There are several treatment options available for people with lung cancer. You can work with your doctor to find the best treatment plan for you based on the type of cancer you have, how far advanced it is, your overall health, and your personal preferences. Standard treatments for lung cancer include:
- Surgery
- Medications, such as chemotherapy and targeted therapy
- Radiation therapy
Surgery aims to remove the cancer and the surrounding tissue. This is typically done when the cancer has not spread beyond the lung and the nearby lymph nodes. Types of surgery for lung cancer include:
- Wedge resection to remove the small part of the lung that includes the tumor
- Segmental resection, which removes a larger piece of the lung
- Lobectomy to remove an entire lobe of the lung. A lobe is about a third of the right lung or half of the left, which is smaller to make room for the heart. Pneumonectomy to remove an entire lung
The surgeon may also remove nearby lymph nodes for biopsy to see if the cancer has spread.
Risks of surgery include bleeding and infection. If you have surgery on your lungs, you can expect some shortness of breath at first, until your lung expands to fill the empty space.
Medical treatment for lung cancer includes chemotherapy and targeted therapy.
Chemotherapy uses drugs to attack cancer cells aggressively and stop them from growing. Chemotherapy may be used:
- Before surgery to shrink a tumor
- After surgery to wipe out any remaining cancers
- Alone or with radiation or targeted treatments for small cell lung cancer or more advanced non–small cell lung cancer
Because it is so aggressive, chemotherapy also kills some healthy cells with the cancer. Chemotherapy is given in cycles, with a break in between to reduce the damage, but it can still cause serious side effects, such as hair loss, extreme nausea, and a weakened immune system. Most of these side effects go away after treatment is finished.
Targeted therapy is a term for newer treatments that work against a specific weakness in cancer cells. These include:
- Angiogenesis inhibitors such as Avastin (bevacizumab), which cut off the blood supply to the tumor by stopping the growth of new veins and arteries. Angiogenesis inhibitors are usually given in combination with chemotherapy. Side effects include bleeding, blood clots, and high blood pressure.
- EGFR inhibitors such as Tarceva (erlotinib) to block a protein called epidermal growth factor receptor (EGFR), which signals cancer cells to grow and divide. Side effects include skin rash and diarrhea.
- ALK inhibitors such as Xalkori (crizotimib) to block the ALK gene, which allows cancer cells to grow out of control and outlast normal cells. Side effects include nausea, blurred vision, and double vision.
EGFR inhibitors and ALK inhibitors are only used for non–small cell lung cancer, and only if you have the gene or protein they are meant to block.
New treatments are also under development, and you may be able to benefit from an experimental treatment if you enroll in a clinical trial. Taking part in a clinical trial may help you and also benefit future generations.
Radiation therapy uses x-rays or other high-energy beams or particles to kill cancer cells. Like chemotherapy, radiation may be given before or after surgery, or as a primary treatment in more advanced cancer. Newer methods of radiation therapy may improve the chance of success or reduce side effects by targeting the tumor more precisely. For instance, stereotactic radiotherapy fixates on a small tumor and bombards it from all sides at once.
Side effects of radiation therapy include nausea and vomiting, weight loss, fatigue, and a rash on the spot where the radiation is administered. These side effects usually end after treatment is finished.
