Surgery will continue to be "the mainstay" for lung cancer cure strategies, but promising results are emerging when it is combined with other forms of treatment such as chemotherapy and radiation.
According to the US lung cancer specialist, Dr William Sause of LDS Hospital in Salt Lake City, "combined modality treatment" has been shown to yield "a modest but real improvement in long-term survival". That improvement would increase over the next decade as treatment combinations were evaluated.
Surgery is frequently not possible in patients with advanced cancer and associated problems such as heart disease. Moreover, many of such patients fall into the older age category. Equally, non-surgical treatment only occasionally results in long-term survival or cure. Combined treatment is likely to be particularly effective in treating younger and "more healthy" patients with lung cancer, he said.
The treatment was a complex combination of therapies; some before surgery, others after it and some were repeated. Research at various centres throughout the world was establishing the best combinations and whether they should be administered concurrently or sequentially. Determining the appropriate dose would be a key factor as it could provoke a toxic reaction.
As the combined treatment was being shown to work in certain cases, there would be a temptation for doctors to increase the dose. Medical teams needed to be careful on this front and to "select patients well" before embarking on such an aggressive form of treatment.
Chemotherapy for many years was not successful, Dr Robert Ginsberg, a New York-based cancer specialist, told the conference in UCD. It delayed recurrence of the cancer all right but did not improve survival. However, a lot of new drugs were kinder on patients, easier to use and were getting better results. "Hopefully, in the near future, the newer, more active agents will further improve the management of the disease."