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Treatment Options For People With Lung Cancer

Several lung cancer treatments are currently available and the determination as to which one is prescribed depends on the lung cancer stage that has been diagnosed, the location of the cancer, and the patient’s health. The most common treatments for lung cancer include Surgery, Radiation, Chemotherapy, and Targeted Therapy.

In some cases you may choose not to undergo treatment. For instance, you may feel that the side effects of treatment will outweigh the potential benefits. When that’s the case, your doctor may suggest comfort (palliative) care to treat only the symptoms the cancer is causing, such as pain.

Treatment options for non-small cell lung cancers
Stage Common options
I Surgery
II Surgery, chemotherapy, radiation
IIIA Combined chemotherapy and radiation, sometimes surgery based on results of treatment
IIIB Chemotherapy, sometimes radiation
IV Chemotherapy, targeted drug therapy, clinical trials, supportive care
Treatment options for small cell lung cancers
Stage Common options
Limited Combined chemotherapy and radiation, sometimes surgery
Extensive Chemotherapy, clinical trials, supportive care

Surgery

Surgery involves cutting away a cancerous tumor and a portion of the tissue that has surrounded the tumor. Sometimes the surgical treatment involves removal of the entire affected lung. Surgery is often effective, but recovery time can be long. Because the surgeon will have to cut through the rib cage to get to the lungs, there will be pain and bed rest for one to two months after the procedure.

In addition to traditional surgical methods, other types of surgical procedures can be used depending on the location of the tumor and also the patient’s physical condition. A craniotomy, which is basically surgery performed through a hole made to the skull can be prescribed to tumors located in the brain.

Procedures to cutting or remove lung cancer include:

  • Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue
  • Lobectomy to remove the entire lobe of one lung
  • Pneumonectomy to remove an entire lung

If you undergo surgery, your surgeon may also remove lymph nodes from your chest in order to check them for signs of cancer. If your lymph nodes contain cancer cells, this usually indicates that cancer has spread, even if cancer hasn’t been detected outside of your chest.

Lung cancer surgery carries risks, including bleeding and infection. Expect to feel short of breath after lung surgery. Your lung tissue will expand over time and make it easier to breathe. You may also feel pain in the muscles of your chest and in your arm on the side where you had the operation. Your doctor may recommend physical therapy or a rehabilitation program to help you restore your strength and range of motion.

Chemotherapy
Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be administered through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that your body can recover.

Chemotherapy can be used as a first line treatment for lung cancer or as additional treatment after surgery. One problem associated with chemotherapy is that it can also cause damage to healthy cells and the cells that produce blood that reside within the bone marrow. Low blood counts can lead to a number of different problems so Chemotherapy treatment must be closely monitored.

Radiation therapy
Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy can be directed at your lung cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy).

Radiation therapy can be used alone or along with other lung cancer treatments. Sometimes it’s administered at the same time as chemotherapy. Radiation therapy can also be used to lessen side effects of lung cancer.

Targeted drug therapy
Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Targeted therapy options for treating lung cancer include:

  • Bevacizumab (Avastin). Bevacizumab stops a tumor from creating a new blood supply. Blood vessels that connect to tumors can supply oxygen and nutrients to the tumor, allowing it to grow. Bevacizumab is usually used in combination with chemotherapy and is approved for advanced and recurrent non-small cell lung cancer. Bevacizumab carries a risk of severe bleeding.
  • Erlotinib (Tarceva). Erlotinib blocks chemicals that signal the cancer cells to grow and divide. Erlotinib is approved for people with advanced and recurrent non-small cell lung cancer that haven’t been helped by chemotherapy. Erlotinib side effects include a skin rash and diarrhea.

Clinical trials
Clinical trials are studies of new lung cancer treatment methods. You may be interested in enrolling in a clinical trial if lung cancer treatments aren’t working or if your treatment options are limited. The treatments studied in a clinical trial may be the latest innovations, but they don’t guarantee a cure. Carefully weigh your treatment options with your doctor. Your participation in a clinical trial may help doctors better understand how to treat lung cancer in the future.

Supportive (palliative) care
When treatments offer little chance for a cure, your doctor may recommend you avoid harsh treatments and opt for supportive care instead. If you’re receiving supportive care, your doctor may treat any signs and symptoms you experience to make you feel more comfortable, but you won’t receive treatment aimed at stopping your cancer. Supportive care allows you to make the most of your final weeks or months without enduring treatment side effects that can negatively impact your quality of life.

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Lung Cancer Can be Deadly

Lung tumor is the product of malignant cells forming in the tissues of the lung, usually in the cells lining the air passages. The cells in our bodies are constantly dividing and reproducing. Usually, there’s an organized pattern to this reproduction as cells use and specialize to convene particular needs. Occasionally, however, a faction becomes smashed. There’s a mutation in its DNA, and instead than budding and final as is ordinary, it continues to mimic unimpeded. In essence, this is pest – uncontrolled reproduction and tumor of abnormal cells in the body.

