Author: Matthew Romeo

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FAQ Lung Cancer

Biomarker Testing

Biomarker Testing

You may have heard your care team mention the possibility of biomarker testing when trying to develop a plan of action for diagnosis or a potential diagnosis of cancer. While biomarker testing has been around since the 1950s, it’s not a term you come across often if you aren’t in the medical field. 

Biomarker testing is an effective tool for doctors to help identify targeted therapies for driver mutations or issues with the immune system for cancer patients. 

In this article, we will help you better understand what biomarker testing is and answer any questions that you may have about biomarker testing. This way you can make an informed decision about what is best for you and your body. 

Table Of Contents
  1. What is Biomarker Testing?
  2. Why is Biomarker Testing Useful for Cancer Patients?
  3. When Should I Consider Biomarker Testing?
  4. Which Types of Biomarker Testing Should I Be Asking For?
  5. Are There Different Types of Biomarker Testing?
  6. How is Biomarker Testing Done?
  7. Biomarker Testing Patient Stories
  8. Medical Experts on Biomarkers

What is Biomarker Testing?

Biomarker testing, also known as molecular or genomic testing, is the use of a laboratory test to measure biomarkers found in your bodily fluids or tissue. A biomarker is a biological molecule found in any bodily fluid that may indicate a sign of abnormality as in a disease or a condition. 

Doctors are able to use the tissue of a tumor to test for abnormalities in its DNA and levels of specific proteins in the tumor in order to identify what is causing the tumor to grow. In turn, they can then apply targeted therapy that will help remove the cancerous cells without damaging healthy cells. 

Why is Biomarker Testing Useful for Cancer Patients?

Biomarker testing is a great tool for cancer patients because it allows your care team to diagnose the type of cancer. This in turn can help your doctor determine the best treatment plan.

According to the National Cancer Institute (NCI), biomarker testing can also be used to identify genes the may lead to cancer or see how your treatment plan is progressing. 

“It’s helped us on three different occasions not only with diagnosis, but on each time that he had progression of his cancer, the liquid biopsy was able to say, here’s the mutation, here’s the new mutation, and here’s the direction the clear plot path that you need to take for survival.”

Read more about Rhonda’s success with Biomarkers

When Should I Consider Biomarker Testing?

The National Institutes of Health recommends biomarker testing for all patients with non-small cell lung cancer. Biomarker testing can also be useful for several other types of cancer including melanoma and breast cancer.

Three key times you should consider asking your doctor about biomarker testing are:

  • When your doctor suspects cancer and you are getting a biopsy done.
  • If you have been diagnosed with cancer but did not get biomarker testing done.
  • If lung cancer reoccurs after treatment

Essentially, if you are diagnosed with lung cancer you should discuss the potential for biomarker testing with your doctor.

“I wish I had actually asked for the full biomarker testing to see what their report was and ask questions about it. Cancer runs in my family, but I had done genetic testing. I didn’t understand this was different testing.”

Read More about Terri’s lung cancer story

Which Types of Biomarker Testing Should I Be Asking For?

There are two types of biomarker testing that should be done if you’ve been diagnosed with or your doctor suspects lung cancer:

  • Driver Mutations – an error in a gene’s DNA
  • Expression of PD-L1 – an immunotherapy biomarker

Let’s dive further into the two types of biomarker testing to understand what they indicate and how they impact your treatment plan.

Driver Mutations

In order to understand driver mutations, it’s important to understand the basics of how genes and DNA work. 

DNA makes up genes. When everything is working normally each gene has its proper DNA code which then results in the production of proteins. 

A mutation occurs when a gene has an error in its DNA. Mutations are normal and happen often. A single mutation likely won’t cause cancer; however, the accumulation of multiple mutations over time is what typically results in cancer. 

Mutations are often sorted into two general categories:

  • Somatic (acquired) – The mutation is limited to just the tumor and is not passed to offspring.
  • Germline (inherited) – The mutation is present in all cells of the body and can be passed to offspring. 

There are several different types of driver mutations that can result in cancer. Some of the most common ones include:

  • Activating Mutation – The protein is always active.
  • Fusion – The fusion of one gene with another.
  • Amplification – More copies of a gene than normal.
  • Deletion – Part of or the entire gene is missing. 

Research has so far found 20 different driver mutations commonly found in non-small cell lung cancer treatment and small cell lung cancer treatment. Much more research is needed to continue identifying the potential mutations and develop targeted therapies. 

