Lung Cancer | Cancer NZ

Avastin is a Prescription Medicine. For detailed information click here ...

Avastin® (bevacizumab) is a Prescription Medicine used to treat metastatic (spreading) colorectal and kidney cancer.Avastin should not be used if you have untreated cancer in your brain or spinal cord. Tell your doctor if you have inflammation of the bowel or stomach ulcers; high blood pressure; a history of bleeding and/or blood clots, stroke or a blocked lung artery; a history of Reversible Posterior Leukoencephalopathy Syndrome (RPLS); have had major surgery in the last 28 days or a wound that has not healed properly; are pregnant or breast feeding; have heart disease, have ever received anthracylines for cancer or radiotherapy to your chest; or are >65 years of age. Possible unwanted effects: Common: high blood pressure, body pain, tiredness/weakness, diarrhoea, nausea, constipation, bleeding, sore mouth, mouth ulcers, loss of appetite, shortness of breath, nose bleed, runny nose, dry, scaling or inflamed skin, change in skin colour, taste change, dizziness/faintness, headache, sleepiness/drowsiness, wounds that won’t heal, changes in your voice, fever. Serious (rare): severe body or stomach pain; severe diarrhoea, nausea and vomiting; pain and/or swelling in the lower legs, feet or hands; severe bleeding; seizures, headache, abnormal thinking, and/or eye problems; abscesses, severe infections; feelings of numbness or tingling in feet or hands. Ask your oncologist if Avastin is right for you. Use strictly as directed. If symptoms continue or if you experience side effects or would like further information, please talk to your oncologist or pharmacist, or visit www.medsafe.govt.nz for Avastin Consumer Medicines Information. Avastin (100mg in 4mL and 400mg in 16 mL vials) is an unfunded medicine, you will need to pay for this medicine. A prescription charge and normal oncologist fees may apply.

Tarceva is a Prescription Medicine. For detailed information click here ...

Tarceva® (erlotinib) is a Prescription Medicine used to treat advanced or metastatic (spreading) non-small cell lung cancer (NSCLC) after previous treatment with chemotherapy. Tell your doctor if you have liver or kidney problems, are a smoker, are intolerant to lactose, if you are pregnant or breastfeeding, or taking other medicines. Possible unwanted effects: Common: Tiredness, loss of appetite, itching, dry skin, eye irritation, nose bleeds, unusual hair loss, and swelling around the nails. These are generally mild and short-lived. You should contact your doctor if the following are persistant or get worse: red/purple spreading rash, eye pain, diarrhoea, cough, nausea, vomiting, and dehydration (dry skin, dark coloured urine, thirst, weakness, fatigue or loss of appetite). Tell your doctor immediately if you have shortness of breath/difficulty breathing, infection with fever/chills, stomach pain, or if you notice sores/blisters in the mouth, nose or near eyes which are red or painful. Serious: Severe/persistent diarrhoea, nausea, loss of appetite or vomiting; severe stomach pain, vomiting blood or material that looks like coffee grounds, bleeding from your rectum, black sticky bowel motions, or bloody diarrhoea;Sudden onset of new or worsening breathing difficulties, associated with cough or fever; nausea, vomiting, loss of appetite, feeling unwell, fever, itching, yellowing of the skin and eyes, and dark coloured urine which may be due to liver problems. Ask your specialist if Tarceva is right for you. Use strictly as directed. If symptoms continue or if you experience side effects or would like further information, talk to your specialist or visit www.medsafe.govt.nz for Tarceva Consumer Medicines Information. Tarceva (25mg, 100mg and 150mg tablets) is an unfunded medicine, you will need to pay for this medicine. A prescription charge and normal specialist fees may apply.

Neulastim is a Prescription Medicine. For detailed information click here ...

Neulastim® (pegfilgrastim, 6 mg in 0.6 mL PFS) is a Prescription Medicine used for reducing the duration and incidence of neutropenia (decrease in white blood cells) and infection, in patients treated with chemotherapy. Neulastim should not be used if you have had an allergic reaction to Neulastim, filgrastim (Neupogen®), E-coli-derived proteins or any of the ingredients listed on the medicine pack; if you are currently receiving chemotherapy or radiotherapy, or have received chemotherapy in the last 24 hours. Tell your doctor if you have other health problems, including myelodysplastic syndrome, leukaemia, spleen problems, sickle cell disease, you are receiving high dose chemotherapy, you are pregnant or plan to become pregnant or are breastfeeding. Possible unwanted effects: nausea, vomiting, headache, bone, joint or muscle pain; swelling, pain or itching at injection site; skin rash or red itchy spots, breathlessness, difficulty breathing, pain in the chest area. Ask your doctor if Neulastim is right for you. Use strictly as directed. If symptoms continue or you experience side effects or would like further information, please talk to your health professional or visit www.medsafe.govt.nz for Neulastim Consumer Medicines Information.

Neulastim is listed under Part II and Part IV of Section H of the Pharmaceutical Schedule. Funding is at the discretion of the DHB.

