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                      Ramesh Kaul, MD., FCCP., MS.                          Satyasagar Morisetty, MD FCCP
       Cheryl Lindsey CRNP                           Mary Beth Hein PA        Andrew Shedwick PA
The Medical Arts Building 2602 Wilmington Road
Suite 102, New Castle, Pennsylvania 16105
phone: +1 724-657-5285                fax: +1 724- 657- 6714


How is lung cancer treated?
Surgery remains the treatment of choice for individuals who can undergo resection of the cancer. Prompt evaluation and immediate diagnosis is always encouraged for individuals with abnormal symptoms. Other types of lung cancer treatments include chemotherapy which involves receiving medication into the blood stream that attacks the cancer cells in all parts of the body. Yet another type of lung cancer treatment utilizes radiation therapy to eliminate the tumor cells. In fact, most tumors can be precisely targeted with radiation therapy. New modalities for lung cancer treatment are Radio Frequency Ablation of the tumor, Use of Cyber Knife Radiation,
What are the different types of lung cancer?
There are two major types of lung cancer: one is small cell lung cancer and the other is non-small cell lung cancer. Small cell lung cancer accounts for approximately 25% of all lung cancers and exhibits rapid cell growth and spread. It is treated primarily with chemotherapy and radiotherapy. Non-small cell cancer is much more common, accounting for 75% of all lung cancers and is treated primarily with surgery and radiotherapy. Non-small cell lung cancers can consist of three major types:

squamous cell carcinoma, adenocarcinoma and large cell carcinoma. Of these three,      squamous cell lung cancer is more responsive to radiation therapy.

Broncho-alveolar carcinoma is a variant of adenocarcinoma.

How fast does it spread?
The rate at which lung cancer spreads varies greatly with each individual and with each cell type. However, tumor growth is typically seen over months as opposed to days or years. How does it spread to other parts of the body? Cancer cells are abnormal and divide without control or order. These cells can invade and destroy the tissue around them, break away from a malignant tumor and can enter the bloodstream or lymphatic system. This process is referred to as "metastasizing" and is how cancer spreads from the original tumor to form new tumors in other parts of the body.
What tests may be ordered?

Chest X-rays A chest x-ray is often the first study ordered to evaluate a patient with a complaint of cough or shortness of breath. It actually allows a photographic image of the lungs to be checked for abnormalities.

CAT Scan Computed tomography is a type of scanning where cross-sectional images of an area are performed to assess tumor size or possible spread. Typical areas scanned include the chest, head, abdomen and pelvis.

MRI Scan : Magnetic Resonance Imaging is good for lymph nodes, Pleural mesotheliomas and metastatic disease to chest wall and adrenals and brain.

Bronchoscopy Bronchoscopy is a procedure which allows direct visualization of the airways by your physician. After a numbing medication and sedation are provided, a special flexible tube is passed through the mouth or nose and into the airways where specimens can be taken, aiding in diagnosis.

New technology in Bronchoscopy with Endo bronchial Ultrasound probe.

Sputum Examination With coughing, tumor cells can be released right into the sputum. Collecting an early morning specimen can be very helpful in detecting abnormal cells.

PET Scan The PET scan is a diagnostic tool used to aid in the assessment of tumors. A small dose of a chemical called a radionuclide combined with a sugar in small  plastic tube is injected intravenous  into the arm. Because malignant tumors grow at a faster rate than normal tissue, they preferentially take up the sugar and therefore, appear abnormal on the scan as this sugar consumed releases positrons which register on the scan. Thus the areas which consume sugar light up. More intense sugar uptake means more light-up of the tumor thus more likely malignant.

PET-CT Scan or Dual Scan-  The PET and CT scans are done together and images are superimposed to get an accurate detail of tumor and if images are superimposed and match they suggest cancer.

Bone Scan A bone scan is used to detect areas of bone growth, infection or tumor. This test may be ordered to detect evidence of spread of lung cancer to the bones

CT Guided Needle Biopsy - This is a method of doing CAT scan and taking a needle and piercing the chest wall and doing a biopsy from the chest, lungs or lymph nodes.

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