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Monday, June 2, 2008

Lung cancer symptoms & treatment

Lung cancer is one of the most insidious & aggressive neoplasms in the whole realm of oncology.

 

symptoms:

  • cough(75% cases)
  • weight loss(40%)
  • chest pain(40%)
  • dyspnea(20%)

treatment:

Combinations of chemotherapy, radiation therapy,targeted therapy, or surgery may be of greater value than any single treatment alone.  

The treatment options for lung cancer are surgery, radiation therapy, chemotherapy, and targeted therapy either alone or in combination, depending on the stage of the tumor.

surgery:

Depending on the type and stage of the cancer, surgery may be used to remove the tumor and some of the lung tissue around it.

  1. if  a lobe of lung removed-lobectomy.
  2. if entire lung removed-pneumonectomy

 chemotherapy:

Chemotherapy refers to the use of drugs to kill cancer cells.

The drug combinations most frequently used for initial chemotherapy for non-small cell lung cancer are cisplatin or carboplatin combined with 1 of the following: 
Paclitaxel 
Docetaxel 
Gemcitabine 
Vinorelbine 
Irinotecan 
Etoposide 
Vinblastine 
Bevacizumab
(targeted therapy used in combination) 

most commonly used combinations:

  • Limited Stage
    Cisplatin and etoposide 
    Carboplatin and etoposide 
  • Extensive Stage
    Cisplatin and etoposide 
    Carboplatin and etoposide 
    Cisplatin and irinotecan

  1. Chemotherapy drugs used if there has been a relapse of the small cell lung cancer include: 
    Ifosfamide, paclitaxel, docetaxel, or gemcitabine, if the relapse occurred within 2 to 3 months 

  • Topotecan, irinotecan, cyclophosphamide/doxorubicin/vincristine (CAV), gemcitabine, paclitaxel, docetaxel, oral etoposide, methotrexate,
    vinorelbine if the relapse occurred from 2 to 3 months to 6 months 
             
  •  For relapses after 6 months, the original chemotherapy can be repeated.

Targeted therapy:
In the past few years, much lung cancer research has focused on drugs that are specifically targeted at cancer cells and interfere with their ability to grow.

1.erlotinib (Tarceva®)-for use in patients with NSCLC who are no longer responding to chemotherapy (this is usually determined after 1 or 2 different chemotherapy combinations)

      Common side effects of erlotinib include skin rash and diarrhea.

2.Bevacizumab (Avastin®)-most commonly used to treat colon cancer, but has also been studied as a treatment for NSCLC.

       side effects- Bevacizumab causes bleeding, which means it cannot be used in patients who are coughing up blood, whose cancer has spread to the brain, or who are on “blood thinners” (anticoagulation therapy). It also cannot be used in patients with squamous cell cancer, because it leads to bleeding from this type of lung cancer. Other rare but serious side effects include blood clots and high blood pressure  

3.Gefitinib (Iressa®) is a targeted therapy used to treat patients in good health, but with NSCLC that begins to grow after initially responding to treatment.

     side effects-diarrhea or skin reactions.

Radiation Therapy :Radiation therapy uses high-energy rays (such as x-rays) to kill or shrink cancer cells.

1.external radiation-most common used.

2.brachytherapy-from radioactive materials placed directly in the tumor (internal or implant radiation)

 a good site for more informaton about lung cancer. 

and a wonderful site with chest radiographs and mcqs



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