Personalized Treatment Planning in Lung Cancer

By | 18 February 2021

Lung cancer, which is among the most common types in the world, is a fatal disease mostly caused by smoking or genetic predisposition. Lung cancer is basically divided into two as small cell lung and non-small cell lung. Studies show that non-small cell lung cancer is also divided into three groups as “epidermoid”, “adeno” and “large cell”. Apart from all these types, there are also types called “carcinoma tumor” and “neuroendocrine originated lung tumor”.

The stage of cancer determines the treatment method

Lung cancer treatment, as in all other types, depends on many factors such as the general health condition of the patient, the stage of the disease, and the type of cancer. Different treatment combinations are applied as well as personalized treatments. For this reason, lung cancer treatment should be done under the control of a fully equipped hospital and specialist physician staff.

Tumor type and stage constitute the most important stage in determining the treatment of lung cancer. In general, it is possible to treat the disease with surgery in the early stages (Stage 1-2-3A), while non-surgical treatment methods are appropriate in the late stages (Stage 3b and Stage 4). The type of lung cancer is also important in terms of response to treatment. In general, a better response to treatment is obtained in non-small cell lung cancers.

Treatment methods used to beat lung cancer

– Early-stage surgery saves lives: Lung cancer surgery is one of the treatment methods. The type of surgical intervention depends on the location in the lung. It is an operation to remove a small piece of the lungs. If only one lobe is surgically removed from the lung, it is called lobectomy, and if either the right or left lung is removed, it is called a pneumonectomy. Some tumors cannot be operated on due to their location, size, stage, and general health status of the patient.
– Cells are destroyed with medication: Chemotherapy is another treatment method used in the treatment of lung cancer. The main purpose is to destroy cancer cells with medication. Whether a patient will receive chemotherapy or not, and if so, how many days it will take determines the age, general condition, tumor stage, and type of the patient.
– Pain and shortness of breath are relieved by radiotherapy: Radiotherapy is the use of rays to kill cancer cells. It is applied to a limited area and affects cells in that area. Radiotherapy can be applied before surgery to shrink a tumor or after an intervention to destroy the cancer cell. It is generally used as the first alternative in patients whose cancer cannot be performed with chemotherapy and has progressed locally but has not spread to the distant region. In patients with advanced stages, radiotherapy is also used to relieve symptoms such as shortness of breath and pain.

– Targeted therapies: Immunotherapy and vaccine treatments, called targeted therapy, can be routinely given simultaneously to chemotherapy and radiotherapy in the treatment of lung cancer for the last few years. In recent years, it can also be used as the first-line treatment in patients with advanced-stage non-small-cell lung cancer, if the pathology reports are appropriate. Advanced pathological examinations performed in these patients are called the EGFR mutation test and ALK fusion test. These tests have a higher rate of positive detection in non-smokers. However, even in individuals who smoke, the rate of one out of both tests being positive is around 20%. This is the possibility that every five patients will benefit from these treatments, which should never be ignored.
– New treatments with vaccines: Vaccine applications have been used in lung treatment for the last 5 years. It is a treatment method that mostly concerns non-small cell, stage 4 lung cancer patients. It is used with other treatments.

Smoking negatively affects not only you but also future generations
Smoking is the main known cause of lung. For this reason, it is of great importance not to start smoking at all, even not in the smoking environment. However, every air that is drawn into us affects the quality of our lungs. Staying away from chemicals and reducing radiation exposure help prevent lung cancer from occurring.

Apart from physical causes, lung cancer can also be caused by genetics. There are studies on genetic predisposition and transition in lung cancers. Although large epidemiological studies reveal the relationship between smoking and cancer, some familial inheritance characteristics in lung cancers have been identified. Metabolic phenotypic characteristics of smokers or individuals under environmental exposure play a role in carcinogenesis. The balance of oncogene products and their changes within the cell cause genomic changes and cancer in cells.

The most important genomic changes in recent years are epidermal growth factor receptor (EGFR mutation) and Echinodermomicrotubule protein-like 4 anaplasticrinfomakinase (EML4-ALK) regulation, which is more common in Asian patients than non-Asian patients. Targeting the proteins affected by these genetic changes improves the prognosis in patients.