Cancer Information Charity Foundation (CICF) announced on Oct. 25 the survey results on “Treatment of Brain Metastasis in Non-Small Cell Lung Cancer Patients.” The survey found that over 90 percent of the respondents understand that brain metastasis is common in lung cancer, and more than 80 percent of them believe it is necessary to understand the treatment methods for brain metastasis before starting treatment. The “Cancer Information Network” stated that new third-generation targeted therapies have emerged, which can more effectively control the symptoms of brain metastasis, and urged authorities to promptly include these drugs in the safety net provided by the Hospital Authority to benefit lung cancer patients.
The brain is a common site for metastasis lung cancer, especially in cases of Anaplastic Lymphoma Kinase (ALK) non-small cell lung cancer, where approximately 30-40 percent of patients may develop brain metastasis. In June and July of this year, CICF surveyed 100 non-small cell lung cancer patients. The results revealed that 93 percent of the respondents were aware of the frequent occurrence of brain metastasis in lung cancer, and it imposed significant emotional stress on patients. They considered the impact on the brain and their overall quality of life as their primary concerns. Eighty-three percent of the respondents believed that it is essential to understand the treatment methods for brain metastasis before initiating any treatment. When contemplating new therapies, the effectiveness of treating brain metastasis was deemed the most critical factor, followed by considerations of survival and symptom alleviation.
ALK is a genetic mutation found in non-small cell lung cancer, categorized as a fusion gene resulting from the accidental rearrangement and fusion of two normal genes. Non-small cell lung cancer is divided into four stages, and metastasis can occur, with the brain being a common site for metastasis in lung cancer. This situation is particularly relevant for ALK-positive non-small cell lung cancer patients. Following metastasis, depending on the location of the tumor in the brain, patients may experience symptoms such as headaches and seizures, significantly affecting their physical condition and quality of life.
CICF pointed out that due to the blood-brain barrier’s selective blockade of substances between the bloodstream and the brain, not all cancer drugs can effectively penetrate the brain to exert their effects. Currently, there are new-generation targeted therapies that have better penetration through the blood-brain barrier, allowing for more effective control of brain metastasis symptoms.
Dr. Cheng Chi-kin, a specialist in clinical oncology, stated, “Currently, newer third-generation targeted therapies with improved penetration through the blood-brain barrier have emerged, allowing for more effective control of brain metastasis symptoms. For patients, these can reduce or delay the need for other brain metastasis treatments such as radiation therapy or surgical interventions.”
Jennifer, a non-smoker and non-drinker, was diagnosed with stage 3 ALK gene mutation lung cancer approximately ten years ago. After undergoing surgery, her cancer recurred about a year later. Following her doctor’s advice, she decided to take targeted therapies to control the disease. She has been on targeted therapies, progressing from the first-generation to the current third-generation drugs, and her condition has become stable.
Jennifer is fortunate not to have experienced brain metastasis, but she is aware of the challenges it poses to lung cancer patients. She also knows that the current third-generation targeted therapies are effective in treating brain metastasis. She admits that the high cost of medication is not affordable for everyone, and she can take the medication for free because she participated in a clinical trial. Therefore, she urges society as a whole to provide more support to lung cancer patients with brain metastasis, especially when it comes to covering the costs of medications.
CICF points out that many cancer drugs are costly, and being diagnosed with cancer is already a significant misfortune, the cost of cancer treatment further impacts the financial situation of many patients and their families. The survey reveals that 39 percent of respondents had their careers affected after their diagnosis, and 40 percent had a monthly household income of less than HK$20,000 ($2,556).
Chairperson of CICF, Fong Ka-yi, points out that 86 percent of the respondents consider the cost as a significant factor when contemplating new treatments, emphasizing that the financial pressure brought by cancer treatment should not be underestimated. Ninety-two percent of the respondents expressed economic concerns due to the potential need for second-line medications, and 26 percent of patients have experienced medication interruptions due to financial issues. The survey also reveals that 89 percent of respondents believe the lack of government subsidies is a major potential barrier to initiating new treatments. CICF urges authorities to swiftly include these drugs in the safety net and provide government assistance to benefit lung cancer patients.
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