Therapy is based on a number of factors including the location of the tumor and gene mutation status. It’s also critical to know the stages of lung cancer. Staging for non-small cell lung cancer and small-cell lung cancer occurs during diagnosis, and ranges from early-stage disease to stage IV lung cancer, which means the cancer cells have already spread to distant sites in the body. The stage of disease impacts lung cancer survival rates and treatment approaches.
Some patients' cases are discussed at a multidisciplinary tumor board — a conference that is attended by doctors from all different specialties related to lung cancer that might be required for your care.
The main types of treatment for lung cancer — both non-small cell and small-cell — include surgery, chemotherapy, radiation, targeted therapy, immunotherapy, and laser therapy.
Many patients have some type of surgery to remove the lung tumor and surrounding tissue. Possible lung surgeries include:
- Wedge resection, in which the surgeon removes the tumor and some of the surrounding normal tissue.
- Lobectomy, which involves removing a whole lobe (section) of the lung.
- Pneumonectomy, in which the surgeon removes one whole lung.
- Sleeve resection, which is surgery to remove part of the bronchus, the large airway that leads from the windpipe to the lung.
- Video-assisted Thoracic Surgery (VATS), which can be used to treat some early-stage cancers located near the outside of the lung.
Radiation therapy uses energy from radiation beams, radio isotopes, or charged particles to target tumors and to eradicate cancer cells. Lung cancer patients can receive external radiation therapy, internal radiation therapy (radioactive substances are placed in or near the cancer), and radiosurgery (another method of delivering radiation directly to the tumor). Wilmot was among the first institutions in the U.S. to use stereotactic body radiation therapy (SBRT), a treatment that delivers high doses of radiation precisely to the tumor without harming nearby healthy tissue. Sometimes this type of therapy is used when surgery is not an option.
Chemotherapy uses drugs or combinations of drugs — given intravenously or as pills — to destroy cancer cells. Chemotherapy can be used before or after surgery, although some lung cancer patients will receive chemotherapy as their primary treatment.
These are newer drugs designed to target specific gene changes involved in non-small cell lung cancer. They usually have less severe side effects compared to chemotherapy. Examples of targeted therapies for lung cancer are the drugs Tarceva, Iressa, and Xalkori. Newer drugs are continually being developed and tested for certain subtypes of non-small cell lung cancer.
This approach uses drugs or other types of therapy to harness the power of a patient’s own immune system to fight cancer. The Food and Drug Administration recently approved the drug Keytruda, a type of immunotherapy, for advanced cases of lung cancer with tumors that overexpress a protein called PD-L1.
Laser therapy and photodynamic therapy
These treatments use laser beams or laser light, sometimes in combination with drugs, to kill cancer cells. Typically these treatments are for early-stage or small tumors confined to the outer lung airways.
Many cancer treatments cause side effects such as hair loss or fatigue, but not everyone experiences side effects the same way.
Wilmot's Cancer Control & Survivorship program is one of the oldest and most highly regarded research programs in the country to investigate the management of side effects.
The American Cancer Society also offers a free online class to help patients manage the side effects of their illness.