2. LUNG CANCER
Lung cancer is the most common cancer type in the world. It may be primary (originates from the lung tissue) or secondary (originates from other organs), which is also called metastasis. The most common tumors that metastasize to the lung are breast, large bowel, kidney, bone and testicle cancers.
In the lung, both primary and secondary tumors are frequent, and the treatment varies greatly in the primary versus secondary tumors as well as in different subtypes of the primary tumors (e.g. small cell versus non small cell cancer). That’s why, a correct and detailed pathologic evaluation is extremely important in lung tumors. Although the lung biopsy can be done surgically and broncoscopically, CT-guided core biopsy is preferable to these methods because it is highly accurate, minimally invasive and cost-effective.
• Primary lung cancer:
Since the treatment approach is totally different, the primary lung tumors are divided into two groups, namely small cell cancer and non small cell cancer. In small cell lung cancer (SCLC), standart therapies are chemotherapy and/or radiotherapy, and surgery is very rarely performed. In non small cell lung cancer (NSCLC), the standart therapy is surgery, if the tumor and the patient are eligible. If the patient is not suitable for surgery, percutaneous ablation or radiotherapy can be performed.
In later stages of NSCLC, the tumor is generally too large for surgery. However, such tumors can sometimes be made smaller with chemotherapy or radiotherapy, and then, they can be removed with surgery. In such patients, chemotherapy can be given intraarterially directly into the feding vessels and may be more effective than standart chemotherapy
• Secondary lung cancer (metastasis):
Like liver, lung is also one of the most commonly preferred organs in metastasis. Some common cancer types such as breast and colon metastasize to lungs as well as to the other organs. Some other cancer types such as thyroid, testicle, bone and muscle are less common, but they frequently metastasize to lungs. In patients with lung metastases, there are generally other metastases elsewhere (liver, brain, bone etc) in the body. In such patients, the only tratment option is usually chemotherapy. In some patients however, metastases may be few and confined to the lungs. In such patients, if there is only one metastasis, surgery, radiotherapy or percutaneous ablation can be performed besides chemotherapy. If there are multiple metastases, percutaneous ablation is more suitable than radiotherapy or surgery. The most commonly performed ablation techniques in lung metastases are radiofrequency, microwave and cryoablation.