In occult lung cancer, a diagnostic evaluation often includes chest x-ray and selective bronchoscopy with close follow-up (e.g., computed tomography scan), when needed, to define the site and nature of the primary tumor; tumors discovered in this fashion are generally early stage and curable by surgery.
After discovery of the primary tumor, treatment involves establishing the stage of the tumor. Therapy is identical to that recommended for other NSCLC patients with similar stage disease.
"Two years ago, we didn't recommend the therapy because we had just
preliminary data that it might be helpful, but not enough information to make
it a generally accepted recommendation," says James Rigas, MD, director of
the Comprehensive Thoracic Oncology Program at the Norris Cotton Cancer Center
in Lebanon, N.H.
But in 2004 two studies showed big improvements in survival for patients who
got chemotherapy over those who didn't. Here were the conclusive data that
doctors had been hoping for.
How good was the news? One study by the National Cancer Institute of Canada
showed that, of those who received a two-drug chemo combination, 15% more lived
five years or more after their surgery, while a U.S. study showed a 12%
increase in survival rates.
The chemotherapy drugs used in these studies are not new, yet with these
study results doctors now have better knowledge of how to work with what's
available, meaning many people may live longer without a relapse or spread of
"I think we're going to be seeing a lot more trials to try to improve
upon the fact that we know treatment helps," Rigas tells WebMD.
Targeted Treatment for Lung Cancer
Nearly 60% of all people with lung cancer die within a year of their
diagnosis and an estimated 164,000 Americans -- most of them smokers or
ex-smokers -- are diagnosed each year.
Fortunately, an important development in treating advanced lung cancer was
announced last year.
In a large study, people taking a drug called Avastin, together with
chemotherapy, lived an average of two months longer than those taking chemo
alone -- a big improvement for people with a disease that can kill so
Avastin is a "targeted" treatment, meaning it more specifically
targets cancer cells over normal cells. It works by disrupting the cancer
cells' ability to form new blood vessels, which a tumor needs to grow.
And, in addition to hopefully improving treatment, targeted drugs often
decrease side effects.
Now researchers hope Avastin plus chemotherapy might cure people with
early-stage lung cancer. "If this gives us the same kind of benefit in
advanced disease, which I think it probably will, this will be probably one of
the biggest life-savers for lung cancer," Rigas says.
Another targeted treatment -- approved for lung cancer in 2004 -- is
Tarceva, which targets a protein found on cancer cells that helps them
This drug was tested as a sole treatment on people with late-stage lung
cancer who had not done well with chemotherapy. On average, those taking
Tarceva lived two months longer than those taking a placebo, and also found an
easing of symptoms.