Neulastim® is sold under license from Amgen Inc. Neulastim® is a trademark of Amgen Inc. Consumer panel dated 5 December 2011, based on CMI dated 31 March 2011. Roche Products (New Zealand) Limited, Auckland; Phone 0800 656 464. www.roche.co.nz. All trademarks mentioned herein are protected by law.
ID1128/DA4011BR/2011DEC

What is lung cancer?

Lung cancer is a disease whereby, cells grow uncontrollably in the lung tissue usually beginning in the lining of the bronchi or bronchioles (small tubes in the lungs, through which air passes while breathing). As these tumours enlarge they can block off the bronchi and restrict the airflow into the lung. They commonly spread into the local lymph nodes and occasionally the chest wall. This reduces the airways capacity leading to shortness of breath and coughing. The growth may lead to metastasis, which is when the cancer spreads to other areas of the body. The main types of lung cancer are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). This page discusses only NSCLC.

Smoking is the most common cause of lung cancer and is attributed to approximately 85% of cases. Lung cancer in non-smokers is attributed to a combination of genetic factors, radon gas, asbestos and air pollution, including second-hand smoke.

Non-small cell carcinomas (NSCLC)

The main types of NSCLC include squamous cell carcinoma, adenocarcinoma and large-cell carcinoma. These commonly affect the cells lining the main bronchi of the lungs.

Squamous cell carcinoma has a lower rate of metastasis (spread) than other types of lung cancer and if it is discovered early, may result in a better prognosis following treatment. Adenocarcinoma is a cancer of the glandular cells of the lung and is becoming the most common form of NSCLC.

It is important to emphasise that the differential diagnosis of lung cancer is established first as treatment decisions are dependent on this.

How common is lung cancer?

Lung cancer is the most common cause of cancer death in New Zealand with 1451 men and women dying in 2005 (the most recent published data).

Many more men than women die from lung cancer but while the number of men diagnosed has decreased since 1995, the disease is increasing among women.

How lung cancer is diagnosed

If lung cancer is suspected, several tests can be used to see whether or not it is present.

The doctor will ask you about your past and current health, smoking and work history, followed by a physical examination. Then, your doctor may recommend that you have a test or a series of tests for lung cancer. These can include a chest x-ray and a scan called a CT scan. The diagnosis is confirmed with a biopsy (tissue sample).

‘Staging’ the disease

Your tests will show whether you have cancer, and if you do, where the primary cancer (this is the part or place in the body where the cancer originates from) is, its size and if it has spread to other parts of your body (metastasis).

This helps your doctors ‘stage’ the disease so they can work out the best treatment for you. Your doctors will also consider your general state of health and personal choices when determining treatment options.

What treatments are there for lung cancer?

The main treatments for lung cancer are surgery, radiation therapy (x-ray treatment) and chemotherapy. The choice of treatment will depend on the type of lung cancer, whether it has spread beyond the lung, how well your lungs are functioning and on your general health.

The aim of treatment is to keep you as well and symptom-free as possible, even if your cancer cannot be cured.

Chemotherapy

Chemotherapy is a treatment with one or a combination of anti cancer medicines that aim to destroy or control cancer cells and works by killing cells that divide rapidly, one of the main properties of cancer cells. This means that it also harms cells that divide rapidly under normal circumstances: cells in the bone marrow, digestive tract and hair follicles; this results in the most common side effects of chemotherapy – myelosuppression (decreased production of white blood cells), mucositis (inflammation of the lining of the digestive tract) and alopecia (hair loss)

Managing the side effects of Chemotherapy

One of the common side effects of chemotherapy is a low white blood cell count. This condition is called neutropenia and it is serious because it can increase your risk of developing a life threatening infection. Neulastim is used following chemotherapy to increase the number of white blood cells. This will reduce your chance of developing infections that might require treatment with antibiotics and/or hospital stays. Neulastim may also help to keep your chemotherapy treatment on schedule. Read more about Neulastim on the consumer medicines information site. For more information about Neulastim click on the product logo.

Targeted Therapy

In recent years a new generation of anticancer agents have been developed based on an increased understanding of cancer biology. This knowledge has led to the development of new targeted therapies that are less toxic to the cells in your body (cytotoxic).

Roche produces two types of targeted treatments for NSCLC.

Tarceva is a targeted chemotherapy used for the treatment of advanced or metastatic non-small cell lung cancer (NSCLC) following previous treatment with chemotherapy. In a clinical study, 31% of patients taking Tarceva were alive one year after they started, compared with 22% of patients who took placebo (sugar pill), a 41% improvement. Read more about Tarceva on the site for consumer medicines information. For more information about Tarceva click on the product logo.

Avastin is a biologic therapy, also known as a targeted agent. Biological therapies can be given alongside chemotherapy to improve survival times for patients with cancer. Avastin has been proven to increase survival times for people with advanced, recurrent or metastatic NSCLC cancer. Read more about Avastin on the site for consumer medicines information. For more information about Avastin click on the product logo.