Rizwan Nurani MD discusses Lung Cancer Treatments

Lung Cancer is a complicated medical problem.  Specialists from multiple fields of medicine need to collaborate to come up with the best plan that fits each individual situation.  

Typically the treatment plan is generated once the staging studies and biopsy have been completed.  It is common for the stage to be revised as more studies are completed.  For example, after the initial CT scan, a preliminary stage of lung cancer is usually determined.  However, when the PET scan or MRI are done and show additional information the stage is frequently revised.

Stages of Lung Cancer:

lung anatomy rizwan nurani
  • Stage I:      The lung cancer is contained within one lung.  No lymphnodes are involved.
  • Stage II:      The cancer has spread to the lining around the lung or to lymph nodes adjacent to the lung 
  • Stage III:      The cancer involves critical portions of the airway of the involved lung. It might have spread to lymph nodes in the middle of the chest, between the left and right lungs.  It may also involve adjacent organs such as the chest wall, diaphragm, heart or mediastinum. 
  • Stage IV:      The cancer has spread from one lung to the other or to other parts of the body, such as the brain or bones.

Small Cell Lung Cancer Staging:

While the staging system above applies for both Small Cell and Non-Small Cell Lung Cancer, frequently Clinicians break Small Cell Lung cancer into only two groups:

  • Limited Stage:  The small cell lung cancer is present on only one side of the chest (can involve lymph nodes on the same side of the involved lung or behind the breast bone.
  • Extensive Stage:  The small cell lung cancer has spread beyond one side of the chest (usually corresponds to stage IV above).

A more detailed description of Lung cancer staging can be found here.  

GENERAL TREATMENT APPROACHES FOR LUNG CANCER

 The three major treatments used include surgery, radiation therapy and systemic treatments (chemotherapy or biological therapy).  It is very common to use more than one particular treatment as a planned approach.  Treatment approaches are typically decided by close collaboration between your cancer physcians who will individualize the regimen to fit your particular situation.  Generally speaking the treatment options by stage include:

STAGE I:

  • Surgery alone, Radiosurgery alone, Conventional External Beam Radiation therapy alone.

STAGE II:

  • Surgery and chemotherapy, Radiosurgery alone (select T2b N0), Conventional External Beam Radiation therapy alone or with chemotherapy.

STAGE III:

  • Combination Radiation therapy and chemotherapy, Combination Radiation therapy, Chemotherapy and Surgery, Combination Chemotherapy and Surgery. 

Stage IV (non-curative approach):

  • Chemotherapy, Targeted Biological therapy, Radiation therapy, no active therapy with supportive measures only.
© Rizwan Nurani 2012