Most lung cancers are assumed to father in the epithelial lining of the lungs – the linings of the large and small airways that perform the errand of extracting oxygen from the air. Because this, lung evil is sometimes called bronchogenic carcinoma – melanoma arising from the bronchia. A smaller percentage of lung cancers arise in the pleura – the emaciated tissue sac that surrounds the lungs. These cancers are called mesothelioma. The most frequent form of mesothelioma is related to asbestos exposure.

Lung cancer can cause complications, such as:

  • Fluid in the chest (pleural effusion). Lung cancer can cause fluid to accumulate in the space that surrounds the lungs in the chest cavity (pleural space). Pleural effusion can result from cancer spreading outside the lungs or in reaction to lung cancer inside the lungs. Fluid accumulating in the chest can cause shortness of breath. Treatments are available to drain the fluid from your chest and reduce the risk that pleural effusion will occur again. Cancer that spreads to the pleura is considered inoperable, so surgery isn’t an option for treatment.
  • Cancer that spreads to other parts of the body (metastasis). Lung cancer often spreads (metastasizes) to other parts of the body — most commonly the opposite lung, brain, bones, liver and adrenal glands. Cancer that spreads can cause signs and symptoms, including pain, nausea, headaches or others based on what organ is affected. In some cases, treatments are available for isolated metastasis, but in most cases, the goal of treatment for metastasis is only to relieve signs and symptoms.
  • Death. Unfortunately, survival rates haven’t improved for people diagnosed with lung cancer. In most cases, the disease is fatal. Almost 60 percent, or three out of every five people, diagnosed with lung cancer die within a year. Keep in mind, however, that this number includes people diagnosed with all types of lung cancer at all stages of the disease. People diagnosed at the earliest stages have the greatest chances for a cure. Your doctor can discuss more relevant statistics about your chances for survival with you.
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Symptoms and Causes of Lung Cancer

Lung cancer most commonly begins in the cells that line your lungs. Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked. In these cases, there may be no clear cause of lung cancer. Doctors have identified factors that may increase the risk.

How smoking causes lung cancer
Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately. At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop. Quitting at any age can significantly lower your risk of developing lung cancer.

Other Cause of lung cancer :

  • Your sex. Current or former women smokers have a greater risk of lung cancer than do men who have smoked an equal amount. Though it isn’t known why, some experts speculate that women have a greater susceptibility to the cancer-causing substances found in tobacco. Others believe that estrogen may play a role. Women also are known to inhale more than men do, and they are less likely to quit.
  • Exposure to secondhand smoke. Even if you don’t smoke, your risk of lung cancer increases if you’re exposed to secondhand smoke.
  • Exposure to radon gas. Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Although unsafe levels of radon can accumulate in any building, the greatest exposure risk most people face is at home. Radon testing can determine whether levels are safe.
  • Exposure to asbestos and other chemicals. Workplace exposure to asbestos and other substances known to cause cancer — such as arsenic, chromium, nickel and tar soot — also can increase your risk of developing lung cancer, especially if you’re a smoker.
  • Family history of lung cancer. People with a parent, sibling or other first-degree relative with lung cancer have an increased risk of the disease.
  • Excessive alcohol use. Drinking more than a moderate amount of alcohol — no more than one drink a day for women or two drinks a day for men — may increase your risk of lung cancer.
  • Diet. Scientists are studying many different foods to see how they may change the risk of getting lung cancer. However, any effect diet may have on lung cancer risk is small compared with the risk from smoking. Eating a lot of fat and cholesterol might increase risk of lung cancer.

Your lungs are full of blood vessels and lymph vessels, giving lung cancer cells easy access to travel to other parts of your body. For this reason, lung cancer may spread to other parts of your body before you experience any signs or symptoms. In many cases, lung cancer may spread before it can even be detected in the lungs.

Signs and symptoms of lung cancer may include:

  • A new cough that doesn’t go away
  • Changes in a chronic cough or “smoker’s cough”
  • Coughing up blood, even a small amount
  • Shortness of breath usually results from a blockage to the flow of air in part of the lung, collection of fluid around the lung (pleural effusion), or the spread of tumor throughout the lungs.
  • Chest pain. The pain is dull, aching, and persistent and may involve other structures surrounding the lung.
  • Wheezing
  • Hoarseness
  • Metastasis to the bones is most common with small cell type cancers but also occurs with other lung cancer types. Lung cancer that has metastasized to the bone causes bone pain, usually in the backbone (vertebrae), the thighbones, and the ribs.

Types of lung cancer
Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have. The two general types of lung cancer include:

  • Small cell lung cancer. Small cell lung cancer, sometimes called oat cell carcinoma, occurs almost exclusively in heavy smokers and is less common than non-small cell lung cancer.
  • Non-small cell lung cancer. Non-small cell lung cancer is an umbrella term for several types of lung cancers that behave in a similar way. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
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What Are The Stages Of Lung Cancer?

