Lung Cancer Treatment Options

Small Cell Lung Cancer

Different types of treatment are available for patients with small cell lung cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials (potential new treatments).

A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial, although some are open only to patients who have not started treatment.

Five types of standard small cell cancer treatment include:

1. Surgery
   Surgery may be used if the cancer is found in one lung and in nearby lymph nodes only. However, this type of lung cancer is usually found in both lungs; therefore, surgery alone is not often used.

   Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that may remain. Treatment that is given after the surgery to lower the risk that the cancer will come back is called adjuvant therapy. 

2. Chemotherapy
   Chemotherapy is a cancer treatment that 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.

   When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).

   When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). 

3. Radiation therapy
   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 way the a radiation therapy is given depends upon the type and stage of the cancer being treated.

   There are two types of radiation therapies:

   1. External radiation therapy uses a machine outside the body to send radiation toward the cancer.
   2. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Prophylactic cranial irradiation (radiation therapy to the brain to reduce the risk that cancer will spread to the brain) may also be given. 
4. Laser therapy
   Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill the cancer cells. 
5. Endoscopic stent placement
   An endoscope is a thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may be used to place a stent in a body structure to keep the structure open. Endoscopic stent placement can be used to open an airway blocked by abnormal tissue. Follow-up tests may be needed.

Non-Small Cell Lung Cancer

Depending on the stage of the non-small cell lung cancer, the treatment plan will be adjusted, below is an idea of what treatment plans may look like for each of the stages.

• Occult Non-Small Cell Lung Cancer treatment depends upon where the cancer has spread. It can usually be cured by surgery.
• Stage 0 treatment may include:
  • Surgery (wedge resection or segmental resection).
  • Photodynamic therapy using an endoscope.
  • Electrocautery, cryosurgery, or laser surgery using an endoscope.
• Stage I treatment may include:
  • Surgery (wedge resection, segmental resection, sleeve resection, or lobectomy).
  • External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
  • A clinical trial of surgery followed by chemoprevention.
• Stage II treatment may include:
  • Surgery (wedge resection, segmental resection, sleeve resection, lobectomy, or pneumonectomy).
  • External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
  • Surgery followed by chemotherapy.
• Stage III non-small lung cancer treatment is divided into Stage IIIA and Stage IIIB:

   

  • Stage IIIA: Non-small cell lung cancer that can be removed with surgery may include surgery followed by chemotherapy.
    Non-small cell lung cancer that cannot be removed with surgery may include:
    • Chemotherapy combined with radiation therapy.
    • External radiation therapy alone (for patients who cannot be treated with combined therapy). 
    • Some Stage IIIA non-small cell lung tumors that have grown into the chest wall may be completely removed, and treatment of chest wall tumors may include:
      • Surgery
      • Surgery and radiation therapy
      • Radiation therapy alone
      • Chemotherapy combined with radiation therapy and/or surgery.
  • Stage IIIB treatment may include:
    • Chemotherapy combined with external radiation therapy.
    • External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
• Stage IV treatment may include:
  • External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life
  • Combination chemotherapy
  • Combination chemotherapy and targeted therapy
  • Laser therapy and/or internal radiation therapy using an endoscope.

Follow-up tests or check-ups for both Small Cell and Non-Small Cell Lung Cancer

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based upon the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has returned. These tests are sometimes called follow-up tests or check-ups.