What are the main treatment modalities for lung cancer

  With the development and progress of medical science, the treatment methods for lung cancer are becoming more and more abundant and diverse. After the diagnosis of lung cancer is confirmed, the treatment plan should be determined based on the patient’s general condition, pathological staging of lung cancer, clinical stage, genetic status, PD-L1 expression, and the presence of important co-morbidities.  Overall, the treatment methods of lung cancer include surgery, chemotherapy, radiotherapy (radiotherapy), targeted therapy, immunotherapy, interventional therapy, Chinese medicine, etc. Each treatment method has its own indications and advantages and disadvantages.  Surgery: Surgery is the treatment of choice for stage I, stage II and some stage III non-small cell lung cancer, as well as stage I and some stage IIA small cell lung cancer. Minimally invasive surgery has replaced traditional surgery as the main treatment modality for lung cancer surgery. Minimally invasive surgical techniques of television thoracoscopy (VATS) have been widely used in all stages of lung cancer surgery, and da Vinci robotic surgery is also being carried out gradually.  Chemotherapy: Chemotherapy is a treatment method that uses chemical drugs to kill tumor cells, inhibit the growth and reproduction of tumor cells and promote the differentiation of tumor cells. It is a systemic treatment and has therapeutic effects on primary foci, metastases and subclinical metastases. Chemotherapy is still the cornerstone of lung cancer treatment. In non-small cell lung cancer, chemotherapy combined with targeted drugs, chemotherapy combined with immune drugs and chemotherapy combined with anti-vascular drugs have achieved very good efficacy.  Radiotherapy: radiotherapy is a local treatment method using radiation to treat tumors. The energy generated by large amount of radiation can destroy the chromosomes of cells and stop the growth of cells, thus eliminating cancer cells that can divide and grow rapidly. Radiotherapy for lung cancer mainly includes: stereotactic radiotherapy for inoperable early stage non-small cell lung cancer, simultaneous radiotherapy for locally advanced lung cancer, and palliative radiotherapy for advanced lung cancer. In the treatment of lung cancer patients, about 70% of patients need to receive radiation therapy.  Targeted therapy: refers to the process of apoptosis of tumor cells caused by specific binding of target-specific drugs to specific targets of tumor cells, and this treatment mainly targets tumor cells without killing normal cells. The selection of targeted therapy requires genetic testing of the patient and the selection of the appropriate targeted drug for treatment based on the absence of suitable mutation targets.  Immunotherapy: Generally speaking, immunotherapy is to improve the body’s immune ability and use the body’s autoimmune ability to eliminate and clear tumors. Currently, immunotherapy mainly refers to immune checkpoint inhibitor therapy. Immune checkpoints are a kind of inhibitory immune molecules, which are expressed on immune cells and can regulate the degree of immune activation, and they play an important role in preventing the occurrence of autoimmune effects (abnormal immune function and attack on normal cells). Immune checkpoint inhibitors are therapies that kill tumor cells by regulating T-cell activity through a series of pathways such as co-inhibition or co-stimulation of signaling.  Interventional therapy: It is a less invasive treatment method that involves making small incisions in blood vessels and skin to establish channels without opening the lesion to expose it, or treating the lesion locally under the guidance of imaging equipment (angiography, fluoroscopy, CT, MR1, B ultrasound) via the body’s original pipeline. In other words, different drugs are injected directly into the lesion through blood vessels or through skin puncture to change the blood supply to the lesion and act directly on the lesion, or different materials and devices can be used to act locally on the lesion or placed in the blood vessels or trachea to restore the normal function of these ducts.  Traditional Chinese medicine treatment: mainly through traditional Chinese medicine, it can help to strengthen the root, improve immunity and promote the recovery of body functions, which can reduce the adverse effects of radiotherapy and facilitate the smooth implementation of radiotherapy, etc.  Lung cancer is considered a systemic disease. Except for a few early stage lung cancers that can be cured by local treatment including surgery only, the vast majority of lung cancers require comprehensive treatment by various means, including surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy, interventional therapy and Chinese medicine treatment. Based on the general condition of the patient, tumor type, stage, effectiveness and toxic side effects of each treatment modality, a comprehensive assessment is made to select the most appropriate treatment method.