Lung Cancer Treatment Options
Different types of treatment are available for patients with lung cancer. Some treatments are standard (currently used treatments), and some are being tested in clinical trials. Lung cancer patients may receive one or a combination of the following treatments, including:
Surgery to Remove Lung Cancer
Lung cancer surgery can involve removing a portion of the lung or the entire lung through procedures such as lobectomy, segmentectomy, wedge resection, and pneumonectomy. Surgery is primarily used for NSCLC, rather than SCLC. This is because SCLC has usually spread past the lungs at the time of diagnosis.
Even in cases where the surgeon has removed all of the cancer that can be seen at the time of the operation, some patients are treated with chemotherapy or radiation therapy after surgery to kill any cancer cells that may remain. Treatment that is given after surgery to lower the risk of the cancer coming back is called adjuvant therapy.
Radiation Therapy to Treat Lung Cancer
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The type and stage of the lung cancer being treated determines the way radiation therapy is given.
The two types of radiation therapies are:
- External beam radiation therapy (ERBT). This is most commonly used for patients who have a single area to be treated, or have lung cancer that has developed in another area of the body. Shrinking the cancer with radiation can relieve pain caused by these tumors.
- Internal radiation therapy (brachytherapy). This type of radiation therapy is usually only available to those with small cell lung cancer that is pressing against the airway or esophagus. A radioactive substance sealed in needles, catheters, seeds or wires are placed directly into or near the cancer.
Chemotherapy for Lung Cancer
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. The way the chemotherapy is given depends upon the type and stage of the cancer being treated.
- Systemic chemotherapy. These drugs are usually given through an IV although some can be taken in pill form. They enter the bloodstream and can reach cancer cells throughout the body. This is given in the infusion suite at our cancer center where your treatment is overseen by oncology nurses who specialize in helping patients through each round of treatment.
- Regional chemotherapy. Drugs are placed directly into the spinal column, an organ, or a body cavity such as the abdomen so they mainly affect cancer cells in those areas. This is usually done through a surgical procedure.
Patients whose lung cancer has spread to the lymph nodes or other areas of the body are likely to need chemotherapy because it can be delivered throughout the entire body.
Targeted Therapy Based on Biomarkers for NSCLC
Targeted therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide, and spread. Unlike chemotherapy and radiation therapy, the precision of targeted therapy leaves healthy cells alone, reducing the amount of experienced side effects. Monoclonal antibodies, tyrosine kinase inhibitors, and mammalian target of rapamycin (mTOR) inhibitors are the three types of targeted therapy being used to treat certain types of lung cancer.
If the non-small cell lung cancer is late-stage or recurrent, the biomarker test results can be used to identify a specific targeted therapy that could work to stop or slow the growth of the cancer cells.
There are currently FDA-approved targeted therapies for non-small cell lung cancer tumors showing the following genetic mutations:
- EGFR
- KRAS
- ALK
- ROS-1
- NTRK
- MET
- RET
- BRAF V600E
Patients who do not test positive for a biomarker with an approved targeted therapy will receive different recommendations for treatment options. They may also be eligible for a clinical trial that is identifying treatments based on other biomarkers found outside of those with an established targeted therapy.
Immunotherapy for Lung Cancer
Immunotherapy, also called biologic therapy, is designed to help your immune system fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.
The immunotherapy currently available to treat NSCLC and some cases of advanced SCLC belong to a class called checkpoint inhibitors. These “checkpoints” — proteins on immune cells that need to be turned on (or off) to start an immune response — are what the immune system uses to keep itself from attacking normal cells. Immune checkpoints are molecules on the immune cells that can start or stop an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. These medications allow the immune system to recognize and destroy cancer cells.
Advancements in immunotherapies continue to be made, making them an effective treatment alone and in combination with chemotherapy or radiation. Recent studies have shown that certain patients can obtain a long-term response with immunotherapy.
Cancer treatment vaccines (also called therapeutic vaccines) and adoptive T-cell therapy are other types of immunotherapy that are being studied in clinical trials.
Laser Therapy for Lung Cancer
Laser therapy uses a laser beam (a narrow beam of intense light) to kill the cancer cells. It is sometimes used to open up the airways of patients whose cancer is making it hard to breathe.
While under general anesthesia, the oncologist inserts the laser with a bronchoscope and then aims the beam at the tumor to burn it away. If needed, the treatment may be repeated.
Clinical Trials for Lung Cancer
Some patients may be eligible to participate in a lung cancer clinical trial. In recent years, many new lung cancer treatments have been approved and used in combination with long-standing treatments — sometimes even taking the place of standard treatments because they are more effective. Patients may want to consider taking part in a clinical trial, although some are open only to patients who have not started treatment. Shenandoah Oncology has clinical trials available to our lung cancer patients who qualify.
The Latest Lung Cancer Treatment in Winchester, Virginia
If you have been newly diagnosed with lung cancer and are seeking treatment, the next step is to schedule a consultation with an oncologist. The lung cancer doctors at Shenandoah Oncology offer personalized treatment plans as well as a second opinion on a recommended treatment plan. Our cancer center in Winchester, Virginia, serves patients in and around the area, including the Shenandoah Valley, Northern Virginia, West Virginia, and Western Maryland.
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