Lung Cancer and Chemotherapy

Medical Author: Barbara K. Hecht, Ph.D.
Medical Editor: Jay W. Marks

There are some types of cancer that have a particularly grim prognosis. The diagnosis literally carries a death sentence. One of these dismal diagnoses is pancreatic cancer. Another of these has been lung cancer , many cases until recently have been fatal.

Lung cancer is a particularly important type of malignancy because of its frequency and impact. Lung cancer is "the most common cancer" and it is now the leading cause of death due to cancer. Therefore, any significant advance in the treatment of this disease is correspondingly of great importance.

A new advance in treatment has been reported that concerns the most common form of lung cancer which is confusingly called non-small-cell lung cancer. It is responsible for at least 4 in every 5 cases of lung cancer.

The standard of care for non-small-cell lung cancer in its early stages has been to remove the tumor by surgery and then to monitor the patient carefully for some years. Up to now, this has provided the best hope in such cases.

However, many patients have died of metastatic lung cancer due to distant spread of tumor cells. The surgeon successfully removed the primary tumor but, tragically, the cancer had already stealthily traveled to distant sites in the body.

What has been learned is that chemotherapy given immediately after surgery clearly improves the survival rate with early non-small-cell lung cancer. This has been strongly suspected over the past year or two and now has been nailed down by a report in the New England Journal of Medicine on June 23, 2005.

The difference in survival was dramatic with chemotherapy after surgery. In the study 69% of patients who had chemotherapy were alive 5 years later, as compared to 54%% of those who did not. The addition of 15% in survival with lung cancer is a major advance.

This medical development will surely be much discussed by newspapers, television and other media in the weeks to come. It brings real hope to everyone diagnosed with this type of lung cancer and to their families and friends.

This is something of personal interest to me since my father, father-in-law, brother-in-law and sister-in-law all succumbed to lung cancer, irrespective of whether they were or were not smokers.

References: 1. Winton T, Livingston R, Johnson B, et al. Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 2005; 352:2589-2597. (The key new report). 2. Pisters KMW. Adjuvant chemotherapy for non-small-cell lung cancer - The smoke clears. N Engl J Med 2005; 352:2640-2642. (accompanying editorial)

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