cancer lungs: 13 THERAPY

Treatment of lung cancer, depending on the type and stage of cancer, in addition to the overall health of patients. If the patient has emphysema, for example, the poor pulmonary function inhibits the operation on patients, even if the patients have tumors that can be surgically removed. Other factors may also play a role, no matter what type of cancer patients. There was a time where, for example, when the side effects of treatment greater than the benefits gained. If that happens, patients can be given supportive therapy. This means, treat symptoms of cancer, causing pain and difficulty in breathing, but does not cure the cancer itself.

The purpose of lung cancer treatment are:
 Curative: cure or prolong disease-free period and increase the life expectancy of patients.
 Palliative: reducing the impact of cancer, improve the quality of life.
 Treat home (Hospice Care) in the case of terminals; reduce physical and psychological impact of cancer both in patients and families.
 Supportive: supporting palliative and curative treatment such as terminal nutrition, blood transfusion and blood components, growth factor anti-pain medication and anti-infective drugs.

There is a fundamental difference of biological temperament Small Cell Lung Cancer in Non-Small Cell Lung Cancer, so the treatment must be distinguished:

Small Cell Lung Cancer (SCLC)

Because most small cell lung cancer has spread outside the lungs when found, surgery is usually not an option. The most effective treatment is chemotherapy, either as monotherapy or in combination with radiation therapy.

SCLC is divided into two, namely:
1. Limited stage disease who were treated with curative purposes (the combination of chemotherapy and radiation) and treatment success rates of 20 %.
2. Extensive-stage disease treated with chemotherapy and initial treatment response rates of 60-70% and complete treatment response rates for 20 - 30 %. Median survival time for limited disease state is for 18 months and extensive disease state is 9 months.

Radiotherapy. In some cases inoperable, radio therapy performed as curative and can pengobatab as adjuvant therapy / palliative in tumors with complications are like reducing the effects of obstruction / suppression of blood vessels / bronchus.

This therapy uses X-rays to kill cancer cells. In some cases, radiation may come from outside the body (external radiation). On the other hand, radioactive compounds can be placed on the needle, using a catheter inserted into or near the lung (internal radiation). How radiation given depending on the type and stage of cancer is handled. Radiation therapy can be administered before, during, or after chemotherapy. In all cases, the goal of treatment is to destroy cancer cells with as little as possible interfere with the normal tissue.

Medication side effects may include redness and swelling of the skin, where the radiation enters the body, shortness of breath, fatique, and sometimes hard to swallow. Dysphagia due to post radiation esophagitis often occurs while the post radiation pneumonitis are rare ( <> 50 % tumor measured 50 or more than 5 the number of detected lesions disappeared; c). stable disease 50 % reduction or <> 25 % bigger; e). lokoprogresif: tumors growing within a radius of the tumor (local).

Side effects of chemotherapy is the most disturbing aspect of the treatment of cancer cells with rapid growth. As contained in the digestive tract, bone marrow and hair, is part of the most influential of these drugs. Although many side effects occurred, severity of cancer depends on these drugs. Sometimes patients have several reactions. On the other hand, patients may experience symptoms such as nausea and vomiting, dizziness, feeling very tired and the risk of infection increases.

Non-Small Cell Carcinoma
Surgical therapy is the first choice in stage I or II in patients with adequate reserves remaining lung. In stage IIIA there is still controversy about the success of the operation if the ipsilateral mediastinal lymph or there thorax wall metastases. Tumor removal technique performed a variety of techniques. Thoracotomy or the opening of the chest wall for surgical procedures and operations sternotony median or do by cutting through the breastbone is the standard method for lung cancer surgery.

Operation to treat lung cancer include:
 Wedge resection. In this operation carried out removal of the lung tumors, along with the soft tissue margin.
 Lobectomy. Operation of lung cancer most often committed. Lobectomy is the appointment of the entire lobe of one lung.
 Pneumonectomy. In this operation, the entire lung removed. Because pneumonectomy would reduce lung function, and cause other complications, this action is only done when necessary and if the patient is able to breathe with one lung.

Operating procedures will also have side effects that can cause lymphocytopenia or low number of lymphocytes (white blood cells) in the blood that causes the short survival time in patients with advanced-stage cancer.

The use of chemotherapy in NSCLC patients in the last two decades has been investigated. Curative chemotherapy for the treatment of combined integrated with other cancer treatment modalities in patients with advanced disease lokoregional.

Chemotherapy is used as standard therapy for patients ranging from stage IIIA and for palliative treatment. Sitostatika drugs have good activity in NSCLC with response rates between 15 - 35 %, however the use of a single drug did not achieve complete remission.

Combination has been investigated sitostatika to increase response rates that will have an impact on life expectancy. According to the Food and Drug Administration (FDA), the use of Avastin with paclitaxel and carboplatin can be used for initial systemic therapy in patients who can not do surgery. For patients with metastatic lung tumors in the colon and rectum, Avastin can be used as sitostatika combined with intravenous 5 - fluorouracil.