You may have heard of friends on maintenance therapy for other forms of cancer. Now, the FDA has approved the first “maintenance therapy” for lung cancer.

But first. What is maintenance therapy?

Maintenance therapy involves treatment with a chemotherapy drug to keep a cancer from spreading after it has responded to chemotherapy. The chemotherapy drug pemetrexed (Alimta) has now been approved for people with advanced lung cancer who have already completed a course of chemotherapy, and would not otherwise receive further treatment unless their tumors started to grow again. (Alimta is not a new drug, and had previously been approved for mesothelioma, for patients who were getting worse on chemotherapy, and is often used as a first-line treatment for advanced lung cancer combined with another chemotherapy drug.)

Next. The questions I would want answered if I was a lung cancer survivor: Who is a candidate for maintenance therapy for lung cancer? Will maintenance therapy increase my survival rate? Will it have side effects?

Maintenance therapy with Alimta is designed for people with advanced non-small cell lung cancer after they have responded to chemotherapy (usually 4 to 6 rounds of treatment). It is reserved for two types of non-small cell lung cancer; adenocarcinoma and large cell lung cancer. Unfortunately, those with squamous cell lung cancer do not appear to respond to maintenance treatment.

Survival was improved by about 3 months in people who received maintenance therapy with Alimta. Although Alimta has fewer side effects than some of the other medications used in lung cancer, side effects can include:

• Bone marrow suppression
• Fatigue
• Nausea
• Loss of appetite
• Peripheral neuropathy
• Skin rashes

_Source:

_{Food and Drug Administration. FDA News Release. FDA Approves First Maintenance Drug Therapy for Advanced Lung Cancer. Accessed 07/07/09. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm170515.htm}

Looking out at the lake, the hues of green are quickly becoming a backdrop to red, white, and blue. The burbs here are taking on a small town flavor, as people decorate for the 4th.

But of course, lung cancer prevention remains central in my neurotic mind. So how can I grab the spirit of Independence Day and apply it to lung cancer prevention? Red, white, and blue foods that might play a role in cancer prevention.

Our About.com Guide to Home Cooking, Peggy Trowbridge Filippone provides today’s recipes. Soup, salad, and dessert in patriotic colors with a boost of cancer prevention to boot. Celebrate!

Red - Pomegranates

Pomegranates are rich in substances that are being studied both for cancer prevention and treatment. Top some leafy greens with this dressing.

• Pomegranate Port Vinaigrette Recipe

Blue – Blueberries

Blueberries can be thought of as the broccoli of the fruit family. Blueberries are loaded with phytochemicals that appear to aid in cancer prevention in several ways.

• Chilled Blueberry Soup Recipe

White – Macadamia Nuts

Nuts are often a forgotten treasure when we talk about eating healthy, and make a tasty addition to a vegetable and fruit rich diet.

• Macadamia Banana Cream Pie Recipe

Photo: flickr.com, user Matt McGee

_Sources:

_{Gonzalez, C. and J. Salas-Salvado. The potential of nuts in the prevention of cancer. British Journal of Nutrition. 2006. 96(Suppl 2):S87-94.}

_{Khan, N. et al. Pomegranate fruit extract inhibits prosurvival pathways in human A549 lung carcinoma cells and tumor growth in athymic nude mice. Carcinogenesis. 2007. 28(1):163-73.}

_{Seeram, N. Berry fruits for cancer prevention: current status and future prospects. Journal of Agricultural and Food Chemistry. 2008. 56(3):630-5.}

There is more to the war on cancer than finding new treatments. When we find those treatments, can we afford them? Just as we once dreamed of space travel and have now touched the moon, some novel cancer treatments are now a reality. But just as the cost of space travel limits the adventure to a select few, is the cost of some cancer treatments prohibitive for the masses?

I understand that it is unfair to compare space travel to cancer treatment. Comparing a travel experience to surviving is definitely an oranges and apples scenario. Should cost get in the way of lung cancer treatment? Are the drugs worth the cost?

Researchers looked at the cost of a form of targeted therapy for lung cancer treatment, and pulled out their calculators in an attempt to see the big picture. They looked at the chemotherapy drug cetuximab (Erbitux) a medication that prolongs lung cancer survival 1.2 months. The cost for an 18 week course of treatment is $80,000. Based on this, they calculated that it would cost $800.000 to increase life with cancer by one year.

To get the big picture, they crunched numbers to see what it would cost to prolong the lives of 550,000 people who die in the United States yearly by one year. The answer: $440 billion.

Based on this number, these researchers made a recommendation: If treatment will extend survival less than two months, treatments should only be tested if they cost less than $20,000. This decision was not made rashly. One of the researchers is a bioethicist, and they do state that every life is of infinite value. But with the current status of our health care system, where do we draw the line?

In the past 4 years, over 90% of cancer drugs approved in the U.S. cost more than this. Other drugs that were looked at included bevacizumab (Avastin) and sorafenib (Nexavar). These drugs are less costly than Erbitux, but well over the $20,000 recommended limit.

Thinking about this puts a chasm between my heart and my brain. I wasn’t born yesterday and I understand economics, but I have known and loved people during the last 1.2 months of their lives with cancer. And I can say that those last days were totally worth the cost.

What do you think? Please take our poll and comment.

Photo: istockphoto.com

_Source:

_{Fojo, T. and C. Grady. How Much is Life Worth: Cetuximab, Non-Small Cell Lung Cancer, and the $440 Billion Question Journal of the National Cancer Institute. 2009. doi: 10.1093/jnci/djp177.}

Being a caregiver for someone with cancer is incredibly rewarding, but can be draining at the same time. Sometimes it feels like there isn’t even enough time to eat or brush your teeth, let alone exercise. But taking time for yourself – taking time to be active – might be just what you need to add more time and energy to your day.

We don’t really need another study telling us exercise is beneficial. But researchers took a step that made me close my mouth, as the words “I don’t have time” came to my lips. Female spouses of patients that were beginning radiation therapy for cancer were asked about their level of physical activity. They were then divided into 2 groups – inactive and active. Compared with the active caregivers, the inactive caregivers:

• Had more difficulty falling asleep
• Slept less at night and needed more sleep during the day
• Had a lower attention span

Getting exercise as a caregiver can result in better sleep, and in doing so, open up more minutes in your day – minutes you can spend refreshed with your loved one.

Further Reading:

Tips for Caring for Yourself as a Caregiver

Photo: istockphoto.com

_Source:

Willette-Murphy, K. et al. Relationship between sleep and physical activity in female family caregivers at the initiation of patients’ radiation therapy. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2009. 38(3):367-74.