The type of treatment given for lung cancer depends primarily on two factors, the type of tumor, and the stage of the disease. Although there are many subdivisions within each category, most lung cancers are divided into small cell lung cancers, almost always caused by smoking, and non-small cell cancer that has numerous potential causes, including exposure to asbestos. The stage of cancer refers to how far advanced the cancer has gotten. By determining the stage, or the progression, of the disease, the doctor can determine available treatment techniques, as well as probable survival rates.
The cancer is first categorized using the TNM system in which the doctor evaluates the tumor size, whether the nodes are affected, and whether the cancer has metastasized. Each item is further subdivided according to the severity of the cancer. For example, a tumor smaller than 3cm in diameter, and located in the lung is identified as a T1 tumor. By contrast, if the tumor is larger than 3cm in diameter, and located in the lung, it is identified as a T2 tumor. The same type of analysis is applied to the lymph nodes where there are 4 categories. Metastasis is simpler: it can’t be determined, it exists, or it doesn’t exist. After the TNM categories are identified the doctor can then give the cancer a stage I thru IV rating. The more progressed the cancer has gotten, the higher the stage rating. Stage I cancer is a relatively small tumor with no involvement of the lymph nodes, and no metastasis. Stage IV cancer is cancer that has metastasized.
Treatment for Stage I cancer will frequently involve surgery since the cancer has not grown large, and has not gotten into the lymph nodes. Part of a lung, or even an entire lung may be removed to try to get the cancer out before it progresses any further.
Stage II cancer is where the disease has moved into the pulmonary hilar or bronchial lymph nodes, but has not spread beyond the lungs or a tumor that is more extensive (i.e invades chest wall) but with no lymph nodes involved. Doctors remove as much infected tissue as possible, and follow up treatment with chemotherapy, radiation, or both.
Stage III cancer is when the tumor invades structures in the chest and/or invades lymph nodes in the mediastinum, but has not yet fully spread through the body. Treatment is much the same as with stage II cancer, but surgery may no longer help some patients where the cancer has gotten to spread out, or has moved into areas like the lining of the heart (As is the case in pericardial mesothelioma, one of the most rare forms of asbestos cancer found), that are not safely operated on or near. In some cases surgery may follow radiation and chemotherapy, or doctors may recommend preventive radiation therapy to the brain.
Stage IV cancer has metastasized. It has spread outside the chest cavity and can be anywhere, including the liver or even the brain. Stage IV cancer is treated with multiple drug chemotherapy to try to kill the cancer at any cost. Combinations of therapies, including surgery, in addition to radiation of the brain work in some circumstances. At this stage a primary goal is often to treat the symptoms as much as the disease. Most people, 70-90%, in stage IV lung cancer require significant pain relief. Radiotherapy, and even massage and other relaxation techniques help people deal with pain issues associated with stage IV cancer. For some people oxygen helps ease labored breathing and shortness of breath (As would be the case for those suffering from the most common form of asbestos cancer, pleural mesothelioma), and in other cases surgery or radiation to remove tumors pressing against the trachea help deal with these issues. Some pain and difficulty in breathing is caused from an accumulation of fluid in the lining of the lungs. When the fluid is removed, the pain eases and breathing becomes more manageable. Another frustrating symptom of advanced lung cancer can be paralysis of the vocal cords. This can lead to not only changes in a person’s voice or an inability to speak at all, but worse, can cause a person to choke on their own vocal cords. An injection into the area that makes the vocal cords thicker can prevent them from falling backward into the throat causing the person to choke.
On July 5, 2007, Medical News Today reported findings that men and women react differently to chemotherapy drugs used in treating advanced lung cancer. Women over the age of 60 have a much higher survival rate than men with the same degree of cancer involvement. Under the age of 60, the sex differences seem to largely disappear. The scientists are hypothesizing that estrogen plays a role in the change. If it can be identified and quantified it may open new treatment options for both men and women. While clinical trials offer no guarantees, they do offer the patient hope. They also give the knowledge that even if the worst happens, and the person does not survive the cancer, that person has still contributed to research that will hopefully cure cancer someday.