Cancer therapies serve the purpose of curing the patient of the disease (“curative” = healing therapy) or to stop the further growth and spread of the tumor as long as possible, to relieve discomfort and to prolong the lifetime (“palliative” = alleviative) Therapy). An indispensable component of oncological care is the so-called “supportive therapy” (supportive therapy). It treats and prevents complications of cancer and survival-related but often aggressive cancer therapies.
How is lung cancer operated?
If the tumor has not exceeded a certain size and has not yet formed distant metastases, surgery is sought with the aim of completely removing the tumor tissue and the lymph nodes affected by tumor cells. The operation plays an important role especially in non-small cell lung cancer – as small cell lung cancer is often diagnosed at a later stage, then other treatments are in the foreground.
The surgical procedure is preceded by extensive research. In particular, it must be ensured that after the removal of part of the lung, the remaining lung sections are able to sufficiently take over the respiratory function. The condition for the operation is a good general condition of the patient; Severe comorbidities often rule out surgery. Furthermore, removal of the tumor should not pose a risk to neighboring vital organs such as large blood vessels or the esophagus. If the expected burdens and restrictions are too great, a different therapy strategy must be chosen.
During surgery, the tumor-bearing lung section and the adjacent lymph nodes are removed. The most common procedure is the removal of a lung lobe (lobectomy). With very large tumors the removal of an entire lung wing may be necessary (pneumectomy). In many cases, however, it is possible to avoid the removal of the entire lung through special, organ-preserving surgical techniques.
Possible side effects:
As a result of the operation, the available breathing area of the patient is reduced. However, if the lung function before surgery is sufficient, it will not be a major problem for the patient, and he will usually be able to compensate well for the loss of lung tissue. Special breathing exercises in rehabilitation also help to improve lung performance after tumor therapy. The first exercises can already be learned in the clinic under the guidance of a physiotherapist and later be continued at home. For smokers, however, they should stop smoking immediately before the operation to improve their lung function.
What happens during an irradiation?
Radiation therapy is the only therapy for non-small cell lung cancer in stages I and II when surgery is not possible and for selected patients in stage III. Otherwise, it is usually combined with chemotherapy in patients with stage III and small cell lung cancer. If cancer has secondary tumors, called metastases, in other organs such as the brain or the bones, they may also be irradiated.
The high-energy ionizing radiation, which is directed from the outside to the tumor, destroys the cancer cells. The total radiation dose is divided into several single doses, which are administered about five times a week. In the so-called hyperfractionated radiation, which can be used in lung cancer, is even twice a day at intervals of several hours, but then irradiated with lower single doses.
In addition to conventional radiotherapy, the so-called stereotactic radiotherapy is also used. Here, the disease is in a few sessions, sometimes in only one, irradiated with a high dose of radiation. This is possible because the beams are directed to the target area from different directions after computer-controlled irradiation planning. There, all the rays meet at one point and add up to the total dose, which is thus maximum at the site of the disease, while the surrounding healthy tissue is largely spared. For this reason, stereotactic radiotherapy is particularly well suited for small tumors and tumors in delicate environments, such as brain metastases.
Possible Side Effects:
Side effects of radiotherapy may be hoarseness and difficulty swallowing. The skin is also sensitive to the treatment. In combination with chemotherapy in particular, mucous membrane inflammation and fungal infections can occur in the oral cavity. A late consequence is a pneumonitis, an inflammation of the irradiated lung tissue. Overall, the severity of side effects depends on the type and intensity of the radiation used.
How does the chemotherapy work?
Chemotherapy uses cell-growth-inhibiting drugs known as cytostatics. They act primarily against fast-growing cells and thus especially against cancer cells. For the treatment of lung cancer several chemotherapeutic drugs are available, which are selected according to individual requirements.
Which medicines are used depends on various factors, including the stage of the disease, the general condition, and concomitant diseases. Usually, two or three substances are combined, with cisplatin or carboplatin as the basic drug in most cases. Commonly used cytostatic drugs in non-small cell