Lung cancer treatments have progressed and improved over the past years, but as with any type of cancer, early detection is still key to receiving the best prognosis. Though it is the second-most common cancer for adults in the United States, lung cancer can often be difficult to diagnose when it’s in the early stages. That’s why those at high-risk for the disease—people with a history of moderate to heavy smoking—should start getting screened early and regularly.
Lung Cancer Treatment Options
Treatment options for lung cancer can vary based on the type of lung cancer—small-cell lung cancer (SCLC) or non-small-cell lung cancer (NSCLC)—and if the cancer has spread.
“Small cell lung cancers make up 15-20 percent of all lung cancers. If your cancer has spread—referred to as extensive-stage—the main treatment is systemic therapy: either chemotherapy or a chemoimmunotherapy combination,” said Laurie Gaspar, MD, a radiation oncologist with Banner Health in Colorado. “If your lung cancer is confined to the chest—commonly referred to as limited-stage small cell lung cancer—then chemotherapy combined with chest radiation therapy will likely be recommended.”
Non-small-cell lung cancer is the most common type of lung cancer. “If you’re an otherwise well person, the standard treatment for early stage NSCLC is surgery to remove the portion of your lung containing the cancer,” says Dr. Gaspar.
Elbert Kuo, MD, a thoracic surgeon with Banner MD Anderson Cancer Center, explained lung cancer surgery this way: “If you imagine your lungs are like a big tree, radiation is like pruning the diseased leaves off the tree. This saves a lot of leaves and lung tissue. In surgery, we cut the branch at the base; this removes all the cancer and takes out any lymph nodes and lung tissue where the lung cancer could spread.”
Dr. Kuo noted that most lung surgery can now be performed using minimally invasive techniques, like video assisted or robotic lung surgery.
“Using small incisions and a camera, we can remove the lung tissue with the cancer and lymph nodes that drain into the area. With improved pain management techniques, you may only stay in the hospital for three days and be walking and eating the night of your operation.”
If you have early stage NSCLC but are in poor general health or have difficulty breathing or shortness of breath, you may not able to undergo surgery, but you can receive a special form of radiation therapy called stereotactic body radiation therapy (SBRT). This form of radiation is painless and is usually done in three or five treatments over 1-2 weeks. SBRT has shown to be successful in preventing recurrence of lung cancer in the majority of cases, says to Dr. Gaspar.
If your non-small-cell lung cancer has spread from your lungs to the adjacent lymph nodes in the middle of your chest but has not spread outside of the chest, the usual treatment is the combination of radiation therapy with chemotherapy, followed by immunotherapy.
“The most significant advancements have occurred in patients with advanced stage cancer that has spread to other organs,” said Jiaxin Niu, MD, director of Banner MD Anderson’s Lung Cancer Program. “More sophisticated testing on tumor samples or your blood is performed to look for specific gene mutations or immunotherapy markers.”
Markers are measurable things in your body that can indicate illness.
Dr. Niu noted another exciting development: immunotherapy. “By removing the cloak of lung cancer, immunotherapy called checkpoint inhibitors has been shown to be the real game changer in many patients, and some patients even go to complete remission,” Dr. Niu said.
Another option to consider is whether you want to join a lung cancer clinical trial, in addition to your standard treatments. Not all patients will qualify or be eligible for a clinical trial, and they may not be the right option for you. Your doctor can help you decide if a clinical trial is an option for you.
Determining your Treatment Options
You’ve been diagnosed with lung cancer and are aware of the different treatment options, but how do you know what’s best for your individual case? Dr. Gaspar and Dr. Kuo recommend you consult with a multidisciplinary team consisting of a medical oncologist, radiation oncologist, interventional pulmonologist and thoracic surgeon.
“The most appropriate type of treatment is sometimes not known until you have seen several types of specialists,” said Dr. Gaspar.
Some providers, like Banner MD Anderson, provide all these specialists in one location, so you can see the specialists in one day, allowing you to make a decision about your treatment more quickly.
“The providers will go over your individual situation and together, with you, come up with a customized treatment plan,” said Dr. Kuo. “Each patient is unique, and the treatment plan needs to be tailored to that patient.”