lung cancer treatment

As is true of many cancers, the treatment of lung cancer depends upon a variety of factors. The most important factors are the histopathologic (diseased tissue) type of tumor that is present and its stage. Once a lung cancer has been staged, the physician and patient can discuss treatment options. An individual then has a better idea of the value of different forms of therapy. Other factors that are taken into account include the person's general health, medical problems that may affect treatment (such as chemotherapy), and tumor characteristics.

The characteristics of the lung tumor help to separate individuals into two groups: (1) those who are at low risk of cancer recurrence and (2) those who are at high risk of cancer recurrence. Specific prognostic - disease-forecasting - factors place patients in either of these groups. In particular, the histopathologic groupings of small cell lung carcinoma (SCLC) versus non-small cell lung carcinoma (NSCLC) may be used to better predict a patient's prognosis and response to therapy.

Surgical resection, or cutting away, of the tumor generally is indicated for disease that has not spread beyond the lung. Such resection may be conducted using a variety of techniques. Thoracotomy - the opening of the chest wall for surgical procedures - and median sternotomy - surgery performed by cutting through the breastbone - are standard methods used for lung cancer surgery. Alternative approaches include anterior limited thoractomy (ALT), thoractomy performed on the frontal chest using a small incision; anterioraxillary thoracotomy (AAT), thoracotomy performed on the frontal chest near the underarm), and posterolateral thoracotomy (PLT) thoracotomy performed on the back/side region of the trunk. ALT, in particular, is less invasive than standard thoractomy - that is, it involves less disturbance of the body by incisions or other intrusive measures. ALT may result in less surgical blood loss, less postoperative drainage, and less postoperative pain than standard thoracotomy.

Recently, surgeons have developed other less invasive procedures for the removal of tumorous tissue. For example, video-assisted thoracoscopy (VAT), otherwise known as video-assisted thoracic surgery (VATS), uses a video camera to help visualize and operate upon the lung within the chest cavity. The surgical incisions made during VAT are much smaller than those needed for thoracotomy or sternotomy. However, some physicians caution that VAT does not allow complete lung examination to identify and remove metastases that are not detected by preoperative chest X-ray. VAT is perhaps most appropriate for Stage 1 and Stage 2 cancers that require lobectomy (surgical removal of a lung lobule) with lymphadenectomy (removal of one or more lymph nodes) and for peripheral (outer edge) lung tumors that can be removed by wedge resection. In such cases, follow-up is required to establish a long-term prognosis.

Computed tomography (CT) scans also have been added to VAT technology to improve lung cancer surgery. Experts have found that percutaneous (through the skin) CT-guided localization wires help to identify tumorous lung nodules. In this way, wires can be used to assist VAT in cases that need sublobectomy resection (partial removal of a lung lobe).

Unfortunately, surgical procedures may cause lymphocytopenia - low number of lymphocytes (white blood cells) in the blood - which is linked with shorter survival times among patients with advanced lung cancer. Lymphocytopenia may be related to a deficiency in interleukin-2 (IL-2), a hormone that controls the activity of T lymphocytes (thymus-dependent lymphocytes). Preoperative treatment with recombinant human interleukin-2 (rhIL-2) may help to prevent the lymphocyte decrease that occurs after surgery for operable lung cancer.

If the tumor is more aggressive and/or widespread, chemotherapy and radiotherapy (radiation therapy) also may be necessary. In addition to chemotherapy and radiotherapy, other treatments are now available for the management of lung cancer.

Photodynamic therapy (PDT) may be especially useful for the care of persons with inoperable lung cancer. Photodynamic therapy begins with the injection of a light-activated drug (e.g., photofrin/polyhaematoporphyrin, lumin). Then, during bronchoscopy (examination of the airways using a flexible scope), the lung tumor is illuminated by a laser fiber that transmits light of a specific wavelength. At that time, the laser light is used to destroy the sensitized tumor tissue. Skin photosensitivity (light sensitivity) is a side effect of PDT. The curative potential of PDT is the most exciting aspect of this therapy in lung cancer patients whose tumors are occult (hidden, unseen) on chest X-ray. The tissue-sparing effects of PDT may be particularly important for individuals with limited lung function.

Electrosurgery

· A lump is detected, which is usually single, firm, and most often painless.

· A portion of the skin on the breast or underarm swells and has an unusual appearance.

· Veins on the skin surface become more prominent on one breast.

· The breast nipple becomes inverted, develops a rash, changes in skin texture, or has a discharge other than breast milk.

· A depression is found in an area of the breast surface.

Women's breasts can develop some degree of lumpiness, but only a small percentage of lumps are malignant.

While a history of breast cancer in the family may lead to increased risk, most breast cancers are diagnosed in women with no family history. If you have a family history of breast cancer, this should be discussed with your doctor.