Expression of Programmed Death Ligand 1 (PD-L1)

The testing of your PD-L1 levels is what helps identify if you need immunotherapy. According to the National Library of Medicine, a PD-L1 test helps measure the amount of PD-L1 on cancer cells. 

This is important because PD-L1 proteins are what prevent your T-cells, otherwise known as immune cells, from attacking the cancer cells. Essentially, the abnormal cancer cells are hiding behind the PD-L1 proteins to stop your body from doing its job.

To learn more about immunotherapy visit our FAQ page.

“If you catch a patient stage one, you can have a greater than 90% chance of curing that patient from lung cancer. So that’s what it’s all about.”

– Dr. Michael Gieske

Read more about Dr. Gieske’s fight for early lung cancer screening.

Are There Different Types of Biomarker Testing?

Yes, there are several different biomarker tests that can be done. The type of biomarkers and test that is performed depends on the type of cancer that you may have. 

Some common tests include:

  • Single Biomarker Test – Only looking for one single biomarker.
  • Multigene Test – Looking at a panel of several different biomarkers.
  • Whole-Exome Sequencing – Looking at all of the genes in your cancer.
  • Whole-Genome Sequencing – Looking at all of the DNA in your cancer.
  • Tumor Mutational Burden Testing – Looking at genetic changes in your cancer to determine if you need immunotherapy.
  • Liquid Biopsies – Assessing blood or other bodily fluids for biomarkers.

The type of biomarker that is run depends on your cancer type and what your doctor is trying to learn from the test. 

How is Biomarker Testing Done?

An important part of deciding if biomarker testing is right for you may be how the actual test is performed. The test can be done in one of three ways depending on the type of biomarkers that are being tested for:

  • If you are having surgery, the surgeon can take a sample of your tumor during the operation.
  • They may need to take a biopsy of your tumor if you aren’t having surgery.
  • Some biomarker tests can be completed using just a blood draw.

In some instances, you may need to get an additional biopsy done if the cancer is reoccurring, or they didn’t get enough tissue to complete the test.

What Will My Biomarker Test Reveal?

The results of your biomarker test may help identify the best course of treatment by indicating what type of mutation is causing your cancer or if you are a candidate for immunotherapy. If there is an FDA-approved drug to treat your results you may be able to avoid chemotherapy or even potentially surgery.

“Research is going to biomarker testing that’s going towards targeted therapy. That’s the future of cancer care. That’s not just about lung cancer. So as we make it more people more aware of biomarker testing that goes across all cancers, that’s an education that is critical research.”

Read more about Chris Draft’s experience with lung cancer and his efforts to build awareness.

Biomarker Testing Patient Stories

Learn about how biomarkers impact a cancer diagnosis and treatment from real-life patients.

Lung Cancer

Chris Draft



Background: Chris' wife Keasha passed away from stage 4 lung cancer one month after they married. He's been a passionate lung cancer advocate ever since.
Focus: Leading with love, making connections to grow lung cancer community, NFL liaison

Rhonda & Jeff Meckstroth



Background: Jeff was diagnosed with stage 4 lung cancer and given months to live, but his wife, Rhonda, fought for a specialist that led to biomarker testing and better treatment options
Focus: Education of biomarker testing for driver mutations, patient and caregiver self-advocacy

Terri C., Non-Small Cell Lung Cancer, KRAS+, Stage 3A



Symptoms: Respiratory problems
Treatment: Chemotherapy (cisplatin & pemetrexed), surgery (lobectomy), microwave ablation, SBRT radiation

Stephen H., Non-Small Cell, ALK+, Stage 4 (Metastatic)



Cancer details: ALK+ occurs in 1 out of 25 non-small cell lung cancer patients
1st Symptoms: Shortness of breath, jabbing pain while talking, wheezing at night
Treatment: Targeted therapy (alectinib), stereotactic body radiation therapy (SBRT)

Shyreece P., Non-Small Cell, ALK+, Stage 4



Cancer details: ALK+ occurs in 1 out of 25 non-small cell lung cancer patients
1st Symptoms: Heaviness in arms, wheezing, fatigue
Treatment: IV chemo (carboplatin/pemetrexed/bevacizumab), targeted therapy (crizotinib, alectinib)
Breast Cancer
Francina B.


