Choosing the Best Lung Cancer Treatment for You

By

Sarah Lewis, PharmD

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Nurse Showing Patient Test Results On Digital Tablet

There are two main types of lung cancer—non-small cell and small cell. Non-small cell lung cancer (previously called "squamous carcinoma") is the most common type. It accounts for about 85% of lung cancers. Small cell lung cancer accounts for 10 to 15% of lung cancers. It tends to be aggressive and spread rapidly. Generally, doctors base treatment options on the cancer’s type and stage and a person’s overall health. Here is a summary of the treatment options for both types of lung cancer.

Surgery

Surgery removes the lung tumor and some healthy tissue around it. This may involve taking out a wedge, lobe or section of a lung. Sometimes, doctors recommend removing an entire lung. The medical term for removing the lung is pneumonectomy. Removing more lung tissue increases the chance of cure. So doctors may recommend more extensive surgery if a person’s remaining lung tissue is healthy enough. Recovery from lung cancer surgery takes weeks to months.

With certain cancer patients, immunotherapy can give people the chance to have a normal life.

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Surgery is a common treatment for most early stage non-small cell lung cancers that have not spread beyond the lung. It offers the best chance of cure in these cases. Surgery is rarely an option for small cell lung cancer because this type usually affects both lungs. Doctors may recommend certain lung surgeries to treat symptoms in advanced cases of either type of lung cancer. 

Chemotherapy

Chemotherapy—or chemo—uses potent medicines to treat cancer. Chemotherapy is usually a systemic treatment, meaning that it goes throughout the body to kill cancer cells or stop them from growing. Chemo drugs also have potent side effects that can include hair loss, fatigue, digestive problems, and nerve damage. Doctors give these medicines in cycles that last for a few weeks.

Chemotherapy is the main treatment for all stages of small cell lung cancer. Doctors may also use chemotherapy for late stage non-small cell lung cancer when surgery isn’t possible. Chemotherapy may be appropriate for some early stage non-small cell lung cancers to shrink a tumor before surgery or to kill any cancer cells left after surgery.

Radiation

Radiation therapy uses high-energy waves or particles to destroy cancer. For lung cancer, external beam radiation is the main form. External beam radiation delivers radiation from a machine outside the body. Doctors most often use two very precise types for lung cancer—three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT). 

Both types of lung cancer can benefit from radiation therapy. Doctors often combine it with chemotherapy when chemotherapy is the main treatment. Clinical research has demonstrated that adding radiation therapy yields better outcomes than giving chemo alone. This includes non-small cell lung cancer when surgery isn’t possible and small cell lung cancer when it is not widespread. It is also an option before or after surgery for non-small cell lung cancer. In the late stages of either type, radiation can help relieve symptoms.

Immunotherapy

Immunotherapy uses a person’s own immune system to fight cancer. Different immunotherapies work in different ways. Some help to increase the immune system’s activity. Boosting the immune system can help it find and kill cancer cells. Some drugs in this category block efforts by cancer cells to deceive the immune system from recognizing and destroying the tumor. Other immunotherapy drugs train the immune system to specifically attack cancer cells. Doctors most often use immunotherapy drugs for advanced lung cancer.

Targeted Therapy

Targeted therapies are a new advancement in lung cancer treatment. These medicines work differently from standard chemotherapy drugs. They target specific markers that are only present on cancer cells. This often means fewer or less severe side effects and sometimes they work when standard chemotherapy does not.


Currently, targeted therapies are an option for non-small cell lung cancer. Doctors most often use this approach for advanced stages. However, not all tumors have the markers that these drugs use to identify and kill cancer cells. Doctors will test tissue from the tumor to see if it has the markers that would make this treatment worthwhile. 

Other Treatments 

Other local treatments include radiofrequency ablation (RFA), photodynamic therapy (PDT), laser therapy, and stenting. These techniques are generally useful for early stage tumors that are close to the outside of the lungs or are accessible through the airways. They can also help relieve breathing problems when large tumors block an airway.

Making the Decision

Talk with your doctor about the treatment options available for the type and stage of your lung cancer. Other considerations include your general health and the risk of side effects. Consider getting a second opinion about your treatment options. Your doctor should always encourage this. It can give you more information about your diagnosis and make you feel better about your treatment decision.

Once you’ve decided on a course of action, think about where you will receive your care. Picking a hospital or treatment center is just as important as choosing the right doctor. Find out whether the best treatment for you is available locally or not. Think about whether you are willing to travel to a center of excellence for lung cancer.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Jan 19, 2017

© 2018 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

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