Once a diagnosis of lung cancer has been made, the doctor will attempt to determine the stage the lung cancer is at. The staging system is somewhat like a measurement system, with the numbers indicating: whether the cancerous tumors are localized or whether the tumors have spread to other parts of the body; the tumor’s size; and whether or not the tumors have spread to the lymph nodes. There are four main stages of lung cancer (Stages 1 – 4) and identification of one of the stages is what helps doctors prescribe an appropriate treatment method.

Different Cancer, Different Stages of Lung Cancer

The staging system is a bit more complicated than simply assigning a number. First of all, the stage numbering system differs slightly depending on whether the lung cancer has been diagnosed as small cell lung cancer or non-small cell lung cancer.

Non-Small Cell Lung Cancer

Non-small cell lung cancer is the more common form and it progresses more slowly than the other type. Non-small lung cancer can be broken down into 4 stages. Stage 1 means that the tumor is local; it has not spread to the lymph nodes. Adding the letter A or B to the stage 1 classification indicates the size of the tumor (“A” means it is less than 3 cm across) and whether it’s larger and growing in a sensitive area (“B”). Stage 2 means the tumor has spread into lymph nodes or the chest wall. Again, an “A” and “B” designation determines the size and the location of the tumor. Stage 3 is more complicated and can mean several things. For example, it can indicate that the tumor has spread, but it’s still only affecting one side of the lung, or that tumors have spread to other nearby body parts such as the chest wall, or that fluid is collecting in the lungs. Stage 4 is of course the worst stage and means that cancerous tumors have spread into a whole other part of the body like the pelvis or liver.

Small-Cell Cancer

In cases of small-cell cancer, there are two stages of lung cancer – Stage 1 and Stage 2. These stages are used to designate whether the cancerous cells are limited in number or whether there exists an extensive amount that have invaded the chest and other parts of the body. When they’re limited in number, patients have a good chance of receiving effective treatment and possibly even resuming a near normal life. An extensive amount however, means treatment options are very limited.

The Staging Challenge

Although the stages of lung cancer seem well-defined, categorizing a person’s cancer into one of these stages is often challenging. Each case of cancer involves so many different factors and the combination of factors can be interpreted in many different ways by different doctors. Proper diagnosis and classification takes time and may take several rounds of testing. CT scans, MRIs, blood tests, bone scans and even testing the pleural effusion (if present) may all be needed.

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What is Lung Cancer?

Abnormal cell growth in either one or both of the lungs is the simple answer to the question, “What is lung cancer?” In healthy individuals, the cells within the lungs go about their business duplicating at a normal rate and turning into more and more lung tissues. The lungs continue to function properly and all is well.

But in damaged lungs, this rate of cell duplication becomes uncharacteristically fast yet new lung tissue fails to develop. These damaged (cancerous) cells begin to clump together and ultimately turn into cancerous tumors. Eventually, the tumors begin to interfere with the impacted lung’s ability to function normally and that is when the full impact of the disease known as lung cancer begins to be noticed.

Interestingly, although it usually takes many years for lung cancer to develop, the cells begin to take on abnormal characteristics almost immediately upon being exposed to cigarette smoke or the other environmental contaminants that can cause trouble in the lungs such as radon, asbestos, coal, air pollution, and even second-hand smoke.

Lung cancer can strike anyone regardless of gender, age or race. Even though it is more likely to strike those who are or who have been a smoker, lung cancer can develop in those who have never taken up this habit. Lung cancer in non-smokers is very rare, occurring in only about 10% of the cases, meaning that in almost 90% of the lung cancer cases, cigarette smoking is the instigator. Why is that so?

The primary purpose of the lungs is to breathe in air. The lungs remove the oxygen from this air and push it out into the blood where it can travel around the body as needed. Because the air we breathe is not always pure – it’s filled with dust, dirt, and other types of pollutants – the upper part of the lung system was designed to clean it before allowing it to enter deeper into the lungs. In the case of smokers, the carcinogens in cigarette smoke can break down the lung’s cleansing capabilities and as a result, dirty air and the contaminants within cigarette smoke continue to freely enter into the lungs. It is the absence of this cleansing capability that ultimately causes the cells inside the lungs to function abnormally.

Besides being the #1 cause of cancer death in the United States, lung cancer is unfortunately so far a disease that has no cure. In fact, by the time lung cancer is discovered, few people will survive the first year after diagnosis.

Small cell lung cancer and non-small cell lung cancer are the two types of lung cancer that can develop. Eighty percent of the lung cancer cases are the slower-moving non-small cell type. The problem with this type of lung cancer is that it often spreads to other parts of the body. Sophisticated lung scans are generally the way most tumors are detected, but unfortunately, such scans are not part of routine medical care. That’s probably why most lung cancer goes undiagnosed for so long.

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