Lung cancer treatment options often include surgery, radiation, chemotherapy or a combination. There are three levels in the body that are considered in controlling lung cancer: local, regional and systemic (or whole body control).
- Local control is considered when the lung cancer is in the chest cavity and can be achieved with surgery and/or radiation therapy.
- Regional control is considered when the lung cancer has spread outside of the lung to lymph nodes within the chest. Regional control may include radiation therapy, chemotherapy and occasionally surgery.
- Systemic control is considered when the lung cancer has spread to other parts of the body outside the chest. Chemotherapy is often the treatment of choice for systemic control. Occasionally, radiation therapy is also used for control of selected areas outside of the chest.
There are different types of surgery used in the treatment of lung cancer. Your doctor may recommend one of the following procedures in the treatment of your lung cancer.
- Segmentoctomy is the removal of the tumor and a small part of the lung.
- Lobectomy is the removal of the tumor and up to a third or half of the lung, a lobe.
- Pneumonectomy is removal of the tumor and an entire lung.
This surgery may be done by video-assisted thoracoscopic surgery (VATS). Using this procedure, several small incisions are made to remove a portion of a lung. Occasionally the operation cannot be done by VATS and a larger incision has to be made in the chest to remove the tumor and lung. This is called a thoracotomy.
Radiation Therapy (Radiotherapy)
Radiation therapy is used to kill cancer cells and/or keep cancer cells from growing where the radiation is provided. Radiation therapy is aimed from a machine outside the body targeting the tumor. This is often used with lung cancer and performed by a radiation oncologist. The radiation therapy is calculated so you receive a high enough dose of radiation aimed at the tumor while sparing normal tissue. Radiation therapy can also be provided internally with a radiation device placed inside the body by the tumor. This is not used as often with lung cancer.
Radiation therapy may also affect normal cells. Radiation therapy may affect normal cells that duplicate quickly and are near the radiation area. This may lead to side effects.
Side effects of radiation for lung cancer may include:
- Dryness and irritation to the skin where the radiation is given
- General fatigue
- Trouble swallowing (if the radiation is given near the esophagus)
- Damage to normal lung resulting in scarring
Talk with your radiation oncologist about helpful techniques to treat the side effects.
Chemotherapy is the use of medications to kill the cancer cells and stop them from duplicating.
Chemotherapy is often given through a vein in an IV (intravenous) catheter, or through a large catheter, called a port, that is implanted in the chest. This will prevent you from having a needle inserted in a vein each time you need medicine. Chemotherapy is less irritating when it is placed in a large vein through a port. The chemotherapy then moves throughout the body to kill cancer cells. This is systemic treatment. Some newer chemotherapy medications may be given as a pill.
Chemotherapy is often given in cycles. These cycles last approximately 3 weeks, although this may vary depending on the chemotherapy used. The chemotherapy is often given several times during this 3-week period. Then your body is given a chance to rest before another cycle is started. The number of cycles may vary, but often 4-6 cycles of chemotherapy are given.
Two to three chemotherapy medications are often given together to treat lung cancer. The combination of medication is selected by your oncologist to best control your lung cancer.
Chemotherapy can also affect normal cells. Normal cells that duplicate quickly are most often affected and this is often related to side effects.
Side effects of chemotherapy for lung cancer may include:
- Hair loss
- Sores in the mouth
- Loss of appetite
- Nausea and vomiting
- Increased chance of infection
- Bruising easily
- Anemia/low blood count
- General fatigue
Talk with your healthcare provider about helpful techniques to treat the side effects. Your chemotherapy may need to be adjusted based on your side effects and your response to the chemotherapy.
Advances in chemotherapy include targeted therapy. Medication is targeted toward the cancer cells without harming normal cells. This is an exciting new area of lung cancer treatment, but it cannot be used in everyone - only in particular types of lung cancer. Targeted therapy may be used alone.
Your oncologist will consider many factors to determine the best lung cancer treatment plan for you. These factors include your age, the specific type of cancer you have, the stage of cancer, your general health and your history of any past treatments given for cancer. In addition to considering your lung cancer treatment options, supportive care of symptoms is also important.