Lung cancer in older adults: Local treatment

Abstract

Lung cancer is a malignancy that primarily affects the elderly. It is commonly diagnosed in patients with comorbidities who may have concerns about complications from aggressive therapies. This chapter is written for the nononcologist to provide guidance on how best to approach elderly patients with lung cancer. An emphasis is made regarding the value of a multi-disciplinary team-based approach, given the evidence continues to evolve for an optimal approach in many clinical situations. It describes the advantages of minimally invasive thoracic surgery that have been reported in randomized clinical trials. It also summarizes the serendipitous outcomes following stereotactic radiotherapy for early stage disease that currently calls into question the time-honored belief that surgery provides the only hope for cure. A section is dedicated to the evaluation of treatment paradigms for patients with locally advanced lung cancer which has led to lower doses and smaller fields of radiotherapy than ever before. Finally, an update is provided regarding management options for localized small-cell lung cancer.