The large majority of such cases have micro-metastases and nowadays such patients receive chemotherapy in addition to irradiation as this has been shown to increase their median survival and long term survival rate. Important work has come out of Japan on the bast way to combine these two modalities. In particular, it was shown that giving chemotherapy and irradiation concurrently was better than giving them sequentially. However, there still remain important questions to be answered such as the dose and fractionation of irradiation and the possible use of cytotoxics which are also radiosensitizers. Any discussion of progress in combating lung cancer must include the importance of combating cigarette smoking.
Smoking is, for example, to be banned in public places.
One can be sympathetic to the discomfort that some anti-smoking measures might cause to smokers, many of whom would like to stop smoking but cannot as they are physically addicted to smoking. Nevertheless, the gain to general public health will be so large that these measures should be strongly supported. A topic of interest was the assessment of quality of life in patients with lung cancer. This is now a formalized science with validated tests. A great help in the conduct of these tests is the availability of research nurses to distribute and collect the questionnaires.