Added (adjuvant) Treatments
It is my practice to recommend adjuvant radiation therapy in all cases in which lymph node metastasis is found at the time of surgical resection. I also ask the patient to have a consultation with a medical oncologist in these cases, for consideration of adjuvant chemotherapy. Since optimal adjuvant chemotherapy has not yet been determined, I will refer the patient to an oncologist who can offer the patient a variety of clinical trials if at all possible. Radiation therapy may also be indicated if the edge of the tumor was at or near the line of removal of the cancer. Sometimes radiation therapy is indicated before surgery. The most common indication for pre-operative radiation therapy is the so called superior sulcus tumor. These tumors invade into the ribs at the highest part of the chest cavity and cause severe pain in the arm and shoulder. Radiation therapy before surgery can shrink the tumor down and allow the surgeon to completely remove the tumor. Surgical cure can be obtained in this way in approximately 35% of selected patients. Pre-operative or "neoadjuvant" chemotherapy is a new approach to the treatment of advanced lung cancer that is being tried in a number of clinical trials at the present time. It shows some promise in these patients.
Frederic W. Grannis Jr. M.D If you have trouble contacting me with the address above, I may also be reached at 76516,2333@compuserve.com and at fgrannis@cris.com |