Q: My father has lung cancer stage III B. He has taken 6 courses (21 days tablet and 7 days rest) of oral treatment for cancer. He had the side effects of vomiting, nausea etc. My question is, can we continue the treatment or can we give a break for 3 to 6 months? If you want more details, please mail me. Please give your suggestions.

A:There are several histologic subtypes of carcinoma lung like adenocarcinoma, broncho-alveolar carcinoma, squamous cell carcinoma, large cell carcinoma and small cell carcinoma. Most lung cancers cannot be cured with currently available therapeutic modalities and a combination of surgery, chemotherapy, and radiation therapy is used. The addition of biologic therapy has helped to improve quality of life and disease-related symptoms. The estimated 5-year survival rates for Stage IIIA is about 10-35%. At present, chemotherapy alone has no role as potentially curative therapy. Two small, randomised trials have suggested that neoadjuvant chemotherapy (i.e. chemotherapy given prior to surgery) prolongs survival in subjects with stage IIIA disease but other similarly designed trials failed to confirm this. Patients with good performance status and less than 10% body weight loss are good candidates for chemotherapy and in such patients, platinum-based chemotherapy provides better palliative benefits. The commonly used regimens include carboplatin-paclitaxel, cisplatin-gemcitabine, and cisplatin-vinorelbine, all of which achieve similar results. Radiation therapy reduces local failures in completely resected (stages II and IIIA) non-small cell lung cancer but has not been shown to improve overall survival rates. Unresectable tumour is treated with chemotherapy or a combination of chemotherapy and radiation therapy. Antiemetic treatment has to be given aggressively to prevent, not treat, nausea and vomiting as the drug regimens and the dose used have a high emetogenic potential. Your oncologist will be best placed to advise you on the dose schedule based on the protocol followed.