Lung Cancer: Basic and Clinical Aspects

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Lung cancer is one of the biggest challenges in oncology today. The challenge is due to the recognition of the possibility of prevention in at least 70-80 % of all the cases and the extreme difficulties encountered in the treatment of this neoplasm. Despite the knowledge of prevention measures such as cessation of cigarette smoking the incidence continues to increase in many countries. The increase is particularly notable in females in the west­ ernized countries where the death rate in females in certain regions sur­ passes that of breast cancer. Furthermore, in many developing countries lung cancer is now being diagnosed with increasing frequency in both sexes and it is expected to be a major cause of death in those countries later in this century or the beginning of next century if the tobacco consumption will continue its rapid rise. With respect to therapy the 1970'es brought considerable progress in understanding of the clinical behaviour of lung cancer thereby establishing the importance of distinguishing between the major histologic types. Thera­ peutic advancement was particularly experienced in small cell carcinoma with the introduction of combination chemotherapy after this special dis­ ease entity among lung cancers was recognized as being a disseminated dis­ ease in almost all cases at the time of diagnosis. It was expected that the improvement in therapy would have continued in the early 1980'es, not only for small cell lung cancer but also for the other cell types.