PT Health Life- When diagnosed with cancer, the patient as well as their family members will certainly be extremely frightened and worried. How long can you live with cancer and how to treat it are always questions that every cancer patient in general and lung cancer in particular always asks.
In fact, it is not easy for doctors to give a specific answer to this question, because the survival rate of lung cancer patients depends on many factors such as stage of disease, physical condition, mental state, and environment. life… of the patient.
For decades, lung cancer has always been one of the cancers with the leading incidence and mortality rates worldwide. In America, most patients are diagnosed at a late stage and have distant metastatic lesions.
1: What is lung cancer?
Primary lung cancer occurs when cancer cells start from cells in the lungs, mainly from cells lining the inside of the bronchial tubes , terminal bronchioles or alveoli.
Primary lung cancer is classified into two main types. Small cell lung cancer: accounts for 10-15% of lung cancer. Non-small cell lung cancer: accounts for about 85 – 90%. This is a common and common type of cancer.
1.1 Non-small cell lung cancer
Non-small cell lung cancer is divided into 3 subgroups according to histopathology including:
– Adenocarcinoma: accounts for about 40% of lung cancers . This type of cancer originates from the mucous gland cells that line the inside of the air ducts.
– Squamous cell carcinoma: accounts for about 25 – 30%. This type of cancer originates from the epithelial cells lining the air ducts and is common in smokers.
– Large cell carcinoma: accounts for about 10 – 15%.
1.2 Small cell lung cancer
Small cell lung cancer accounts for 10-20% of all lung cancers , but has a very high level of malignancy. Cancer cells often grow quickly and metastasize early to other organs. There is a clear link between small cell lung cancer and smoking. Most patients are diagnosed in the disseminated stage, accounting for about 75%. Current treatment measures mainly improve quality of life and prolong survival for patients.
2: Choose a lung cancer treatment method
Depending on each patient and the stage of the disease, doctors will have specific instructions. Below are some treatments for non-small cell lung cancer.
2.1 For early stages
When the tumor is still localized in the lung, has not metastasized to the lymph nodes, has not metastasized far and is potentially curable, the main treatment method is surgery to remove the tumor and systematic lymph node dissection. Adjuvant chemotherapy after surgery is indicated for some cases.
2.2 On-site advanced stage
A multimodal treatment approach is often used to shrink the tumor or in some cases completely eliminate the tumor. Combining chemotherapy, radiotherapy or surgery with chemotherapy.
2.3 Late stage, metastasis
When cancer has spread to many other organs and parts of the body. Various systemic anticancer therapies are used in an attempt to slow tumor growth, improve symptoms, and quality of life. This is called supportive treatment and palliative care.
Current main treatment methods for non-small cell lung cancer include the following main methods:
- Surgery
- Radiotherapy
- Chemistry
- Targeted treatment
- Immunotherapy
- Palliative care
Choosing treatment options is mainly based on:
- Disease stage
- Histopathological type
- Gene mutations
- Cancer markers
- Health condition
- The patient’s wishes
3: Lung cancer treatment methods
3.1 Surgery
– Indicated in the early stages: Stages I, II. Laparoscopic surgery or open surgery. Lobectomy or removal of the entire lung with systemic lymph node dissection.
3.2 Radiotherapy
– Radiation therapy can be used instead of surgery in the early stages, which is not currently recommended.
– Radiation therapy is often combined with radiotherapy and is often applied to locally advanced lung cancer or to control symptoms when the cancer is too advanced to be operated on or to treat symptoms with radiotherapy (anti-compression, much edema,..)
– Radiation techniques currently being applied: Stereotactic body radiotherapy (SBRT), dose-modulated radiotherapy (IMRT), volumetric modulated radiotherapy (VMAT),…
3.3 Valence
– Methods of using cytotoxic drugs that affect the growth and division of cells to kill cancer cells.
– Chemotherapy is prescribed before surgery (neoadjuvant chemotherapy), after surgery (adjuvant chemotherapy),
– Chemotherapy combined with radiotherapy (simultaneous radiotherapy), life extension and palliative care.
– Depending on the physical condition, accompanying diseases, histopathology, etc., doctors decide to choose the appropriate treatment regimen.
– Some chemicals commonly used in lung cancer treatment: cisplatin, carboplatin, etoposide, docetaxel, paclitaxel,…
3.4 Targeted and anti-angiogenic therapy
– Targeted therapy is indicated for patients with late-stage, advanced, distantly metastatic cancer for whom surgery and radiotherapy are no longer indicated.
– Targeted therapy drugs limit the growth and spread of the disease through blocking signaling pathways in cancer cells, which cause increased division and uncontrolled cell growth. , or increases the proliferation and development of blood vessels and lymphatic vessels to nourish and facilitate distant metastasis of the tumor.
Targeted drugs are drugs that block specific genes or proteins found in cancer cells or cancer-related cells.
– Targeted treatment drugs are prescribed; When examining histopathology, molecular biology detects whether cancer cells have genetic mutations or carry abnormal molecules.
– Targeted therapy (referred to as targeted therapy) is divided into two main groups: monoclonal antibodies, small molecule medicine.
+ Monoclonal antibody: typically an anti-angiogenesis drug: Bevacizumab.
+ Small molecule drugs: these drugs can penetrate inside cells, blocking targets that are molecules related to cell division, growth, and survival. EGFR inhibitors, ALK inhibitors, ROSI, MET, HER2, BRAF V600E,…
+ EGFR TKIs (EGFR Tyrosine Kinase Inhibitor): erlotinib, gefitinib, afatinib, erlotinib.
+ ALK TKIs (Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitor): Alectinib, crizotinib, ceritinib
3.5 Immunotherapy in cancer
– Is a cancer treatment method that helps increase the body’s own immune system’s ability to fight cancer cells.
– Immune checkpoint inhibitors (Checkpoint Inhibitor)
– Drugs that block the PD -1/ PD – L1 pathway:
+ Targeting PD – 1: Pemprolizumab, Nivolumab,…
+ Targeting PD-L1: Atezolizumab, Durvalumab,…
4: Doctor’s advice
In summary, determining the survival time of a patient with cancer depends on many factors including detecting the disease at the stage of the disease the patient is suffering from. In addition, the patient’s physical condition, whether there are accompanying diseases or not, and psychology are also extremely important factors.
Medicine is increasingly developing along with the application of new treatment methods in lung cancer such as targeted drugs and immune drugs, which have contributed significantly to changing the prognosis and quality of life for patients. . Therefore, cancer patients need to be optimistic to overcome their disease.
