Without treatment, the condition deteriorates rapidly and the patient dies within a few weeks. Surgical resection is the treatment of choice, with resectability dependent on tumour stage and lung and heart health. Primaries that are extensive or have spread beyond the lung are not resectable. Radiotherapy is used alone for cancers unsuitable for resection and as adjuvant therapy in cases where resection is inadequate or nodes are involved. Radiotherapy is now site-specific and side effects are minimal.
Some patients undergoing lung irradiation for large primaries develop pneumonitis.
This presents with fever and dyspnoea, and usually settles rapidly with high-dose oral steroids. Mesothelioma Mesothelioma is difficult to diagnose and, in most cases, has a very poor prognosis. Surgery is the treatment of choice in the rare cases in which cure is a possibility. When lung cancer progresses, both metastatic disease and local extension can lead to symptoms. Locally extensive disease can result in Horner's syndrome, vocal cord paralysis, phrenic nerve damage and obstruction of any structure in the chest, most frequently the superior vena cava.