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EXTENT OF PRIMARY GROWTH – SURGERY
Surgery and radiotherapy are both local forms of treatment. This means that they act only where they are applied and not in other parts of the body. Obviously they have a chance of being successful only if all of the cancer is within the treated area. A lung cancer starting near the heart and extending into it would not be cured by removing the lung. Radiotherapy for the same lung cancer would have no chance of controlling it unless the heart was included in the area being treated. Local treatment cannot be properly planned until the local extent of disease is known. To assess this, the doctor must firstly find out exactly what symptoms the patient is having and then examine him or her carefully. Depending where in the body the primary growth is, endoscopic methods, X-rays, scans or other tests might also be useful. For example, if a patient with lung cancer complains of chest pain, the doctor should suspect that the cancer has grown out of the lung into nearby structures because cancer in the lung itself is not painful. With or without pain, bronchoscopy, mediastinoscopy, ordinary X-rays and CT scanning are tests which should be considered before deciding to go ahead with surgery. Surgical removal of part or all of the lung should not be attempted until it is fairly sure that removal of the whole cancer is possible.
*90/40/1*
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