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Biology of Lung Cancer and its Treatment Options

Lorenzo Vinante

Histologically, there are two types of lung cancer: small cell and non-small cell. Cough, dyspnea, hemoptysis, and systemic symptoms like anorexia and weight loss are the most common signs of lung cancer. Chest radiography should be performed on high-risk patients who present with symptoms. Computed tomography and possibly positron emission tomography should be used if no likely alternative diagnosis is found. A diagnostic evaluation is necessary if there is a high suspicion of lung cancer. There are three simultaneous steps in the diagnostic evaluation—tissue diagnosis, staging, and functional evaluation—all of which have an impact on treatment planning and prognosis. It is best to employ the least invasive technique possible. A team of specialists, including a pulmonologist, a medical oncologist, a radiation oncologist, a pathologist, a radiologist, and a thoracic surgeon, are needed to diagnose and treat a patient with lung cancer. New targeted molecular therapies can be used to treat non-small cell lung cancer if various mutations are found in the samples. To ensure that the patient's values and wishes are taken into account and, if necessary, to coordinate end-of-life care, the family physician should remain involved in the patient's care. Quality of life is improved and survival may be prolonged by early palliative care. At each visit, family physicians should focus on early detection of lung cancer and encourage smoking cessation as a means of prevention. In high-risk patients, the U.S. Preventive Services Task Force recommends lung cancer screening with low-dose computed tomography. The American Academy of Family Physicians, on the other hand, comes to the conclusion that there is insufficient evidence to recommend screening or not. The physician and the patient should jointly decide whether to screen high-risk patients.