CONTENT:
8.4. The Management of Lung Cancer Recurrence
8.5 Lung Cancer Screening and Future Treatments
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8.4. The Management of Lung Cancer Recurrence
Approximately 30 % of patients who relapse following surgery will have an isolated lung cancer recurrence on the same side of the thorax. Most of these patients will also have metastatic spread of their lung cancer. A definitive treatment plan may begin if they do not have evidence of cancer metastases.
When a patient has an isolated local tumor recurrence following initial surgical resection, a further resection may be considered. Further surgery is only an option if the recurrence is a stage 1 or stage 2 tumor and then only if the patient can tolerate further surgery.
For patients with stage 1 or 2 tumor recurrences that are not able to tolerate further surgery, ‘salvage’ radiation therapy will be a treatment option. Should the recurrence be a stage 3 tumor, chemoradiotherapy may be given.
8.5 Lung Cancer Screening and Future Treatments
The hope for lung cancer screening is that more tumors will be detected at an early stage, before surgery becomes difficult and before the lung cancer has begun to spread.
With earlier detection of lung cancer comes the development of new, and less invasive treatments.
New radiation therapy techniques for early-stage NSCLC include proton beam and carbon ion therapy that have been used on an experimental basis in some patients with stage I Non-Small Cell Lung Cancer (NSCLC). So, other image-guided techniques include radiofrequency ablation (RFA), cryoablation, microwave ablation and laser ablation. Evaluation is underway for these treatments to see if they may be useful in treating lung cancer in the future.
Lung cancer screening is done to detect cancer at a stage when a cure or limitation of the spread of the tumor is possible. Although patient survival from the time of diagnosis of lung cancer is the key beneficial outcome that is reported in screening trials, this measure may be misleading. So in future an evaluation of the screening effect on lung cancer mortality rather than on patient survival may be necessary to validate lung cancer screening methods clinically. Time will tell.
References
Goodgame B, Viswanathan A, Zoole J, Gao F, Miller CR, Subramanian J. et al. (2009) Risk of recurrence of resected stage I non-small cell lung cancer in elderly patients as compared with younger patients. J Thorac Oncol. 2009 Nov;4(11):1370-4. doi: 10.1097/JTO.0b013e3181b6bc1b. (Retrieved 4th May 2015): http://www.ncbi.nlm.nih.gov/pubmed/19692932
Levin WP, Kooy H, Loeffler JS, DeLaney TF. (2005) Proton beam therapy. Br J Cancer. 2005 Oct 17;93(8):849-54. (Retrieved 4th May 2015): http://www.ncbi.nlm.nih.gov/pubmed/16189526
Patient Information
National Cancer Institute Non-Small Cell Lung Cancer Treatment: Treatment Options for Recurrent Non-Small Cell Lung Cancer (Retrieved 4th May 2015): https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq
American Cancer Society What’s new in non-small cell lung cancer research and treatment? (Retrieved 4th May 2015): http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-new-research
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