Lung Cancer: Treatment Choices
Lung cancer can be treated in several ways.. Which treatment may work best for you? It depends on a number of things. These include the type, size, location, and stage of your cancer. Factors also include your age, overall health, and what side effects you’ll find acceptable.
Learning about your treatment options
You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.
Your doctor is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. It is important to take the time you need to make the best decision.
Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get another opinion before deciding on your treatment plan. In fact, some insurance companies may require a second opinion. In addition, you may want to involve your family and friends in this process.
Understanding the goals of treatment for lung cancer
For some lung cancers, the goal of treatment is to cure the cancer. If cure is not possible, treatment may be used to shrink the cancer or keep it under control for as long as possible. Treatment can also improve your quality of life by helping to control the symptoms of the disease. The goals of lung cancer treatment can include one or more of these things:
Remove or destroy the cancer in the lung
Remove or destroy tumors in other parts of the body
Kill or stop the growth or spread of lung cancer cells
Prevent or delay the cancer's return
Ease symptoms from the cancer, such as pain or trouble breathing
Types of treatment for lung cancer
Several types of treatment can be used for lung cancer. Different combinations of treatment may be used, depending on the type and stage (extent) of the cancer and other factors. Each treatment has its own goals. Here is an overview of each type of treatment:
Surgery. If you have non-small cell lung cancer (NSCLC) that has not spread, surgery is often the first choice for treatment. It is often followed by other treatments. Surgery is used for only a small number of people with very early stage small cell lung cancer (SCLC). Occasionally, surgery may be considered after radiation or chemotherapy in people who have responded well with a decrease in tumor size.
Radiation therapy. Radiation therapy uses X-rays or radioactive particles to destroy cancer cells. It is often an option when you have an early stage tumor but are not a candidate for surgery. It can also be used for more advanced cancers. It may be used by itself or with chemotherapy. Radiation therapy can also be used to help relieve symptoms from cancer that has spread.
Chemotherapy. Chemotherapy is the use of anticancer medicines. It is usually part of the treatment for SCLC, as well as for more advanced stages of NSCLC.
Targeted therapy. This type of treatment uses medicines that zero in on the specific changes in cancer cells or in nearby tissues that cause the cancer to grow and spread. Several targeted medicines can be used to treat some advanced NSCLCs, either alone or along with chemotherapy.
Immunotherapy. Immunotherapy uses medicines to boost your own immune system to attack the cancer cells. Medicines called immune checkpoint inhibitors can be used to treat advanced NSCLC.
Photodynamic therapy (PDT). For PDT, a light-sensitive medicine is injected into the body. Then a special light on the end of a bronchoscope is aimed at the cancer cells, killing them. This treatment can be used to reduce symptoms of lung cancer, such as trouble breathing. It may also be used to treat very small tumors in people who cannot have the usual treatments.
Laser therapy. Very small lung cancers in the linings of airways can sometimes be treated with a laser on the end of a bronchoscope. Lasers can also be used to help people with advanced tumors breathe better by opening up blocked airways.
Radiofrequency ablation (RFA). RFA can be used to treat some small tumors near the outside of the lungs, especially in people who can't or don't want to have surgery. A metal probe is passed through the chest wall and into the tumor. High-energy radio waves are used to heat and destroy the tumor.
Supportive care. Your healthcare provider may advise therapies that help ease your symptoms, but don’t treat the cancer. These can sometimes be used along with other treatments. Or your healthcare provider may suggest supportive care if he or she believes that available treatments are more likely to do you more harm than good.
Clinical trials for new treatments
Researchers are always looking for new ways to treat lung cancer. These new methods are tested in clinical trials. Talk with your doctor to find out if there are any clinical trials you should consider.
Talking with your doctor
At first, thinking about treatment options may seem overwhelming. Talk with your doctors, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your doctor before making a decision.
March 21, 2017
Alteri, Richard, MD,Gersten, Todd, MD