Lung Cancer Treatments

Lung Cancer Treatments

Not everyone receives the same treatment. Often, more than one type of treatment is used. Your doctor will tailor treatment to you based on tests.

Local therapy

Local therapy treats cancer in a limited region. It cannot fully treat cancer that is widespread. Local therapies for lung cancers include surgery, radiation therapy, and ablation.

Surgery

Surgery is a treatment that removes tumors or entire organs with cancer. It is a very common treatment for stages I, II, and III. The type of surgery done depends on where and how much cancer has grown. Common lung surgeries are:

• Wedge resection – A small part of a lobe is removed
• Segmentectomy – A large part of a lobe is removed
• Lobectomy – An entire lobe is removed
• Sleeve lobectomy – An entire lobe and part of the bronchus is removed, and
  Pneumonectomy – The entire lung is removed.

Removal of a lung tumor can sometimes be done with one of two methods. The classic method is thoracotomy. This surgery removes tissue through
a large cut. Thoracoscopy is a newer method. It removes tissue through small cuts. It can be done with or without help from a robot.

Radiation therapy

Radiation therapy most often uses high-energy x-rays to treat lung cancer. The x-rays damage DNA in cancer cells. This either kills the cancer cells or
stops new cancer cells from being made. For lung cancers, the most common radiation method is EBRT (external beam radiation therapy).
A large machine makes high energy x-rays used for treatment. Conformal techniques are used. These techniques shape the radiation dose to the cancer site to spare healthy tissue. Common techniques for lung cancer are:

• 3D-CRT (three-dimensional conformal radiation therapy) delivers a photon beam that matches the shape of the target. Treatment is completed in about 6 weeks.
• IMRT (intensity-modulated radiation therapy) is a form of 3D-CRT. It further modifies the beam’s intensity during treatment.
• SABR (stereotactic ablative radiotherapy) treats cancer with very precise, high-dose photon beams. It is also called SBRT (stereotactic body radiation therapy). Receiving SABR is much like other conformal techniques except treatment is finished in about 1 to 2 weeks.
• Proton therapy treats cancer with proton beams that deliver radiation mostly within the tumor. Treatment is completed in about 6 weeks.

A lung tumor is harder to target than some other tumors in the body. This is because breathing causes the tumor to move. IGRT (image-guided radiation therapy) can improve how well the radiation beam targets the tumor. It uses a machine that delivers radiation and also takes pictures of the tumor.

Ablation

Ablation destroys small tumors with little harm to nearby tissue. It isn’t used often for lung cancer. It may be used for small tumors. Radiofrequency
ablation kills cancer cells using heat or cold from electrodes that are passed through a bronchoscope. This treatment is done by an interventional
radiologist.

Systemic therapy

Systemic therapy is a cancer treatment for the whole body. It will treat cancer in your lungs. It will also treat cancer in your lymph nodes and elsewhere. For stages I–III, chemotherapy and immunotherapy are used.

Chemotherapy

Chemotherapy works by stopping the cell life cycle. As a result, cancer cells cannot make new cells. Chemotherapy can also cause cells to destroy
themselves. Often, cisplatin or carboplatin—drugs made with platinum—is used with another drug. These regimens are called platinum-doublet chemotherapy. Most chemotherapy drugs for lung cancer are liquids that are slowly injected into a vein (infusion). Some are a pill that is swallowed. Chemotherapy is given in cycles of treatment days followed by days of rest. The cycles vary in length depending on which drugs are used. Ask your doctor how many cycles and days of treatment there are within a cycle of your treatment.

Immunotherapy

T cells are part of your body’s disease-fighting (immune) system. They are unable to attack cancer cells that have PD-L1. Durvalumab is a treatment
that enables T cells to attack cancer cells. It is given by infusion every 2 weeks for 60 minutes.