Lung cancer

Chairman
Dr David Planchard

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Lung cancer

Lung cancer treatment

Patients with lung, pleural or mediastinal cancer may be offered different treatments, depending on the type of cancer and its spread or stage at the time of diagnosis. Treatments may be combined during therapy.

Local treatments

Surgery

The aim of surgery is to remove the entire tumour. Depending on the extent of the cancer, either part of the lung or the entire lung is removed. A complete lymph node dissection is also performed. The purpose of surgery is to complete tumour resection by removing any tumour lymph nodes. General treatment may be considered after the procedure.

Radiotherapy

Radiotherapy aims to destroy tumour cells using ionising radiation. Modern techniques use powerful radiation beams that precisely target the tumour through the skin while preserving the organs. 
Radiotherapy is the recommended treatment for early-stage cancers when surgery is not an option. It can also be used to treat some localised metastases. Radiation therapy is combined with chemotherapy in locally extensive stages devoid of surgical procedure.
Thanks to its technical radiotherapy platform, Gustave Roussy offers conformal radiotherapy to the vast majority of patients and, in some cases, breath-hold conformal radiotherapy. High-precision stereotactic radiotherapy is available for lesions of a certain size (Novalis® and Cyberknife radiotherapy machines). These treatments are the result of teamwork involving Gustave Roussy's expert clinicians, physicists, radiotherapy manipulators and dosimetrists.

Thermal ablation by interventional radiology

In some cases, small lung tumours can be destroyed by burning them with an electrode introduced through the skin (radiofrequency) or by cryotherapy (cold treatment). These interventional radiology techniques are guided by simultaneous imaging (CT scan, ultrasound, endoscopy), which provides in-depth views without resorting to conventional surgery. 
► More information about interventional radiology

Medicinal treatments

Conventional chemotherapy

Chemotherapy provides the basis for advanced lung cancer therapy. It is also used post-surgery when the tumour is larger than 4 cm and/or when some of the removed lymph nodes are pathological. 
The aim of chemotherapy is to prevent the proliferation of tumour cells. It is administered intravenously via a port or an implantable chamber placed under the skin. The duration and number of therapeutic sequences vary depending on the type of tumour and the patient's tolerance.

Targeted therapies

Targeted therapies are modern treatments that aim to destroy tumour cells by targeting specific tumour anomalies. These treatments can only be administered if the tumour presents certain molecular characteristics or anomalies. The most well-known mutations currently involve the EGFR, ALK and ROS1 genes. They are not common, affecting between 1 and 12% of patients, and tend to be found in non-smoking patients. Targeted therapies are administered alone and for a variable, often prolonged, period.

Immunotherapy

The purpose of immunotherapy is to stimulate the immune system in the fight against tumour cells. Indeed, tumour cells can hamper immune system activity by attaching themselves to an immune cell receptor. Immunotherapies are antibodies that prevent the action of tumour cells by blocking this receptor. These treatments are currently administered alone or in combination with conventional chemotherapies. Several studies are ongoing and their ranking in the therapeutic sequence will probably change.

Towards advanced therapy medicinal products for lung cancer

Depending on the characteristics and stage of the cancer, doctors can invite patients to participate in clinical trials. Patients can be referred to a clinical trial during treatment by their referring oncologist. Patients can therefore receive “standard” treatment or more innovative treatment as part of the clinical trial framework.
► View the ongoing clinical trials at Gustave Roussy

New techniques to analyse your cancer

The referring oncologist/chest specialist may recommend a fluid biopsy (blood sample) to test for a molecular anomaly likely to target your treatments more efficiently. The therapeutic strategy can be discussed at a multidisciplinary "molecular" meeting, if required.

Supportive care

In addition to medical care, supportive care is also offered to Gustave Roussy patients in line with their wishes and needs (psychological, nutritional and pain management, adapted physical activities, etc.).

 

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