INHALED CHEMO
Osteosarcoma is a rare childhood bone cancer that can be fatal because it spreads to the lungs. But now a new chemotherapy is being studied that not only minimizes side effects, but better targets the tumors.
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Cheryl Hatton is living a parent's worst nightmare.
Cheryl Hatton
Child has cancer
"She used to tell me she wished she died because it hurt too much, all the time."
Her 17-year-old daughter Rebecca has osteosarcoma -- a rare bone cancer that spread to her lungs and required aggressive chemotherapy.
Rebecca West
Has osteosarcoma
"It's a little hard because I'm a girl and losing your hair is not fun, and being away from school and friends is a little hard."
Cheryl Hatton
"It's like watching someone torture your child week after week."
But now Rebecca is trying a new type of chemo. It's inhaled instead of given through an IV. A tent is used, so the chemo doesn't get in the atmosphere.
Richard Gorlick, MD
Pediatric Oncologist
The Children's Hospital at Montefiore
Bronx, NY
"Inhalation chemotherapy is a means of targeting chemotherapy that it goes selectively to the lungs and has much lower concentrations in the blood stream."
More chemo reaches the cancer cells, but patients experience fewer side effects. So far, it's shrunk Rebecca's tumor.
Rebecca West
"I get a little nauseous."
The drug being inhaled is cisplatin. For the clinical trial, it's being inhaled and given through an IV.
Richard Gorlick, MD
"So you couldn't use this as a replacement yet, but hopefully in the future."
Rebecca West
"I try to be positive on it cos you don't always wanna be negative about it all the time, and feeling sorry for yourself."
It's that attitude that keeps Rebecca's mom strong as she watches with hope.
Doctor Gorlick says if the study is successful, in the future inhalation chemotherapy can be used to treat any cancer that begins in the lungs or spreads there.
OSTEOSARCOMA: Osteosarcoma is the most common type of bone cancer, and the sixth most common type of cancer in children. Although other types of cancer can eventually spread to parts of the skeleton, osteosarcoma is one of the few that actually begin in bones and sometimes spread (or metastasize) elsewhere. Because osteosarcoma usually develops from osteoblasts (the cells that make growing bone), it most commonly affects teens that are experiencing a growth spurt. Boys are more likely to have osteosarcoma than girls, and most cases of osteosarcoma involve the knee.
SYMPTOMS: The most common symptoms of osteosarcoma are pain and swelling in a child's leg or arm. It occurs most often in the longer bones of the body such as above or below the knee or in the upper arm near the shoulder. Pain may be worse during exercise or at night, and a lump or swelling may develop in the affected area up to several weeks after the pain starts. In osteosarcoma of the leg, the child may also develop an unexplained limp.
TREATMENT: A new treatment involves inhaling a mist of chemotherapy, so it goes directly into the lungs. The goal is to maximize the delivery to the area needing treatment and minimize the toxicity to the rest of the body. By doing this, doctors hope to treat the cancer better and produce fewer side effects. The drug is inhaled using a nebulizer, which relies on the patient's breaths to get the drug to the lungs rather than an aerosol, which ends up sending much of the drug to the back of the throat. Patients go receive the treatment in a tent to keep the drug from escaping into the air.
The animal studies reveal a 25 percent response rate with aerosolized chemotherapy in dogs with end-stage lung cancer. Furthermore, researchers found there was a 25-fold increase in the amount of chemotherapy found in the lungs compared with the level obtained with traditional intravenous delivery.
SIDE EFFECTS: Researchers say side effects were very mild but included nausea and vomiting. Researchers point out that these are much less severe than chemotherapy.
CENTERS STUDYING INHALATION CHEMO: The Phase I trial of inhaled Cisplatin is ongoing at several centers including:
Memorial Sloan-Kettering Cancer Center in New York
The Arthur G. James Cancer Hospital in Columbus
Richard J. Solove Research Institute in Columbus
The University of Chicago
The University of Wisconsin
Yale University
National Cancer Institute in Bethesda
Sharon Butler
Children's Hospital at Monefiore
subtler@montefiore.org
(718) 920-4014
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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