good to know that we had done the best we could”– and that he really wanted to. That part of it was probably just as important as the treatments that he took subsequently in his hometown. His doctor even confided that the PathSOS review had given him insights and handholding from another team of specialists. Even when a "second opinion" does not make a big change in diagnosis or treatment, it’s just good to know that you are doubly sure. Because it’s not work the risk to make such a mistake.
Cancer Immunotherapy|How Immunotherapy Works|Types of Cancer Immunotherapy - PathSOS
Activating the immune system for therapeutic benefit in cancer has emerged as one of the most promising developments in immunology and oncology. In the past few decades, scientists have been trying to manipulate the human immune system to attack cancer cells. It's called immune therapy (or immunotherapy) and it works by harnessing the body's own natural killing cells to kill tumours. Cancer Immunotherapy has become a key part of treatment for many different types of the cancer. How Immunotherapy Works Against Cancer The immune system monitors all of the substances normally found in the body. Any new foreign substance that the immune system doesn’t recognize raises an alarm, causing the immune system to attack and kill it. However immune system has a tougher time targeting cancer cells because they are able to hide from your immune system and multiply rapidly. To overcome this, researchers have found ways to help the immune system to mark and destroy these cells. as emerged as what many in the cancer community now call the “fifth pillar” of cancer Types of Cancer immunotherapy The main types of immunotherapy currently used to treat cancer include: Monoclonal Antibodies These are man-made versions of immune system that bind to specific antigens on cancer cells. They have been designed as one of the most successful therapeutic strategies for both hematologic malignancies and solid tumors. T-cell Therapy Chimeric antigen receptor (CAR) T-cell therapy has been restricted to small clinical trials, largely in patients with advanced blood cancers. It requires drawing blood from cancer patient’s blood, and genetically altering them in a lab to produce specific receptors known as chimeric receptors so they can seek out and kill cancer cells. Immune Checkpoint Inhibitors Checkpoint inhibitors are currently the most generally utilized type of immunotherapy. They obstruct the activity of inhibitory molecules or enact stimulatory molecules which are found on the surface of numerous T cells. They are infused into the blood where they find the body's natural cancer-killing immune cells and keep them switched on so they can attack tumours. Cytokines cytokines are often given in combination with chemotherapy or radiotherapy to promote tumor immunity, inflammation, and carcinogenesis. These are of two types interleukins, which speed up the division of immune cells, and interferon’s, which helps the body in resisting cancer. Cancer Vaccines Cancer treatment vaccines are designed to treat cancers that have already been developed by strengthening the body’s immune system against the cancer. They are made from a patient’s own tumor cells by building up antibodies without actually contracting the illness. Nowadays getting a second opinion is considered an essential and necessary component when you’ve been diagnosed with cancer. Seeking the opinion of our international experts in cancer care can ease your mind and help you feel more secure in the decisions you are making about the treatment plan. At PathSOS, we welcome patients who seek 'second opinions for cancer' care or "Cancer Immunotherapy . Our expert team of cancer care specialists focus on selective and the best treatment plan for each patient. In addition to recommending standard therapies, our specialists may also offer innovative treatment options not widely available at most hospitals, including clinical trials that may be right for you.
Immunotherapy for Lung Cancer - PathSOS
Immunotherapy is a type of treatment that uses drugs to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. Immunotherapy is being increasingy used to treat some forms of non-small cell lung cancer of the lung, also known as NSCLC in short. This subset can be diagnosed by assessing PDL-1 expression with immunohistochemistry. In 2015, the FDA approved nivolumab (Opdivo®) and pembrolizumab (Keytruda®), for the treatment of non-small cell lung cancer that has stopped responding to standard chemotherapy — in other words, as second-line therapy. These drugs block a protein called PD-1, which is normally found, on immune cells. PD-1 acts like a brake on the immune system, clamming down immune responses. Nivolumab and pembrolizumab release this brake system, allowing the patient’s ownimmune system to mount a stronger attack against cancer cells. A number of clinical trials are testing immunotherapy drugs in all settings: before and after surgery for early stage lung cancers, as first-line therapy in patients with advanced lung cancers, and in patients who have previously received chemotherapy. At PathSOS our cancer diagnostic specialists have immense experience in diagnosing cancer that show positivity with PDL-1 and is eligible for therapy, thus enabling precision medicine with tailored therapy. What are Immune Checkpoint Inhibitors? A very crucial role of the immune system is its ability to prevent itself from attacking normal cells in the body. To be able to do this, it uses “checkpoints” – which are molecules on immune cells that need to be turned on (or off) to start an immune response. It has been found that Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. But newer drugs that are being discovered can target these checkpoints may hold a lot of promise as next line of cancer treatments. Nivolumab (Opdivo) and pembrolizumab (Keytruda) target PD-1, a protein on immune system cells called T cells that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth. Atezolizumab (Tecentriq) targets PD-L1, a protein related to PD-1 that is found on some tumor cells and immune cells. Blocking this protein can also help boost the immune response against cancer cells. Durvalumab (Imfinzi) also targets the PD-L1 protein. This drug is used a little differently than the other immunotherapy drugs. It is used in people with certain types of NSCLC whose cancer has not gotten worse after they have already received chemotherapy along with radiation (chemoradiation). The goal of treatment with this drug is to keep the cancer from getting worse for as long as possible. Mode of drug delivery: These immunotherapy drugs are given as an intravenous (IV) infusion every 2 or 3 weeks. Immunotherapy Possible Side Effects As with all drugs, there are side effects of these drugs which include fatigue, cough, nausea, itching, skin rash, loss of appetite, constipation, joint pain, and diarrhea. Other, more serious side effects can also occur nut less often. It is important to report the side effects promptly to your treating doctor for action. PATHSOS team of specialists is trained in these treatments and diagnosis. According to Dr Abha Malik PATHSOS expert lung cancer diagnostician; proper interpretation and analysis of PD-L1 expression , is the critical step here to identify the subset of patent’s that will benefit from this new lung "cancer immunotherapy".