Understanding Lung Cancer -- Diagnosis and Treatment
Surgery for Lung Cancer
The decision to perform surgery is based not only on the type of lung cancer and how far it has spread but also on the patient's overall health, especially the function of their lungs. Many patients with lung cancer -- especially smokers -- have existing lung or heart problems that make surgery difficult. Cancer that has spread to lymph nodes between the lungs was once considered inoperable, but combining surgery with chemotherapy afterwards has improved survival rates.
When feasible, the preferred treatment for non-small-cell lung cancer is surgery. During the operation, the surgeon removes the tumor along with surrounding lung tissue and lymph nodes. Sometimes, the entire lung must be taken out. After surgery, patients stay in the hospital for several days.
Lung Cancer Radiation
Radiation therapy may be necessary to kill remaining cancer cells, but it is usually delayed for at least a month while the surgical wound heals. Non-small-cell lung cancers that cannot be treated surgically are usually treated with radiation therapy, usually in combination with chemotherapy.
Chemotherapy and Combination Therapy
Because of its tendency to spread extensively, small-cell lung cancer is typically treated with combination chemotherapy -- the use of more than one drug -- often in conjunction with radiation therapy. Surgery is occasionally used, but only if the cancer is thought to be at a very early stage. This is uncommon.
Patients whose cancers have metastasized, or spread to distant sites, are usually treated with either chemotherapy or radiation therapy. Since metastatic lung cancer is very difficult to cure, the main goals of treatment are to provide comfort and prolong life. Current treatments can shrink tumors, which may lessen pain and other symptoms.
It is now recommended that all patients with advanced lung cancer receive palliative care (care designed to only ease pain and other symptoms) while also having the cancer actively treated. This has been shown not only to provide comfort, but to improve outcome if chemotherapy is given at the same time.
Recent data also suggests that chemotherapy helps prevent recurrence of lung cancer in patients with early stages of the disease.
Future Lung Cancer Treatment
Researchers are constantly looking for better ways to treat lung cancer, to relieve symptoms, and to improve patients' quality of life. New combinations of chemotherapy, new forms of radiation, and the use of drugs that make cancer cells more sensitive to radiation are always being studied.
Stereotactic radiosurgery and radiofrequency ablation have been used to treat early lung cancers in persons who are not candidates for surgery. This type of therapy may be used to treat localized recurrent tumors as well.
Drugs that target a growth factor receptor (Tarceva, Gilotrif, and Erbitux) and the tumor blood supply (Avastin) have shown significant activity in helping to control advanced lung cancer. There is also a drug called crizotinib that attacks a certain molecule seen in lung cancers. It is now common for patients to be tested to determine if these drugs can effectively fight their type of lung cancer.