Francina B., Breast Cancer, Stage 2B



Initial Symptoms: None
Treatment: Surgery (lumpectomy, removal of cancerous sentinel nodes); Chemotherapy (doxorubicin, paclitaxel); Radiation

Abigail J., Metastatic Breast Cancer, HER2-low, PIK3CA+



Symptoms: Back and leg pain, lump in breast



Treatments: Surgery, chemotherapy, radiation, CDK4/6 inhibitors
Leukemia
Mary Clare

Mary Clare B., Acute Myeloid Leukemia (AML)



Symptoms: Extreme fatigue, upset stomach, bad & persistent headaches
Treatments: Chemotherapy, radiation, bone marrow transplants

Medical Experts on Biomarkers

Dr. Saad Usmani

Saad Z. Usmani, MD



Dr. Saad Usmani, Chief of Myeloma Service at Memorial Sloan Kettering, talks about CAR T-cell therapy, bispecific antibodies, novel therapies and combination therapies.

Deciding Best Myeloma Treatment for a Patient Using a New Strategy



Focus: Possible way of determining optimal treatment for patients without them having to go through treatment first, via using new approaches of studying tumors outside the body, gene expression, and computational data.
Featuring: Praneeth Sudalagunta, Ph.D, Moffitt Cancer Center

Tim Fenske, MD, MS



Role: Hematologist-Oncologist
Focus: chronic lymphocytic leukemia (CLL) & leukemia and lymphoma | CAR T, targeted therapy
Provider: Medical College of Wisconsin

Irene Ghobrial, MD



Role: Clinical investigator and professor of hematological oncology
Focus: Multiple myeloma, Waldenström’s Macroglobulinemia, early screening, clinical trials
Provider:Dana-Farber Cancer Institute (Boston)
Categories
FAQ Health Wellness Integrative

Should I Start Using Cannabis as Part of My Cancer Treatment Plan?

cannabis

Should I Start Using Cannabis as Part of My Cancer Treatment Plan?

Even just a few years ago the use of marijuana used to be an extremely taboo subject. However, as more and more states begin to legalize marijuana both medically and recreationally you may be wondering if you should consider using cannabis products as part of your cancer treatment plan.

While there are no credible studies that support the ability of cannabis to treat or cure cancer, it has been linked as an effective way to help with pain and symptom management. This includes both the physical and mental side effects that are linked with cancer and chemotherapy.

In this article, we will take a look at all of the ways cannabis can help and hurt with symptom management.

Table Of Contents
  1. Should I Start Using Cannabis as Part of My Cancer Treatment Plan?
  2. Which Chemo and Cancer Symptoms Can Marijuana Help With?
  3. What is the Best Way to Ingest Cannabis to Help Manage Cancer Symptoms?
  4. What are the Negative Side Effects of Cannabis Use in Cancer Patients?
  5. Do CBD Products Work in Helping Manage Cancer Symptoms?
  6. Where is Medical Marijuana Use Legal?
  7. Should I Consult with My Doctor Before Using Cannabis to Manage Cancer Symptoms?

Which Chemo and Cancer Symptoms Can Marijuana Help With?

There is a lot of information on the internet about how marijuana is a cure-all and the solution to every medical problem. 

While there is a definite need for further research on the benefits of the cannabis plant, it’s important that you get your information from a credible source before using cannabis to help manage symptoms. 

Additionally, it is important to consult your doctor and care team prior to using marijuana. That being said, cannabis has been shown as an effective way of helping manage the following symptoms associated with chemo and cancer:

  • Nausea and vomiting
  • Stimulation of appetite
  • Pain relief

Watch our interview with Dr. Donald Abrahms to learn more about the impact of cannabis in managing cancer and chemotherapy symptoms.

What is the Best Way to Ingest Cannabis to Help Manage Cancer Symptoms?

When it comes to cannabis you have a lot of options when choosing how to consume it. Each method of consumption will impact you differently. One of the best ways to consume cannabis in terms of the effectiveness of managing symptoms is through smoke inhalation. 

However, what’s best for you may vary based on how you react to each form of consumption and the type of relief that you are looking for.

I always tell people, if you want better control over the onset, the depth and the duration of the effect, inhalation is probably better than oral ingestion.

Dr. Donald Abrahms
Smoke or Vape Inhalation

When you inhale cannabis by through smoke, it takes about two and a half minutes to heat peak concentration in your plasma. It then dissipates rapidly. 

For this reason, you have more control over when you get a “high” from inhaling the plant, and over time you will understand how long the high lasts. You also are less likely to “overdose” yourself because the feeling is more instant.

Oil Vaping

Another popular method of consumption of cannabis is through oil vaping. While this will produce the same psychological effects as smoke inhalation, you are also inhaling the oil. This is unnatural and can damage your lungs. 

