Surgery Versus Radiation Therapy for Early-Stage Lung Cancer: Patient Selection is Crucial

Lung cancer remains the leading cause of cancer related death in the United States with mortality rates surpassing breast, prostate, brain, and colorectal cancers combined [1,2]. Recent data shows that susceptibility for both men and women for developing invasive lung and bronchogenic carcinoma peak after the age of 70 years [2]. As the generation of baby boomers age, those older than 65 years will nearly double and the number of elderly population older than 85 years will triple from 2020 to 2050 [3]. These shifting demographics are an early sign of the improvements and advancements in overall care of the elderly population. It therefore remains imperative that lung cancer treatment and selection criteria evolves accordingly in elderly and high-risk population. Some of the challenges facing the elderly and high-risk population relates to comorbidities, limited cardiac and pulmonary function reserve, decreased decision-making capacity, quality of life issues and lack of social support among others [4,5].