Lung Cancer Treatment

Lung cancer is the abnormal cell proliferation found in the respiratory organs of the body. There are two main types of lung cancer namely small cell lung cancer and non-small cell lung cancer. These categories are based on how the cancer cell looks like under the microscope. Non-small cell cancer is more common than small cell lung cancer and can be effectively treated by surgery.

There are many treatment options to cure lung cancer and the doctor chooses the effective option based on the type and stage of cancer, overall health of the patient and client’s preferences.

Chemotherapy for Lung Cancer

Chemotherapy is a non-invasive method of treating cancer. This involves the use of medicines and drugs that are toxic to the cancerous cells. The drugs are given as an intravenous infusion through a large vein or through a central catheter placed in the jugular vein in the neck. Chemotherapy drugs are proven to retard the growth of cancers and also relieve their symptoms for those who do not require or cannot handle surgery. Chemotherapy is sometimes used even after surgery to prevent relapse of the disease.

Chemotherapy causes many significant side effects such as nausea, vomiting, fatigue, headache, etc. Biological agents that have fewer side effects than traditional chemotherapy are also been used recently. The chemotherapy plan for lung cancer comprises of a combination of different drugs and the most commonly used medicines are

  • Paraplatin
  • Taxotere
  • Gemzar
  • Taxol
  • Navelbine
  • Alimta etc

Neo Adjuvant treatment: This is the act of using chemotherapy before other treatments such as surgery and radiation therapy, so as to shrink the cancer cell and prepare it for other treatment options.

Targeted treatment: This is one of the best lung cancer treatment and is a recent development in lung cancer medicine. While chemotherapy drugs do not differentiate tumor cells from normal cells, targeted treatment-specific agents directly attack or block the targets that appear on the surface of malignant cells. Those with advanced lung cancer with certain biomarkers benefit from this treatment. Drugs that are used in the targeted treatment are Erlotinib, Gefitinib, Afatinib, Crizotinib, Ceritinib, etc.

Immunotherapy for Lung Cancer

Immunotherapy is a new lung cancer treatment option available for some types of lung cancers. Unlike chemotherapy that causes a lot of side effects, immunotherapy is generally well tolerated. Immunotherapy makes use of one’s own immune system as a treatment against cancer. The FDA has approved Opdivo and Pembrolizumab as the drugs of choice for immunotherapy to target the metastatic squamous cell carcinoma of the lungs. It interferes with the molecular break down of PD-1 that prevents the immune system from attacking tumors. Immunotherapy treatment for lung cancer falls under the following four categories.

  • Monoclonal antibodies: These are lab generated molecules that target the specific tumor antigens and prohibit the growth of tumor cells.
  • Checkpoint inhibitors: These agents target molecules that serve as checks and balance the regulation of the immune responses.
  • Therapeutic vaccines: These agents target the tumor-specific antigens.
  • Adoptive T-cell transfer: This is an approach in which T-cells are removed from the client and are genetically modified to enhance their activity. They are then re-introduced into the patient with the goal of strengthening the immune response of the client.
Radiation Therapy

Radiation therapy or radiotherapy delivers high energy rays that have the capacity to destroy the cancer cells that are dividing rapidly. They are either used as a primary treatment or before surgery to shrink the tumor. Radiation therapy is also used after surgery to eliminate any cancer cells that remain in the treated area. Apart from attacking and shrinking the tumor, it also relieves some of the symptoms of cancer such as bleeding. The following are the types of radiation therapies.

  • SBRT: Patients who have small and localized lung cancer and do not demand surgery are treated with SBRT or stereotactic body radiation therapy. Here, a small number of focused beams are tracked along with the lung tumor. The treatment is completed in three to five sittings.
  • EBT: Radiation therapy is delivered primarily as an external beam technique targeting directly at the tumor. This conventional treatment option is performed over 6-8 weeks depending on the severity of the tumor.
  • IMRT: Intensity-modulated radiation therapy and three-dimensional radiation therapy are new techniques of delivering radiation based on the 3-D image of the tumor taken with CT scan. The image serves as a precise target for high dose radiation beam treatment. Radiation damage to the surrounding normal lung tissue is minimized by this method.
  • Brachytherapy: In this method, radiation is delivered directly on the site of the disease. After surgical removal of the primary tumor, radioactive seeds are sutured to the site of the tumor. This helps in mitigating the spread of cancer and its relapse.
Surgical Management

Lung cancer surgery is of many types and involves the removal of a partial or entire lobe of the lung where the tumor is located. This is a primary treatment option for clients with early-stage cancer and for those who are in general good health. It is the location and the size of the tumor that dictates how extensive the surgery should be and the type of surgery. Some of the surgical approaches are less invasive video-assisted thoracic surgery, Open thoracotomy, and robotic-assisted thoracic surgery.

  • Lobectomy: Removal of the entire lung lobe, when the tumor is localized and the lungs are functioning pretty well.
  • Sublobar resection: Also known as segmentectomy or wedge resection, where the tumor confined to the specific area is removed along with the surrounding tissue.
  • Pneumonectomy: In this procedure, the entire lung is removed as the tumor is very large and is close to major blood vessels. The surgery carries the risk of a higher mortality rate, especially in elderly patients.

For those who are posted for surgery, the surgeon may also remove the lymph nodes from the chest to diagnose the extent of metastasis. Surgery is an option, only for cancers that are confined to the lungs. Those with a large tumor are commonly treated with radiation therapy and chemotherapy to shrink the tumor size before surgery.

Palliative Care

Supportive care or palliative care is a treatment module where the clients are given supportive care to minimize the signs and symptoms of the tumor. This helps in minimizing the pain and discomfort associated with cancer and its treatment. The aim of the treatment is to mitigate the suffering of the patient and help to enhance their quality of living.

Consulting CancerRounds

CancerRounds is a comprehensive lung cancer care solution provider. A patient can start seeking help from case manager and connect with lung cancer specialist at any time during the treatment. CancerRounds also helps the patient to dicuss the nutritinion requirements in order to recover faster. Contact us through cancerrounds@gmail.com or +918130077375