Why do we care about lymph nodes when staging lung cancer?

Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.

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Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.

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The Radiation Therapy Oncology Group (RTOG) has been working on a large randomized trial in patients with stage III, locally advanced, unresectable NSCLC that asked two key questions:

1) is the best dose of radiation the "old" standard of 60 Gray (Gy), over about 6 weeks, or a higher dose of 74 Gy that has been found to be feasible?

2) Is there a value in adding weekly Erbitux (cetuximab), the antibody to the epidermal growth factor receptor (EGFR), along with weekly carboplatin/Taxol (paclitaxel) and concurrent chest radiation therapy (RT)?

I've mentioned in posts in the past about the settings in which local therapy might be appropriate for someone even when we know the cancer is advanced/metastatic.  Here's a brief video that discusses some of these issues, including a situation in which the local treatment isn't specifically aimed at addressing a symptom, as is the usual reason for treating with local therapy for metastatic cancer, but is rather what I'd consider the "Get the Lead Runner" strategy:

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I'm interested in your thoughts.

Here's the second half of the presentation by Dr. Gerard Silvestri, expert pulmonologist and critical care specialist at the Medical University of South Carolina in Charleston, on pulmonary complications from lung cancer treatment.

Like Charlie Brown always thinking that this time will be different when he tries to kick the football without Lucy pulling it away, we get lulled into thinking that we know the intuitive, obvious answer in medicine without really testing it, only to find that our assumption was wrong yet again.

For non-small cell lung cancer patients with multiple brain metastases, the standard approach of whole brain radiotherapy is not necessarily standard for each and every patient. Each patient's specific situation may sometimes be best approached with various combinations of surgery, radiation, medical/systemic therapy, and non-cancer directed treatment.

When I met my first lung cancer patient in medical school, I found it difficult to grasp the wording of the diagnosis non-small cell lung cancer (and its associated acronym, NSCLC). Why was the diagnosis named so specifically for what it is not, rather than what it is?

We've recently received a series of questions on the question of whether it makes sense to give an oral EGFR inhibitor like Tarceva (erlotinib) or Iressa (gefitinib) concurrently with radiation. This is really a poorly studied question, but a paper just published in the Journal of Thoracic Oncology describes a clinical trial that helps to address this question.