Treating Lung Cancer

NHS

Treatment for lung cancer is managed by a team of specialists from different departments who work together to provide the best possible treatment. This team includes the health professionals required to make a diagnosis, to stage your cancer and to plan the best treatment. If you want to know more, ask your doctor or nurse about this.

The type of treatment you receive for lung cancer depends on several factors, including:

  • the type of lung cancer you have (non-small-cell or small-cell mutations on the cancer)
  • the size and position of the cancer
  • how advanced your cancer is (the stage)
  • your overall health

Deciding what treatment is best for you can be difficult. Your cancer team will make recommendations, but the final decision will be yours.

The most common treatment options include surgery, radiotherapy & chemotherapy. Depending on the type of cancer and the stage, you may receive a combination of these treatments.

Your suggested treatment plan depends on whether you have non-small-cell lung cancer or small-cell lung cancer.

Non-small-cell lung cancer

If you have non-small-cell lung cancer that's in only 1 of your lungs and you're in good general health, you'll probably have surgery to remove the cancerous cells. This may be followed by a course of chemotherapy to destroy any cancer cells that may have remained in your body.

Small-cell lung cancer

Small-cell lung cancer is usually treated with chemotherapy, either on its own or in combination with radiotherapy or immunotherapy. This can help to prolong life and relieve symptoms.

Surgery

There are 3 types of lung cancer surgery:

  • lobectomy – where one or more large parts of the lung (called lobes) are removed. Your doctors will suggest this operation if the cancer is just in 1 section of 1 lung.
  • pneumonectomy – where the entire lung is removed. This is used when the cancer is located in the middle of the lung or has spread throughout the lung.
  • wedge resection or segmentectomy – where a small piece of the lung is removed. This procedure is only suitable for a small number of patients. It is only used if your doctors think your cancer is small and limited to one area of the lung. This is usually very early-stage non-small-cell lung cancer.

People may be concerned about being able to breathe if some or all of a lung is removed, but it's possible to breathe normally with 1 lung. However, if you have breathing problems before the operation, it's likely these symptoms will continue after surgery.

Radiotherapy

Radiotherapy uses pulses of radiation to destroy cancer cells. There are a number of ways it can be used to treat lung cancer. An intensive course of radiotherapy, known as radical radiotherapy, may be used to treat non-small-cell lung cancer if you are not healthy enough for surgery. For very small tumours, a special type of radiotherapy called stereotactic radiotherapy may be used instead of surgery.

Radiotherapy can also be used to control the symptoms, such as pain and coughing up blood, and to slow the spread of cancer when a cure is not possible (this is known as palliative radiotherapy).

A type of radiotherapy known as prophylactic cranial irradiation (PCI) is also sometimes used during the treatment of small-cell lung cancer. PCI involves treating the whole brain with a low dose of radiation. It's used as a preventative measure because there's a risk that small-cell lung cancer will spread to your brain.

Chemotherapy

Chemotherapy uses powerful cancer-killing medicine to treat cancer. There are several ways that chemotherapy can be used to treat lung cancer. For example, it can be:

  • given before surgery to shrink a tumour, which can increase the chance of successful surgery (this is usually only done as part of a clinical trial).
  • given after surgery to prevent the cancer returning.
  • used to relieve symptoms and slow the spread of cancer when a cure isn't possible.
  • combined with radiotherapy.

Chemotherapy treatments are usually given in cycles. A cycle involves taking chemotherapy medicine for several days, then having a break for a few weeks to let the therapy work and for your body to recover from the effects of the treatment.

The number of cycles you need will depend on the type and grade of lung cancer. Most people need 4 to 6 cycles of treatment over 3 to 6 months. You will see your doctor after these cycles have finished. If the cancer has improved, you may not need any more treatment.

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