Lung Cancer

Diagnosis

1. The mass (bump) in the hilar or paraseptal pulmonary parenchyma is shaded on the chest X-ray photograph. Also, the atelectasis and pneumonia caused by bronchial obstruction, mediastinal lymphaednopathy and pleural effusion fluid are accompanied with lung cancer in the progress of the disease. In some cases, lung cancer is needed to be distinguished from pulmonary cystoma, pulmonary tuberculosis or pulmonary abscess, due to the necrosis of the mass.

2. CT is very useful to analyze the cancer position, progress and the proliferation of mediastinal lymph nodes.

3. Sptum cytology is effective to diagnose lung cancer through squamous ephithelial cell.

4. Bronchoscopy is necessary for all the patients who show symptoms of lung cancer. Lung cancer can be correctly diagnosed by biopsy, and is of help to delimit surgical resection.

5. Percutaneous needle aspiration is used in case the bronchoscope is difficult to reach the mass as it is laid at the end of the lung. Its diagnosis rate reaches about 90 percent, but a complication such as pneumothorax and bloody phlegm may be arisen.

Treatment

1. The curability of surgical operations is highest in remedying lung cancer, but it is applied to about 30 percent of patients because the 70 percent miss the opportunity of surgical operations. Prognosis remarkably becomes different as to the progress of lung cancer, and so it has been reported that the primary cancer indicates the recovery rate between 70 and 80 percent and the secondary cancer is between 40 and 45 percent and the tertiary cancer is between 15 and 25 percent. Consequently, it is important for patients to undergo medical treatments between primary or secondary stage. Specifically, periodic checkup and early diagnosis is critical to remedy lung cancer. In the case of the aged and those who have cardiovascular diseases or diabetes, postoperative recovery may take a long time but they have no difficulty in undergoing surgical operations. For more information, refer to ‘Attached File 1’.

2. Anticancer medicines are used for the patients diagnosed with small cell lung cancer, who account for about 20 percent of lung cancer. On the other hand, in the case of non-small cell lung cancer accounting for 80 percent, anticancer medicines are used in combination with other treatments because it is not effective for non-small cell lung cancer as well as lumpectomy is more effective. Anticancer medicine-centered remedy is used for the lung cancer in the 4th stage that shows distant metastasis. High-efficacy medicines have been continuously developed, and those are expected to go a long way with such patients.

3. Radiotherapy
A. With regard to small cell lung cancer, the range of irradiation is effectively delimited as to the progress of cancer.
B. The radiotherapy for non-small cell lung cancer is largely divided into fives.
- Radical Radiotherapy: It is ordinarily irradiated to lymph nodes or the lesion of the lungs. This radiotherapy is performed once a day and five times a week, and so 6,000 to 6,500cGy of radial rays are irradiated covering 6 to 7 weeks. Recently, radial rays have been irradiated twice a day through multi-fraction radiotherapy.
- Preoperative Radiotherapy: This is effective to remedy superior sulcus carcinoma.
- Postoperative Radiotherapy: This is used in case cancer is metastasized into hilar or mediastinal lymph nodes.
- Palliative Radiotherapy: This is used for superior vena caval syndrome, the pooling of pericardial or pleural fluid, the damage of chest wall, ideomotor abnormality and the ache caused by brain metastasis.
- Preventive Radiotherapy: This is used to prevent cancer cells from being metastasized into the brain.

4. GenetherapyAs molecular biology has been remarkably developed, causal genes have been found out in various genetic diseases and so the defect of causal genes are expected to be corrected as well as problematic genes are expected to be replaced by sound ones. In particular, genetherapy has been actively applied to cancer and AIDS, and in result, various genetic abnormalities have been gradually clarified through the gene that proliferates cancer cells, the gene that inhibits the proliferation of cancer cells, the gene that is able to recover the defect of DNA, the gene that interferes metastasis and infiltration, tumor marker factors and otherwise. Genetherapy, which applies such characteristics of genetic abnormalities to remedy, is expected to effectively remedy lung cancer. However, it is on a tentative stage yet and also therapeutic method, efficacy and safety are not secured as yet.

5. ImmunotherapyThe human body has two kinds of immune bodies against cancer cells or foreign substances. One is the specific immunomechanism that attacks the tumor-specific antigen or the tumor-associated antigen on the surface of the cancer cell membrane. Another is the non-specific immunomechanism that detects the change of autologous somatic cells and attacks such cells. Such immunocytes are composed of T helper cells, cell-hindrance T cells and natural killer cells. Immunotherapy is to inject such cells into the human body or the tumor in order that the immunity to cancer may be strengthened and that the tumor may be gone down, but its effect is not satisfactory yet.

6. Endoscopic Laser SurgeryThe endoscopic YAG laser is used to urgently open up the airway in case more than half of the airway is obstructed by a tumor, but hemorrhage or perforation may be arisen. The superficial tumor, which has the inside diameter of 2cm and downward and which is being in the bronchus within the range of the bronchoscope, can be remedied by endoscopic photodynamic therapy.

Preventions

It is most important to stop smoking to prevent lung cancer, and polluted air is needed to be purified at state levels. Likewise, the adults aged 50 and upward are needed to undergo the chest X-ray examination once a year.

from: http://www.hidoc.co.kr/