Edibles

Edibles like baked goods or gummies are also a popular way to consume cannabis. While these can be more convenient, they produce a different kind of “high.”

When you consume an edible the THC takes the first pass through the digestive system. This results in it are taking about two and a half hours to feel the effects of the cannabis. Additionally, it enters your plasma at a much lower concentration. As a result, you feel a little more “zonked.”

Oils and Tinctures

Another form of cannabis consumption is through a liquid drop that you place under your tung. This results in a form of hybrid high between edibles and smoke inhalation. 

You feel the immediate high from the oil absorbed under your tung. However, you also digest some of the oil and get a portion of the prolonged high that you feel from edibles. 

FDA Approved Pills

According to the American Cancer Society, The FDA has approved two pills that contain THC to help in the management of nausea, dizziness, and appetite stimulation. The two drugs are:

  • Dronabinol (Marinol®) – A gelatin capsule of THC.
  • Nabilone (Cesamet®) – A synthetic cannabinoid that acts like THC.

Both drugs give you a high and are absorbed similarly to edibles. The benefit here is that the dose can be controlled and since they are FDA approved, you know what’s going into them.

Of course, cannabis I like for symptom management. Cannabis is good for decreasing nausea. It’s the only anti-nausea medicine that also increases appetite works against pain for some people, it’s useful for anxiety, depression and sleep.

– Dr. Dr. Donald Abrahms

What are the Negative Side Effects of Cannabis Use in Cancer Patients?

While cannabis can help with symptom management, it can also have some negative side effects. Some of the common side effects linked to marijuana use include:

  • Increase heart rate
  • Dry mouth
  • Dizziness or lightheadedness
  • An extended euphoric feeling
  • Lowered blood pressure
  • Vomiting
  • Hallucination
  • Depression
  • Anxiety

If you feel these side effects, but want to continue using cannabis try decreasing your dose or starting a smaller dose and increasing it slowly.

Do CBD Products Work in Helping Manage Cancer Symptoms?

With the legalization of CBD products in several states, there have been many claims as to how CBD can help with cancer symptoms. In reality, it is a combination of THC and CBD that provides symptomatic relief. Therefore, a product that is solely CBD-based has not been scientifically proven to provide relief.

While studies in the future may prove otherwise, you a better of using a product that has THC in it to help manage your symptoms.

The studies in people who use the relief app show that the whole plan is the best for symptom management and that it’s the amount of THC that is associated with relief of symptoms as well as the adverse effects, whereas CBD does neither

-Dr. Donald Abrahms

Where is Medical Marijuana Use Legal?

The status of the legalization of marijuana for medical and recreational use is changing on a yearly basis. If you are looking for the most up-to-date information check out a map of each state’s marijuana law’s here.

Should I Consult with My Doctor Before Using Cannabis to Manage Cancer Symptoms?

You need to consult with your doctor before trying to use cannabis to manage your symptoms. Even if it’s illegal in your state you should still inform your doctor that you are using cannabis. The use of the drug could impact your treatment plan and how your care team is interpreting your medical results.

Categories
FAQ

How Do I Find a Cancer Support Group?

How Do I Find a Cancer Support Group?

Being diagnosed with cancer is an extremely emotional experience. It can be a very confusing time with a whirlwind of feelings. You don’t have to go through this experience alone. A cancer support group can help make the experience easier.

You can find a cancer support group by:

  • Reaching out to your local hospital
  • Completing an internet search
  • Discussing options with other cancer patients
  • Asking your social worker

There are thousands of cancer support groups across the country that cater to every age group, style of support, and type of cancer. Finding a support group may be as easy as completing a simple internet search but finding a group that fits your emotional needs may consider a bit more thought.

In this article, we will give you all of the resources you need to find a local cancer support group along with suggestions on what to consider when choosing a support group that is right for you. 

Table Of Contents
  1. How Do I Find a Cancer Support Group?
  2. How Do Cancer Support Groups Help?
  3. Which Type of Cancer Support Groups Are Available?
  4. How Do I Choose a Cancer Support Group?
  5. Online Resources for Finding a Cancer Support Group
  6. Use Your Care Team as a Reference

How Do Cancer Support Groups Help?

You can experience a wide range of emotions when being diagnosed with cancer: fear, anger, disbelief, and depression. It is a lot to unpack and coping with this wave of emotion can be extremely difficult. 

While families and loved ones are a great resource, they may not understand the difficulties that you are experiencing. You may have thoughts or feelings that you don’t feel comfortable sharing with the people closest to you. That is where support groups come in.

