A number of factors decide the course of treatment for lung cancer. Oncologists have to first determine the histopathologic type of the lung cancer and the stage of progression of the disease. Apart from that, the health of the patient, his other medical conditions and the prognosis of the disease are all quite important for the development of the treatment plan. The options for treatment include surgical resection, radiation and chemotherapy, individually or in combination, depending on the factors mentioned above.
If the tumor is contained in the lung and is operable, surgical resection is indicated. There are many standard techniques for lung cancer surgery that are invasive like thoracotomy and median sternotomy. There are alternative methods too, of which anterior limited thoracotomy is less invasive. The patient loses less blood overall and has less pain and postoperative drainage.
The latest surgical procedures like video assisted thoracoscopy require much smaller incisions as they involve the use of video cameras. Yet some doctors feel that VAT is appropriate only for the initial stages of lung cancer because the lung examination with the cameras is not perfect. VAT technology has therefore been improved with Computed tomography scans for more effective lung cancer surgery.
However, surgical procedures are known to result in lymphocytopenia, in other words, deficiency of lymphocytes in the blood which shortens the survival period of the patients who are in an advanced stage of lung cancer. To take care of the decrease in the white blood cell count caused by surgical procedures, the patient is treated preoperatively with interleukin-2.
Not every lung cancer is operable. In non-small cell lung carcinoma, surgery is, in most cases, a good option in stages I and II. When the progression of the disease in stage IIIA is very limited, surgery may be recommended, but certainly not in stage IIIB. But in small cell lung carcinoma, surgery is not possible except in rare cases when the disease is at a very early stage of growth. The treatment option here is a combination of radiotherapy and chemotherapy.
Radiotherapy for each patient is planned on the basis of the progression of his disease and the state of his health. Mostly it is given in combination with chemotherapy and where surgery is possible, with surgery too. Advanced imaging techniques like CT and PET scans help radiologists in targeting the tumor precisely from several angles with limited damage to healthy tissue. Stereotactic body radiotherapy works with great precision on small tumors and research is on to see this as an alternative to surgical intervention.
Chemotherapy is a kind of drug treatment that kills cancer cells. It can be taken orally or intravenously. Together with radiation therapy, it deals effectively with cancer. At the extensive stage of the disease, it is the principal treatment option. When the tested drugs fail to contain the disease, experimental drugs under clinical trial are also administered. These drugs may not cure lung cancer but may improve the quality of the patient's life and may, actually, extend it too.