Read our guide to explore treatment options for lung cancer and identify which one is suitable for you or a loved one.
Whether yourself or a loved one is concerned about or has been diagnosed with lung cancer, knowing how you can tackle the disease is vital. We look at the different types of the disease and explore treatment options for lung cancer.
Lung cancer occurs when cells in the alveoli (lung tissue) and lining of the bronchi change and grow more rapidly. Ultimately the growth gets out of control, forming a tumor and – if not treated effectively – spreading to other parts of the body. This mutation in DNA results in one of two broad types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). General symptoms of the disease can include a worsening cough which persists, shortness of breath, chest pain which is exacerbated by laughing or deep breathing, coughing up blood, and hoarseness.
The most common type of lung cancer, approximately 80-85% of lung cancer cases are NSCLC. Within this broad group, there are three major subtypes of NSCLC:
Depending on the stage of NSCLC, the lung cancer survival rate will vary. At stage one the five year survival rate is approximately 60-80%, while at stage four, lung cancer prognosis decreases dramatically, with a five year survival rate of less than 10%.
The most aggressive form of the disease, small cell lung cancer tends to be fast spreading and affects between 10-15% of lung cancer cases. The large majority of SCLC cases are caused by cigarette smoke, with the disease being rare in those who don’t have a history of smoking.
The two types of SCLC that you can contract are small cell carcinoma – referred to as oat cell cancer – and combined small cell carcinoma. These fast forming cancer cells tend to start in the airways (bronchi) around the center of the chest. This type of lung cancer is particularly aggressive; tumors grow fast and spread rapidly to other body parts including the liver, bones and brain, so it is vital to explore treatment options for lung cancer of this type immediately after diagnosis.
Patients with SCLC will either be diagnosed at the limited or extensive stage. Those at the limited stage have a better lung cancer prognosis than those at the extensive stage. Due to the aggressive nature of SCLC, 25% of people with this disease will be diagnosed at the limited stage, which has a median lung cancer survival rate of 16-24 months, with a five year survival rate of 14%. The median lung cancer survival rate at the extensive stage is currently 6 to 12 months but the long term survival rate is very low.
Depending on the type of lung cancer that you have been diagnosed with and the stage of the disease, as well as other factors specific to the patient, you need to explore treatment options for lung cancer, as there are a variety of a different ways to treat it.
If NSCLC is discovered in the early stages of cancer growth, surgery can be a suitable treatment option for lung cancer. It offers the best chance to cure the disease when compared to other treatment for lung cancer, but the surgery itself is a complicated procedure which carries risks. From a pneumonectomy wherein the surgeon removes an entire lung, to a sleeve resection wherein they remove the section of the airway which is cancerous, each can result in complications. Furthermore, if the disease has already spread to other body parts, this option is no longer a suitable treatment, and you need to explore treatment options for lung cancer that don’t involve surgery.
For patients who have small tumors on the outer edge of their lungs, radiofrequency ablation can be an appropriate lung cancer treatment option – particularly if they are not fit for major surgery. This procedure heats the tumors with high-energy radio waves; an electric current is passed into the tumor through a needle until the cancerous cells are heated to the point of destruction.
Depending on the stage of NSCLC, radiation therapy and chemotherapy might be used either combined or individually as a treatment for lung cancer. Two main types of radiation can be used: brachytherapy (internal radiation therapy) or external beam radiation therapy. Chemotherapy often uses a combination of two chemo drugs – usually cisplatin or carboplatin with another drug.
If the disease has spread from the chest or the patient is not fit for surgery, radiation therapy is the most common lung cancer treatment option – often along with chemotherapy. Sometimes a combination of these two treatment options for lung cancer is used prior to surgery to help kill off any cancer cells surrounding the tumor, or to make the tumor smaller so that it’s easier to operate on. Occasionally radiation therapy is used to treat areas where the cancer has spread, such as an area of the brain where a small tumor has begun to form. Where the disease has progressed to the advanced stages, radiation therapy is also used to reduce (palliate) pain and discomfort caused by symptoms including trouble swallowing or blockage in the airways.
If chemotherapy is ineffective at killing cancerous cells you can explore treatment options for lung cancer that involve targeted therapy drugs, which work by stunting tumor growth. For tumors to continue growing, they require nourishment which they get by forming new blood vessels (a process called angiogenesis). Targeted drugs – referred to as angiogenesis inhibitors – prevent this from happening, blocking the growth of new blood vessels and thereby starving the tumor of nourishment. This treatment for lung cancer is most commonly used when patients are at an advanced stage – sometimes at the same time as the patient receives chemotherapy.
If you do not like the idea of chemotherapy, you can explore treatment options for lung cancer which involve immunotherapy. This treatment utilizes medicines to stimulate your immune system and helps your body to recognize and destroy cancerous cells. Cancer cells are capable of tricking the body’s immune system into ignoring them as a threat. However, these drugs boost the body’s immune response against the disease, which can, in turn, lead to tumors shrinking or slowing significantly in growth.
Due to the aggressive and fast spreading nature of small cell lung cancer, when you explore treatment options for lung cancer of this type, you always needs to include chemotherapy – which is a cancer-killing drug. This is used in combination with other lung cancer treatment options depending on how far the disease has progressed.
If SCLC is limited to the chest (referred to as ‘limited’ stage), surgery is an option to remove the tumor and help prevent the disease spreading. For one in twenty patients, the cancer is found when it is still a singular tumor (i.e. which has yet to spread). Likewise, radiation therapy – which uses powerful rays like external beam radiation therapy to kill the cancerous cells – is usually an effective treatment method at this stage. Both of these can be used alongside chemotherapy to help treat the cancer, with chemotherapy being the ‘safety net’ here to ensure the cancer cells are obliterated from the body. Unfortunately, though, small cell lung cancer is rarely limited to the chest by the time it is diagnosed: it has often spread to other body parts when it is discovered.
If the small cell lung cancer has spread outside of the chest (referred to as ‘extensive’ stage), you will need to explore treatment options that don’t involve surgery. Instead, chemotherapy and radiation are usually used, with the former being used to treat cancer cells which have spread around the body whilst the latter focuses on the known site of the initial tumor. This combination of treatments is called chemoradiation. If the cancer is particularly advanced, such treatment options can still be effective at helping to alleviate pain and discomfort associated with the disease, reducing the size of tumors to aid symptoms such as bleeding, shortness of breath, and other problems. This is part of palliative care.
Regardless of whether the small cell lung cancer is limited or extensive, since this type of cancer usually spreads to the brain, patients are often treated with radiation therapy on the brain. This can help to prevent tumors forming here even if the disease appears to be limited to the chest, as it’s difficult to predict whether small cell lung cancer has started to spread – only time will tell.
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