Support groups offer a safe place to express all of the emotions that you’re feeling as a cancer survivor. It’s a group of people who are all going through a similar experience to you. Meeting with a group of like-minded individuals can help you feel supported in your journey and help you feel less helpless or less alone.

While support groups aren’t right for everybody, they are a great option to try as you adapt to this new reality.

Steve

Read More About Steve’s Prostate Cancer Story.

It’s destructive to men to make them feel like they’re a wuss if they talk about their pain. I do not agree or subscribe to that at all. I live and speak very openly and encourage others to do the same.

-Steve R.

Which Type of Cancer Support Groups Are Available?

Every person has unique interests and needs. Therefore, one type of support won’t fit every individual. That’s why there is a variety of different types of support groups to fit the need of every individual.

Peer-led Support Groups

Peer-led support groups are run by the members of the group. This is a great option for someone looking for a sense of community and a place to work through their emotions with friends. 

Professional-led Support Groups

Professional-led support groups are led by a trained professional such as a:

  • Social worker
  • Counselor
  • Psychologist
  • Other trained professional

This is a great option for someone who is looking for guidance on how to cope with their emotions. It’s still in a group setting so you still get the sense of community and the experience of hearing how others are handling the same situation.

Informational Support Groups

Informational support groups are great for individuals who are looking to learn more about their specific form of cancer and treatment. They are usually led by a professional who then invites doctors, nurses, etc. to give talks on subjects the group is interested in learning more about.

Online Support Groups

You may live in a remote area, not want to travel often, or even feel uncomfortable meeting in person. Online support groups are available to connect people across the world with a community of individuals going through the same experience. 

Groups Designed for Specific Audiences

In order to help you connect with people in a similar situation as you, most support groups are geared towards a specific audience. The type of audiences may be broken down by:

  • Age group
  • Type of cancer
  • Specific stage of cancer

If you’d rather just meet with other individuals with cancer or a wide age range, some groups cater to a more general population as well.

How Do I Choose a Cancer Support Group?

With so many options for support you may be wondering, how do I choose the right group for me? Three are a couple of questions that you should ask yourself before deciding on a support group.

  • What type of support am I looking for? Emotional, professional, or informational?
  • What demographic am I most comfortable sharing personal information with?
  • Am I looking for a large group or a small group?
  • When does the group meet? How often?
  • Where is the group located?
  • Who leads the group?
  • Do I want an online group or an in-person group?

Once you’ve considered some of these questions, reach out to the group organizer and talk over any concerns or questions you may have. You can also try out a couple of different support groups before deciding on one that you will attend regularly.

Read More About Lia’s Cancer Story.

The only way you can go is forward, so keep going. You have a community of people who are waiting to support you and love you. I hope you’ll connect with those around you and other cancer survivors because we are here for you.

-Lia S.

Online Resources for Finding a Cancer Support Group

Now that we’ve had the opportunity to identify which types of support groups are available and the things to consider when choosing a group it’s time to start searching! Here are some resources to help you narrow down your search.

The American Cancer Society

The American Cancer Society has a wonderful database full of support groups of all kinds and sizes. On their website, you can search for a support group by zip code, city, and state. You can even narrow down your search by selecting a specific keyword that interests you.

If you prefer an online support group to an in-person support group, you can sign up for their Cancer Survivors Network which allows you to connect with thousands of other cancer survivors via chat rooms and messaging boards.

Cancer.Net

Cancer.net is another wonderful resource for finding support groups specific to your type of cancer. Similar to the American Cancer Society they have a general database of cancer support groups. 

However, they also have a drop-down option to select specific resources geared towards a specific kind of cancer. This feature is extremely helpful when trying to find a support group that is right for you.

Cancer Support Community

If you are looking for a more informal way to connect with the cancer community cancersupportcommunity.orgoffers a way to connect online. They have a blog and messaging board that is great for getting information and asking questions about the information that has been presented.

They also support traditional in-person support groups through their find a location feature. Additionally, if you are looking for immediate support they have a cancer support helpline that is available from 9 am to 5 pm 7 days a week.

Use Your Care Team as a Reference

While online resources can be a great way to start looking at what groups are available, your care team is the best reference for finding a local support group. Make sure to ask them what support groups they recommend and give them a try.

Ultimately, there is no one specific support group that is a perfect fit for every individual. Keep trying support groups until you feel that you’ve found a community that works for your and helps you through your treatment and beyond. 

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