Lung cancer is the second most common cancer in men and women. It is the number one cause of death from cancer each year in both men and women. According to the American Cancer Society, 234,030 Americans will be diagnosed with lung cancer this year. Cigarette smoking is the most common cause of lung cancer. Exposure to asbestos, radon, environmental factors and secondhand smoke can also cause lung cancer.
There are two main types of lung cancer, non-small cell lung cancer and small cell lung cancer. These names refer to how a cancer looks under the microscope.
Non-small cell lung cancer is the most common type of lung cancer and accounts for 84 percent of cases. There are different types of non-small cell lung cancer, including:
Small cell lung cancer is less common and accounts for 14 percent of cases. Although the cells are small, they multiply quickly and can form large tumors that may spread throughout the body. This type of lung cancer is almost always due to smoking.
Lung cancer treatment depends on several factors, including the type and stage of the lung cancer and your overall health.
Radiation is a high-energy X-ray that can be used to treat lung cancer noninvasively. It passes through the chest to treat lung cancer and can be combined with surgery, chemotherapy or both depending upon the circumstances. Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
In early-stage lung cancer, surgery has been the standard. However, in patients medically not able to tolerate surgery, focused radiation, called stereotactic body radiation therapy (SBRT) is a good treatment option. For large tumors or those involving lymph nodes, radiation (often combined with chemotherapy) may replace surgery as the main treatment. For more advanced cancers, your doctors may recommend radiation to manage symptoms such as cough, shortness of breath or pain.
Medical oncologists specialize in treating lung cancer using various drugs. Chemotherapy means drug treatment, but there are many different kinds of medications that can be used to treat lung cancer. New research is helping oncologists learn which drugs may be most effective. Often, chemotherapy is combined with radiation therapy to make the radiation more effective. However, such combined treatment (chemoradiation) can also increase the side effects of treatment. Ask your medical oncologist about what drugs may be best for you.
Surgery is often a key part of lung cancer care. Even before treatment, surgery may be helpful in diagnosis and finding whether the cancer has spread to lymph nodes in the chest. This type of surgery is part of tumor staging, or understanding how advanced the cancer may be.
In early-stage tumors, surgery by itself can be curative. Your surgeon may remove part of the lung around the cancer. The amount of lung removed will vary based upon location, your health and other factors. If there are no signs of spread, additional treatment is often not needed.
In more advanced tumors, surgery is sometimes replaced by radiation and chemotherapy or can be combined with these treatments. Ask your surgeon or other doctors whether your tumor is early or advanced and whether surgery will be helpful for you.
External beam radiation therapy (also called radiotherapy) is the safe delivery of high-energy X-rays to your cancer. A linear accelerator focuses the radiation beam to a precise location in your body for an exact period of time. Radiation is given in a series of daily treatments, Monday through Friday, for several weeks. In small cell lung cancer, two treatments may be given each day. The full course of treatment varies but can span three to seven weeks.
Before beginning treatment, you will be scheduled for a planning session to map out the treatment area. This procedure is called a simulation. You will undergo a CT scan to design your treatment and small tattoos will be made on the skin to make sure your treatments are accurate.
Different techniques can be used to give radiation for lung cancer.
It is important to care for yourself as well as possible during radiation therapy.
Completing treatment and recovery can be challenging. Seek out help from support groups and friends ahead of time. If you have a support network in place before and during treatment, it will be easier to get through side effects since people you can count on will be around to help you. If you need additional support, let your nurse or doctor know.
Side effects are different for everyone. Some patients feel fine during treatment while others may feel uncomfortable.
Some side effects can be controlled with medications and changes to your diet. Ask your doctor or nurse whether you should make any changes in your diet. Tell them if you experience any discomfort so they can help you feel better.
© American Society for Radiation Oncology, 2016.