“When treating lung cancer, optimal interdisciplinary cooperation is key”, said the internationally renowned oncologist Univ. Prof. Dr. Dr. h.c. Christoph Zielinski. The WPK Academy Central European Cancer Center, in which Prof. Zielinski plays a leading role, is an outstanding example. First-class Austrian physicians from many different fields work together to help patients with lung cancer – and of course other types of tumours – get the best possible treatment.
“The WPK Academy Central European Cancer Center offers lung cancer patients total medical care, which is unique to the private sector”, explains Prof. Zielinski.
The first step is radiological diagnostics, in which the combination of positron emission tomography and computed tomography (PET/CT) plays a decisive role. For diagnosed lung cancer, an endobronchial ultrasound guided biopsy (EBUS) and molecular diagnostics – in an external lab – is conducted in which specific changes in the tumour tissue are searched for and an exact tumour typing is carried out. Based on these examinations, the interdisciplinary tumour board decides on the further course of action, i.e. which surgical, radiotherapeutic and oncological measures should to be taken to combat the lung tumour.
Surgery is the first choice
“The question that matters most is whether surgery should or shouldn’t be performed”, Prof. Zielinski explained. Surgery is still the best option, if possible. “If you can remove a tumour as a whole, then you should do so”, said the oncologist. “Surgical treatment plays an important role, especially in the early stages”, Prof. Dr. Walter Klepetko, a renowned specialist in bronchial carcinoma surgery, explained. “The treatment of choice for early-stage lung cancer is the surgical radical resection of the primary tumour including the systematic removal of the lymph nodes involved. “Minimally invasive surgery has increasingly established itself as the standard procedure for early cancer stages in recent years”, the head of the Clinical Department of Thoracic Surgery at the Medical University of Vienna went on to say. “Unfortunately, however, many of the affected patients are already at an advanced stage at the time of diagnosis. Whether a tumour is operable or not depends on how far it has spread and if other body parts are involved. If cancer has spread to the lymph nodes on the opposite side or if distant metastases are already present in the liver or brain, surgery is not advisable.
If a tumour is not immediately operable, a neoadjuvant chemotherapy is often carried out first, i.e. a chemotherapy that precedes the surgery in order to contain the disease and make it as operable as possible. Chemotherapy is also used in postoperative treatment because tumours have the ability to spread. This means that individual tumour cells can migrate from the tumour to other parts of the body, form new cells and metastasize. “Adjuvant chemotherapy can help to prevent the cancer from returning”, Prof. Zielinski explained. There are currently no alternatives to chemotherapy after an operation.
If a tumour is inoperable, molecular targeted therapy is used where possible. “In about 25 percent of lung cancer cases, we are now able to attack specific targets in the cancer cell”, Prof. Zielinski explained. Molecular diagnostics is used to identify suitable tumours. “In these cases, targeted therapy, which consists of the patient taking one tablet daily, delivers better results than chemotherapy”, the oncologist said.
Another option for inoperable tumours is immunotherapy. This involves the use of antibodies that block those mechanisms that tumours use to suppress the immune system functions. Depending on the immunohistochemical properties of the tumour, this can be done alone or in combination with chemotherapy. “Great progress has been made in recent years in the oncological treatment of lung cancer and other tumours”, Prof. Zielinski said. “Patients of the WPK Academy Central European Cancer Center can benefit from this.”