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Lung Cancer

Treatment of Early-stage Non-small Cell Lung Cancer


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Summary & Participants

Surgery and radiation are the standard treatments for early-stage lung cancer. Now there's evidence chemotherapy may have a role, too. Listen as doctors explain.

Medically Reviewed On: July 05, 2008

Webcast Transcript


ANNOUNCER: Across the globe, and across the US, cigarettes continue to kill.

EDWARD S. KIM, MD: If you just look at the United States figures, it's the leading cause of cancer-related death, both in men and in women: over 175,000 cases a year, and over 160,00 deaths a year.

CHRISTOPHER G. AZZOLI, MD: If I were to list the top ten causes of lung cancer, one through nine would be cigarette smoking.

EDWARD S. KIM, MD: Other causes can include industrial fumes; radon has been tied to it. Other things such as asbestos cause other forms of lung cancer like mesothelioma. But, still, the number-one culprit is going to be cigarettes.

ANNOUNCER: There are two main types of lung cancer.

CHRISTOPHER G. AZZOLI, MD: The most common form of lung cancer is called non-small cell lung cancer. About 15 percent of lung cancer is small cell lung cancer.

ANNOUNCER: Lung cancers don't tend to stay put. They often tend to spread, and how they do so is the basis of a system of staging.

CHRISTOPHER G. AZZOLI, MD: Non-small cell lung cancer starts in the lung tissue and it grows into a tumor and that tumor, if it stays where it started, is stage I. If the tumor has spread to lymph nodes within the lung, it's stage II. If the cancer has spread to lymph nodes in the center of the chest, that is stage III. And then, if cancer cells get into the bloodstream and move around the body, that's stage IV.

ANNOUNCER: In most patients with stage I or stage II disease, the cancer is resectable, which means it can be removed surgically. If a patient is well enough, treatment usually begins in the operating room.

EDWARD S. KIM, MD: The early-stage lung cancer is treated with surgery and, generally, this is at least with a lobectomy.

There are three separate lobes or areas of your right lung and two on your left lung. If a tumor falls within one of those discrete areas, then that lobe is removed which encompasses the tumor.

ANNOUNCER: Radiation is sometimes used, too. But mostly for people who are elderly and frail, or who otherwise cannot tolerate surgery.

A lung cancer patient's chances for survival depend on how the disease may have spread.

CHRISTOPHER G. AZZOLI, MD: If you have stage I disease, and you have successful surgery and removal of the cancer, your chance of being alive in five years is 60 to 80 percent. If you have stage II, it's 40 to 60 percent. And if you have stage III, it's 20 to 40 percent.

ANNOUNCER: There's always the possibility lung cancer returns after surgery. That's usually a very dangerous situation.

CHRISTOPHER G. AZZOLI, MD: If lung cancer were to come back after a successful surgery, chances are it would come back some place outside of the chest, which means that, before the surgeon had a chance to take the cancer out, cells had broken off, gotten into the bloodstream and moved around the body.

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