Lung cancer treatment

Voiceover: There are a few treatment options for lung cancer and which treatment a lung cancer patient will receive depends on two things. The stage and the type. Now the stage of lung cancer is determined mostly by medical imaging. So, I'm drawing an x-ray here, x-rays compiled together in a computerized tomography scan, also called the CAT scan or a CT scan, gives a good 3D view of the cancer cells. MRI's or magnetic resonance images gives us similar image, but they don't use radiation to take the picture of the lungs. And finally, a PET scans or a positron emission tomography track the energy used of the cancer cells to give a 3D image as well. And these are all good because they give an exact location of the cancer cells and an idea of how far the cancer cells have spread. Now for type, type is determined by actually looking at the cancer cells in a sputum sample or a tissue biopsy is taken from the cancer patient. And all these information, oops, I'm out of room, let me give myself a little bit more space. All these information is used to determine the duration of treatment and whether the patient will receive surgery or radiotherapy or chemotherapy or some sort of combination of these three. So let's start by discussing surgery. And you'll see that these lungs are very multicolored and I drew it this way on purpose to remind you that the lungs are made up of segments that are created by all of the branch points off the main airway. And this is going to be important in one of the surgical procedures that we will talk about in just a minute. But also keep in mind that the lungs can be divided into lobes. And I'm going to draw those in here. And I'm only drawing in the lobes of the right lung because I want to focus here and I'm going to extend this segment to include a few more branch points. So here we go, and here are some cancer cells multiplying in the lung tissue and these massive cells will show up on medical images and a surgeon will look at it and say "Okay, they are localized. "Let's remove the place where the cancer cells are, "and a small bit of normal tissue around it. "Just to make sure that "all the cancer cells are captured." And then the surgeon will sew up the parts of the lung tissue that remain and this is called a wedge resection. But what if the cancer cells had spread to other places along this segment? Let's draw that in here. Well, you can imagine that the surgeon would want to take out the entire segment. And this procedure would be called a segmental resection. But if the cancer cells were present in many of the segments that make up this entire lobe, then the surgeon will probably opt to take out the entire lobe of the lung. And again he's going to sew up the lung tissue and close off the airways, so that air isn't escaping into the chest. But if masses of cancer cells are detected in multiple segments in all the lobes of the lungs. Then the surgeon will act to take out the entire lung in a procedure called a pneumonectomy. So the whole lung is removed and the airway is sealed off so that air doesn't escape into the chest when the patient is breathing. I should also mention that lymph nodes located here at the center of the chest along the airways leading into the lungs during any of these surgical procedures maybe removed if it's believed the cancer has spread here. Which is often does, because these are very close to the lungs and the source of the cancer cells. Surgical removal works well when the cancer is confined, but if the cancer advance stage in the other lung or other parts of the body, removing chunks of tissues from multiple places doesn't make a lot of sense. So then, let's get into the other treatments available. Here's a little less colorful lung, and let's focus in here where some cancer cells maybe growing. I'm putting some healthy cells. I'm not going to draw all the healthy cells, but here's a representation of them. Radiotherapy is a treatment option that uses radiation, and I'm going to draw a radiation as a lighting bolt here coming in from the outside of the body. And when the radiation reaches the cancer cells, it damages them so greatly that the cancer cells can no longer live and they die. But the radiation is going to have this effect in the normal healthy cells. And so the radiation really needs to be targeted accurately to the cancer cells with medical imaging. Even still the radiation needs to travel through a lot of tissues from the outside of the body through the cancer cells. And this will cause a bit of discomfort as cells in the skin are in the lung lining are affected and die and possibly leave a scaring. For this reason depending on the location of the cancer cells, the radiation maybe administered internally by putting a probe into the lungs. Some types of lung cancer like small cell lung cancer are more responsive to this type of therapy. But there is also chemotherapy. So I'm going to bring back the image of the lung and include some of the vasculature coming from the heart. Chemotherapy is a systemic treatment, meaning it's going to go everywhere in the body through the vasculature. And let's just say that there are cancer cells here, I'm drawing them in orange, in the lung tissue compressing the airway. Chemotherapy travelling in the blood is going to come to this cancer cells and be taken up with the nutrients that the cancer cells are extracting from the blood. And if the cancer cells are dividing the chemotherapy is going to stop the division, and this stall in division is going to kill the cancer cells. With the whole being that healthy normal cells will grow back and the cancer cells will not. But hold on because chemotherapy is going everywhere in the body. And it's causing the death of any cell that's dividing. And so think about all the places in the body where cells are dividing very rapidly, in the hair, red blood cells, in the GI tract. And all of these cells are also going to die. So this is going to cause side effects all over the body and in just the three systems that I just mentioned, think about how hair is going to be loss, and how anemia may set in, or how nauseousness may occur. And replacing all of these cells is an exhausting process. One side effect that happens in all three types of treatments is pain. The cancer patient is going to need to discuss all of these issues with their oncologist team, at regular appointments throughout their treatment course. And even after the treatments have stopped, follow up appointments will continue indefinitely to address any long-term side effects and also to make sure that the cancer hasn't reoccurred.