What is the treatment of Adeno Carcinoma of Lung?

March 11 22:09 2019 Print This Article

1. The treatment depends on the histological type of cancer, the stage of spread and the patient’s performance. The possible treatment includes the chemo therapy, surgery and radio therapy. The 5 year survival rate is only 14 percent and it depends on the stage and treatment. It depends on the cell type and its spread rate along with the performance status. It includes the surgery, chemo therapy and radio therapy. In the surgery there is a requirement of the CT scan along with a positron emission tomography referred as PET. It is used to know whether the disease is localized and is amenable to surgery or whether it has a spread to the point where the surgery is not feasible. It is also supported by the blood tests and spirometry which is also known as the lung function test. It tells us about the process whether the patient can be operated or not. If one observes poor respiratory reserve one should not go for surgery. It includes the chronic obstructive pulmonary disease which stands for COPD.

Surgery has a death rate of 4 percent and it relies on the patient lung function and other factors. In the case of non small lung carcinoma surgery is the only option available. It is limited to single lung up to stage III A. It is known with a positron emission tomography referred as PET and CT. One must wait for a pre operative reserve so to allow sufficient lung function after the removal of tissue. There is a procedure known as the wedge resection in which a part of the lobe is removed. There is a segmentectomy in which there is a removal of the anatomic division of particular lobe which is followed by the lobectomy in which there is a complete removal of the lobe of lung. There is a bi lobectomy in which there is a complete removal of both the lobes of lungs. There is a pneumo nectomy in which the complete lung is removed. The lobectomy in which there is a complete removal of the lobe of lung is performed in the patients with good respiratory reserve. The chances of recurrence in this case are very less. If there is not a good respiratory reserve it may be treated by the wedge resection in which a part of the lobe is removed.

The recurrence may also be decreased by the radioactive iodine brachy therapy. It is done at the margins of wedge excision. There is a video assisted thoraco scopic surgery and video assisted thoraco scopic surgery lobectomy. They are minimal invasive approaches to the surgery of lung cancer. It provides a quick recovery, less hospital stay and less cost of treatment procedures.

2. A chemo therapy is done in the cases of small lung carcinoma with the help of radiation. Surgery has not much effect in the case of survival. A primary chemo therapy is also given in the cases of non small lung carcinoma. The tumor type decides the combination regime and a non small lung carcinoma is treated with the combination of few medicines which include the cis platin, carbo platin and doce taxel etc. In the cases of small lung carcinoma are treated with the combination of few medicines which include the cis platin and etoposides. In the later stages of small lung carcinoma are treated with the help of celecoxib.

3. There is an adjuvant chemotherapy for the cases of non small lung carcinoma and is done after the surgery. It improves the outcomes and the samples are taken from the lymph nodes in case of surgery. If it has cancer cells the patients have later stages of the disease. In this case the adjuvant chemotherapy is helpful and improves the survival rate by 15 percent. The standard regime is platinum based chemo therapy which includes the cis platin. The use of adjuvant chemotherapy is not successful in few stages of cancer and clinical trials have not demonstrated a survival benefit. The trails done in the case of neo adjuvant chemotherapy in resectable cases of non small lung carcinoma have not been proven much yet.

4. Along with the chemo therapy one must go for the radio therapy and must be use as a curative agent in the patients which are not eligible for the surgery. It is used in the cases of non small lung carcinoma. This type of radio therapy is referred as the radical radio therapy. There is a refinement of this technique which is referred as the CHART which denotes to the continuous hyper fractioned accelerated radio therapy. In this a high dose of radio therapy is given in a short span of time. In the cases of small lung carcinoma which can be treated one must go for the chest radiation along with a chemo therapy. In the cases of non small lung carcinoma the use of adjuvant radio therapy along with the curative intent is not a successful method.

The advantages are limited in those patients in which the tumor spreads to media stinal lymph nodes. In the cases of non small lung carcinoma and small lung carcinoma a smaller radiation to the chest can be used for control of symptoms and is referred as the palliative radio therapy. It is possible to deliver this therapy without having knowledge about the histological conditions of lung cancer. There is a brachy therapy which is referred as the localized chemo therapy in which there is a direct exposure to the air way when the cancer cell infiltrates the short area of bronchi. It is done when the lung cancer blocks the air ways. There are patients with a limited small lung carcinoma stage and are provided with a prophylactic cranial irradiation referred as the PCI. It decreases the risk of metastasis and more recently this technique has been found to be beneficial in cases of later stages of small lung carcinoma.

The patients may also show improvement in the cases of cancer after the chemo therapy. The prophylactic cranial irradiation referred as the PCI also shows decreased risk of metastasis in the brain from 40 to 15 percent annually. There has been a great improvement in the targeting and imaging which have lead to the development of extra cranial stereo tactic radiation in the treatment of early stage lung cancer. In this form of radiation therapy one can look for a high doses in small sessions in the targeting technique. It is quite helpful in the patients which are not surgical candidates due to medical problems.

5. There is an interventional radiology in which one observes the radio frequency ablation which is considered to be investigation technique in the treatment of bronchogenic carcinoma. It is done with the help of small heat probe put inside the tumor so that tumor cells can be killed.

6. There is a targeted therapy in which there is a molecular targeted therapy which is developed for the treatment of lung cancer in the advanced stages. There is a drug known as the gefitnib which targets the tyrosine kinase of epidermal growth factor which is referred as the EGFR. It is expressed in many cases of non small cell lung carcinoma and it did not decrease the survival even the females like Asians, non smokers with a bronchio alveolar carcinoma derive the benefit from this drug. There is erlotinib which again targets the tyrosine kinase and increases the survival rate in lung cancer patients. It has been approved by the FDA as another line treatment for the non small cell lung carcinoma. It increases the chances of bleeding mainly in the patients of squamous cell carcinoma. The advances in cyto toxic drugs and pharmaco genetics have shown a good improvement. There are number of targeted agents at the drug design and have shown promise. There are future areas of research also.

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