Lung cancer is the leading cause of
cancer-related mortality. Since tobacco smoking is the cause in vast majority of cases, the incidence of
lung cancer is expected to rise in those countries with high or rising incidence of tobacco smoking. Even though populations at risk of developing
lung cancer are easily identified, mass screening for
lung cancer is not supported by currently available evidence. In the case of
non-small cell lung cancer, a cure may be possible with surgical resection followed by post-operative
chemotherapy in those diagnosed at an early stage. A small minority of patients who present with locally advanced disease may also benefit from pre-operative
chemotherapy and/or
radiation therapy to down stage the
tumor to render it potentially operable. In a vast majority of patients, however,
lung cancer presents at an advanced stage and a cure is not possible with currently available therapeutic strategies. Similarly,
small cell lung cancer confined to one hemi-thorax may be curable with a combination of
chemotherapy and thoracic irradiation followed by prophylactic
cranial irradiation, if complete remission is achieved at the primary site.
Small cell lung cancer that is spread beyond the confines of one hemi-thorax is, however, considered incurable. In this era of
molecular targeted therapies, new agents are constantly undergoing pre-clinical and clinical testing with the aim of targeting the molecular pathways thought be involved in etiology and pathogenesis of
lung cancer.