Treatment Of Lung Cancer
Treatment Of Lung Cancer
Jay M. Lee (Surgical Director, Thoracic Oncology Program, UCLA) gives expert video advice on: Can I be cured of lung cancer?; What are the treatment options for lung cancer?; How will my doctor decide which treatment is best for my lung cancer? and more...
Can I be cured of lung cancer?
Lung cancer is a very aggressive malignancy. We don't often use the term "cure" because recurrence rates and new lung cancer primaries are high, relatively. After undergoing full treatment for your lung cancer, including surgery where we've removed the lung cancer, and if there's radiographically, and by blood tests and the rest of your workup, there's no evidence of a cancer, you're really in remission. Those patients that have no evidence of disease by our current standards still have about a thirty per cent chance of getting a recurrence. About ten per cent of the time this can be a local recurrence, where the cancer was previously. The other remaining twenty per cent of the time, it can occur in distant sites, elsewhere in your body. And secondly, lung cancer can occur in other sites elsewhere in your lung. This is often what we call a "second lung cancer primary." So, this has really no relation to your previous lung cancer, but because whatever carcinogen or risk factors that you had previously has also impacted on other areas of your lung, so as a result you're at risk of getting another lung cancer.
What are the treatment options for lung cancer?
Treatment options for lung cancer depends on the type of lung cancer; whether it's non-small cell or small cell lung cancer. This will involve surgery, chemotherapy, and radiation treatment.
How will my doctor decide which treatment is best for my lung cancer?
The treatment plan for lung cancer depends on three main variables. The first diagnosis is whether it's small cell or non-small cell cancer. Secondly, you need to diagnose at what stage of your cancer they are at, and thirdly, your overall health and other compatibilities; meaning that you are an acceptable candidate to undergo a surgical operation, or the aggressive needs to undergo chemotherapy.
What is the treatment for 'small cell lung cancer' or 'SCLC'?
Small cell lung cancer is treated predominately by chemotherapy and radiation. Surgery has a limited role and only in the very earliest stages of small cell lung cancer is surgical recession part of your treatment regimen.
What is the treatment for 'non small cell lung cancer' or 'NSCLC'?
Non small cell lung cancer is treated differently from small cell lung cancer. Surgery has a significant role in terms of the treatment. Particularly in the earlier stages, Stages I, II and IIIA, surgery is heavily involved and considered as your predominant treatment. Chemotherapy comes into play in Stage II patients, and patients with State IIIA and IV lung cancer patients. There is a role for radiation in some patients, however, most patients do not undergo radiation therapy.
What are the most promising new treatments for lung cancer?
There are some promising new treatments for lung cancer. These include targeted therapies, which are new types of chemotherapy agents that are currently being investigated and in clinical trials. Their role in lung cancer is being defined currently. The other exciting area is immunotherapy. Immunotherapy for lung cancer really is based on utilizing the patient's own immune system and what we try to do is accentuate the patient's own immune system to fight the lung cancer cells. This currently remains investigational and in clinical trials.
How is advanced lung cancer treated?
In the advanced stages of lung cancer with patients that are not candidates for surgery, then there are medications and treatments that we can give and these include predominately chemotherapy and radiation for the very advanced patients. Surgically, there are palliative treatments where we can improve the quality of life and your breathing. These things may include airway surgeries, stenting or laser surgeries. These are all minor surgeries and the intent is not to take all your cancer out but is simply to improve your breathing and your quality of life. There are other palliative treatments that incorporate radiation. These things may include stereotactic radio surgery and radiofrequency ablation, both of which are very focused uses of high energies to fight off your cancer.
What does it mean if my lung cancer remains stable during treatment?
Stability of the lung cancer during treatment is difficult to interpret. It may mean that 1) the treatment is working and your tumor is not growing, or 2) that it hasn't worked and there's still a underlying tumor. Often what we find, when we take patients after receiving induction chemotherapy, is that there is a subset of patients where you see a persistent lung mass, radiographically, but at the time of surgery, when the tumor is taken out, that there is complete sterility or absence of lung cancer cells there. Stability of a lung tumor can be interpreted radiographically as being cancer still being present, or it may be all sterile and with a good treatment response. So it is, overall, difficult to interpret that situation.