Free Guide for Newly Diagnosed Lung Cancer Patients
Get helpful tips on what to expect and how to prepare your mind and body for lung cancer treatment.
Chemotherapy for Lung Cancer
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. This type of cancer tends to spread quickly throughout the body, so chemotherapy is typically part of the treatment plan to kill these cancer cells.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
- When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
- When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Small Cell Lung Cancer Chemotherapy
Chemotherapy is often a part of treatment for small cell lung cancer. There are a few ways it might be given:
- Chemoradiation: Chemotherapy is used along with radiation therapy for patients with limited stage SCLC.
- Primary Treatment: Chemotherapy is used alone as the main treatment for some patients with advanced stage SCLC.
Non-Small Cell Lung Cancer Chemotherapy
Chemotherapy is not always a part of the treatment plan for non-small cell lung cancer patients. There are a few different occasions when it's used, however, including:
- Before surgery in an attempt to shrink a tumor so that a less extensive surgery can be performed.
- After surgery to kill any remaining cancer cells that can't be seen with imaging technology.
- For advanced NSCLC that hasn't spread to distant areas of the body: Sometimes, chemo along with radiation therapy is given as the main treatment for more advanced cancers that have started to grow into nearby areas of the body making surgery very difficult.
- For metastatic (stage IV) NSCLC that has spread to other organs in the body: For these patients, chemo might be used to treat the lung cancer tumors that developed in other parts of the body such as the brain or liver.
Radiation Therapy for Lung Cancer
There are two types of radiation therapies:
- External radiation therapy, which uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy, which uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Prophylactic cranial irradiation (radiation therapy to the brain to reduce the risk that cancer will spread to the brain) may also be given.
Lung cancer is typically treated using external beam radiation therapy (EBRT), a process in which a machine is used to aim high-energy beams at the cancer tumor from outside the body. External beam radiation, EBRT, is performed completely outside of your body and feels similar to getting an X-ray.
Treatments are usually administered once or twice a day, five days a week, for five to seven weeks, depending on your cancer’s stage and treatment goal.
External Beam Radiation Therapy for Lung Cancer
Rocky Mountain Cancer Centers uses two types of external beam radiation therapy, EBRT, depending on your type of cancer and many other factors. These technologies help minimize damage to surrounding health tissue. The two EBRT technologies used at Rocky Mountain Cancer Centers are:
- 3-dimensional conformal or Intensity-modulated radiation therapy (IMRT) uses specialized computer equipment to break radiation beams into smaller beamlets that can be individually adjusted for intensity. They’re then aimed at the tumor from various angles as the machine moves around your body in order to deliver the most possible radiation per treatment while limiting the dose to healthy tissue, especially that of important nearby structures, such as the spinal cord.
- Stereotactic body radiation therapy (SBRT) uses computed tomography (CT) and magnetic resonance imaging (MRI) to pinpoint the exact location and shape of a lung cancer tumor during radiation therapy. Microbeams, focused to within a fraction of a millimeter, are then aimed at the tumor from various angles while the patient lies in a body frame to reduce the movement of the tumor during breathing. Using this technique, our radiation therapy experts can deliver very high doses of radiation to the lung cancer tumor in just a few treatments. SBRT is most often used in patients who are not eligible for surgery and can be administered in just one to five treatments. Read more about SBRT in this Rocky Mountain Cancer Centers blog post.
Lung Cancer Surgery
Small Cell Lung Cancer Surgery
Surgery for lung cancer is less common with small cell lung cancer but may be used if the cancer is found in one lung and in nearby lymph nodes only. However, SCLC lung cancer is usually found in both lungs; therefore, surgery alone is not often used.
Non-Small Cell Lung Cancer Surgery
Early stage non-small cell lung cancer patients are more likely to have surgery to remove the tumor(s). This becomes harder as the cancer spreads throughout the lung(s) in later stage NSCLC.
After Lung Cancer Surgery
Even if your oncologist removes all the cancer that can be seen at the time of the operation, chemotherapy or radiation therapy after surgery might also be necessary in order to kill any cancer cells that may remain. Treatment that is given after the surgery to lower the risk that the cancer will come back is called adjuvant therapy.
Immunotherapy for Lung Cancer
Immunotherapy drugs are used to help the body’s immune system kill cancer cells. There are several classes of immunotherapy drugs that work in different ways. The immunotherapies currently available to treat lung cancer all belong to a class called checkpoint inhibitors. They can be used for patients with small cell or non-small cell lung cancer.
Your body’s immune system is programmed to attack any cells it perceives as foreign, or not normal. Cancer cells have found ways around this system by hiding from your body’s natural immune system or by weakening the immune system itself. Immune checkpoint inhibitors are medications that are given to allow the immune system to recognize and destroy the cancer cells.
Within the last few years, there has been rapid development of immunotherapies specifically for lung cancer. They have been demonstrated to be effective alone and in combination with chemotherapy or radiation. Recent studies have shown that certain patients can obtain a long-term response with immunotherapy.
Targeted Therapy for Non-Small Cell Lung Cancer
Targeted therapy for lung cancer has recently become available for non-small cell lung cancer patients who are late stage or have had lung cancer return.
Targeted therapies attack the genetic molecules—usually proteins—that allow cancer cells to survive, multiply, and spread. With targeted therapy we are able to precisely target and attack cancer cells, leaving healthy cells alone. Traditional chemotherapy drugs attack all fast-growing cells in the body; however, targeted therapies have the ability to identify and attack just cancer cells. This means less damage to healthy cells and fewer side effects than seen with standard chemotherapy.
Biomarker Testing for Lung Cancer
To create these individualized treatments, patients first go through biomarker testing. Biomarkers are molecules that indicate a normal or abnormal process taking place in your body and may be a sign of an underlying condition or disease. Molecular testing can also be used to help make a more accurate diagnosis in complex cases or help patients learn if there is a risk of cancer that runs in their families. Once an actionable mutation is identified, a treatment can be designed to target the cancer. Extensive research is ongoing to find more uses for targeted therapy for lung cancer patients.
Lung Cancer Clinical Trials
In addition to standard treatments, patients with SCLC may be able to be helped with treatments being tested in clinical trials (potential new treatments).
A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. We currently have several clinical trials open for lung cancer patients diagnosed at various stages of the disease. Talk with your RMCC cancer care team to see if a clinical trial is right for you.
Follow-up Tests or Check-Ups for Lung Cancers
Sometimes, certain tests that were done to diagnose the cancer, or to find out the stage of the cancer, may be repeated. In some cases, it’s to see how well the treatment is working. In others, the results are used to help make decisions about whether to continue, change, or stop treatment altogether. This process is sometimes called re-staging.
Even after treatment has ended, some of the tests will continue to be done from time to time. The results of these tests, sometimes called follow-up tests or check-ups, can show if your condition has changed or if the cancer has returned.
As you go through this cancer journey, know that we will be here every step of the way. Do not hesitate to reach out to your RMCC cancer care team in times of need. We want to ease your mind by addressing any questions or concerns you may have to the best of our ability.