The opportunity to detect the cancer early means more individuals can be cured with surgical excision or with radiation therapy. Either can be followed by adjuvant chemotherapy for those with a high likelihood of microscopic disease spread.

Radiation therapy is a common treatment for lung cancer. The combination of chemotherapy with radiation therapy has curative potential in locally advanced NSCLC and in limited stage SCLC. New approaches to radiation therapy allow for much higher doses of radiation to the tumor with much less damage to surrounding normal tissues. Current chemotherapy drugs, usually used in combination with one another, have clearly improved the quality of life for patients with more advanced disease, slowed progression of the tumor and created a definite, albeit relatively short, survival advantage.

Of interest in drug therapy today is the advent of targeted drugs – ones that inhibit a specific abnormal protein in the tumor cell that is a driver of the cancer. These are the products of DNA mutations or DNA rearrangements and are uncovered by genomic analysis. Because the new drugs are quite specific, they affect the tumor but cause proportionally fewer side effects. Responses among patients with the DNA mutations in their cancers tend to occur rapidly and often with marked regression of the tumor. Unfortunately, relapses eventually occur as resistance develops and the drugs are quite expensive. There is an important proof of principle here that has been accomplished, and improvements in targeted treatment are coming fast and furiously.

There is good evidence that the best results with early diagnosis and with effective treatment lies in organizations that have high levels of expertise and utilize a multi-disciplinary approach to care wherein the patient is seen concurrently by surgeon, radiation therapist and medical oncologist to devise the most appropriate approach to care. Added to this, palliative care begun at the time of diagnosis adds to patient comfort, lessens anxiety, and reduces overall costs while improving satisfaction with caregivers and therapies.

With the advent of early diagnosis with CT screening, more effective yet less damaging approaches to radiation therapy, effective chemotherapy, targeted drug therapy for those with driver mutations, all initiated in experienced hands with a multi-disciplinary approach and early institution of palliative care, perhaps the light is now actually beginning to glow at the end of the tunnel for lung cancer patients and their families.

Written by Stephen C Schimpff, MD
Originally published on