regarding staging and treatment options are prone
to change as more research and clinical trials are
available. An important part of the approach to
managing care is ensuring access to current treat-
ment protocols that may include investigational
regimens. Most treatment protocols combine dif-
ferent therapies for optimal effectiveness. Nutri-
tional support during cancer treatment is
important to help the body fight the cancer and
heal. The available treatments for lung cancer
include
- Surgery, which removes the cancerous tumor
and portion of the lung that contains it, is the
treatment of first choice for NSCLC that
remains relatively confined. When the cancer
has spread to several locations within the same
lung, the surgeon may remove the entire lung
(pneumonectomy). Surgery may also be appro-
priate for very early stage SCLC, though SCLC
is rarely found when it remains in an operable
stage. The key risks of surgery include bleeding,
infection, and limited lung function due to
removal of part of the lung. Before surgery the
person undergoes evaluation to estimate the
ability to function after removal (resection) of
part or all of the diseased lung.
•CHEMOTHERAPY, which launches a widespread
attack on cancer cells throughout the body, is
usually a second-line treatment that follows
surgery (except in SCLC, for which it is often
the first-line treatment) and may be the pri-
mary treatment for cancers that are inoperable
or have already metastasized beyond the lungs.
Common side effects of chemotherapy include
fatigue, MOUTHsores, temporary HAIRloss, and
NAUSEAandVOMITING.
•RADIATION THERAPYtargets inoperable tumors or
follows surgery to eradicate any residual cancer
cells after the surgeon has removed the cancer.
Radiation therapy may be preventive, as in pro-
phylactic cranial irradiation (PCI) which targets
the BRAINto lower the risk for malignant METAS-
TASESthat might form there (the brain is a com-
mon metastatic site for lung cancer). Radiation
therapy also may be the first-line treatment for
limited SCLC or reserved for palliative, directed
therapy (such as to treat an obstruction that
develops in the lung).
- Photodynamic therapy (PDT) is a technique in
which the oncologist administers a light-sensi-
tive DRUGthat the cancer cells absorb and then
targets the cells with a laser that generates light
waves to activate the drug and kill the cells that
contain it. PDT may be the primary treatment
for small or inoperable tumors, particularly
those located in the airways. PDT increases the
SKIN’s sensitivity to the sun or other sources of
ultraviolet light. - Investigational treatments are available
through clinical trials. Oncologists and thoracic
surgeons are aware of what trials are ongoing
for certain types of cancer or patient profiles
and can suggest those that are appropriate. As
well the U.S. Institutes of Health’s National
Cancer Institute (NCI) maintains a current list-
ing of cancer trials, accessible at the NCI’s Web
site (www.cancer.gov/clinicaltrials). Investiga-
tional treatments in the clinical trial stage have
shown promise in research studies and are
undergoing testing in people. It is essential to
fully understand the potential benefits (per-
sonal as well as for the treatment of lung can-
cer in general) and risks of any investigational
treatment when considering whether to partici-
pate in a clinical trial.
COMMON CHEMOTHERAPY DRUGS
FOR TREATING LUNG CANCER
carboplatin cisplatin cyclophosphamide
dexamethasone docetaxel doxorubicin
etoposide gemcitabine ifosfamide
metoclopramide paclitaxel teniposide
topotecan vincristine vinorelbineRisk Factors and Preventive Measures
Although not all lung cancer is associated with
exposure to cigarette smoke, the vast majority is.
In general, were it not for cigarette smoking lung
cancer would be rare. This makes lung cancer one
of the most preventable forms of cancer because
eliminating exposure to cigarette smoke virtually
eliminates the likelihood of developing lung can-
cer. People who smoke are at greatest risk, though
people who live in households or work in envi-
ronments where they continually breathe the
smoke from cigarette smokers face nearly as great
of a risk. Exposure to asbestos further compoundslung cancer 211