Dr. Mai Brooks Lung Cancer Statistics

In the United States in 2014,Dr. Mai Brooks predicts there will be an estimated 224,210 new cases of lung cancer.  Also in 2014, approximately 159,260 people will die from this malignancy.  This blog addresses the more common non-small cell carcinomas (more than 85% of lung cancer cases), not the small cell type.  Risk factors associated with lung cancer include cigarette smoking and asbestos exposure.

A biopsy is crucial to establish diagnosis, with a needle and/or bronchoscopy.  It is important to distinguish primary lung tumor from metastatic tumor, because many  cancer in other organs spread to the lungs (and these cases are treated differently).  Workup includes CT of the chest, abdomen, pelvis and Pet scan.  Sometimes, a mediastinoscopy (surgical insertion of a scope) is necessary to determine ahead of time if lung cancer has spread to the nodes in the mediastinum (upper central chest around the main airway).  

If the cancer is localized, surgery is recommended.  Depending on the location of the cancer, resection of 1-2 lobes or of an entire lung can be performed.  The patient must have enough lung function reserve to tolerate this.  Surgery may be performed with an open incision, a thoracoscope or a robot.  If the patient has significant co-morbidities, then partial surgery (segmentectomy or wedge resection), radiofrequencyablation, or stereotactic radiation may be considered.

Radiation is recommended after surgery if the cancer has aggressive features or if it has spread to lymph nodes.  Lung cancer that cannot be removed with surgery can be treated with radiation.  Cancer that has spread to distant organs (such as brain) may also be given radiotherapy.

Adjuvant (after surgery) chemotherapy is administered to patients with large cancer or if nodes contain cancer.  If these cancer features were known ahead of time based on pre-operative workup, neoadjuvant (before surgery) chemotherapy is recommended in the hope that it would shrink the cancer and make surgery more successful.  Chemotherapy is also given to patients with advanced or metastatic lung cancer.

For advanced lung cancer, there are several new approved "targeted" drugs in addition to chemotherapy.  These agents target specific molecular pathways that drive the proliferation of cancer cells, such as VEGF (vascular endothelial growth factor) and EGF (epidermal growth factor).

Dr. Mai Brooks is a Board Certified Surgical Oncologist with offices in Thousand Oaks, CA. To request an appointment with Dr. Brooks, you may call her at (805) 379-4677 or visit her website.