Lung cancer: to treat or not to treat?

Surgical resection is the best form of treatment for primary non-small cell lung cancer. In resected cases the overall five year survival rate is 35%. The prognosis depends on cell type, nodal status and tumor size. Palliation of symptoms can be controlled in most instances by chemotherapy, radiation therapy or a combination of both. Presently there is no proven role for adjuvant irradiation therapy and chemotherapy after curative resection. Small cell carcinoma should be treated with combination chemotherapy and prophylactic cranial radiation; these therapies prolong survival and control symptoms. Patients' questions should be answered specifically and in no greater depth than the patient desires. Close communication should be maintained between physician, patient and a designated member of the family.