At the beginning of every medical advance is the intention and hope of the researcher to understand a problem in order to then bring it to a solution. Hope is not an unscientific quality, but a vital aspect of any research activity.
There has been some recent movement in the detection and treatment of non-small cell lung cancer (NSCLC), which fuels legitimate hope for significant prognostic improvement.
Accurate histologic differentiation and deciphering of the (previously known) mutational status allow identification of tumor morphology. By means of PET-CT and minimally invasive examination techniques (EBUS, mediastinoscopy), localization and tumor extension can be precisely determined.
After diagnosis and staging, an individual therapy regimen is now developed for each patient with NSCLC in an interdisciplinary structured tumor board. Tumor stage (TNM), histology, molecular genetic status, comorbidity, but also quality of life, personal wishes and needs of the patient are taken into account to design the best individual therapy. This approach applies to both curative and palliative stages of illness.
Tumors located peripherally in the lung are minimally invasive, thoracoscopic lobectomy as standard. Lung-preserving cuff resections allow pneumonectomy to be avoided in many cases of centrally growing lung cancer.In cases of mediastinal lymph node involvement and/or infiltration into the surrounding area, neo- or adjuvant therapy followed by surgical resection is undertaken with curative intent. In locally advanced stages, treatment is with multimodality approaches, i.e., combined chemotherapy followed by surgery or chemotherapy and radiotherapy. For metastatic lung cancer, therapy is determined based on histology and molecular characteristics.
Structured follow-up of patients with NSCL is important with regard to individually appropriate chemotherapeutic maintenance therapies, detection of second tumors, and indications for metastatic surgery.
Because of its high sensitivity and relatively low radiation exposure, computed tomography is currently the method of choice for detecting early recurrences or second tumors.
I hope you enjoy reading the first issue of the new journal InFo ONKOLOGIE & HÄMATOLOGIE!
PD Rolf Inderbitzi, M.D.
InFo Oncology & Hematology 2013; 1(1): 8.
