Treatment plan for Lung Cancer:

Lung Ca has been the leading cause of death in both - men and women in the USA since 1987. Prior to that only in men. 

Small cell Ca is primarily treated with chemotherapy and for exam purposes, is considered inoperable and metastasized right from the time of diagnosis.

On the other hand is the non small cell cancer which is operable in the first 2 stages.

The 3 most important factors in the prognosis of the patient are 

1. Stage
2. Performance status and
3. Recent weight loss

Staging:

Any size tumor may be operable as long as it has not invaded parietal pleura or pericardium or chest wall (although this too is changing, this is what the boards expect). Tumor is also considered inoperable if the nodes in the peri-Tracheal or the contralateral LN are affected. It is still operable if the ipsilateral peri-Bronchial nodes are positive.

Distant metastases obviously render it inoperable as does invasion of the recurrent laryngeal nerve (this is changing too) or a malignant pleural effusion.

Obtaining confirmatory evidence in way of a biopsy is extremely important before one plans treatment. Failure to do so and jumping the gun have led to many a suffering patient as one must keep the differential diagnosis of sarcoidosis and Wegener's granulomatosis in mind.