Lung cancer treatment options: Stages and outlook - Medical News Today

Lung cancer treatment options will vary according to the type of lung cancer a person has, the stage of the disease, and the person's overall health.

Surgery is a standard treatment for the removal of a cancerous tumor, while a person may require chemotherapy and radiation therapy to kill cancerous cells. In some cases, a doctor may recommend other treatment approaches, such as targeted treatments and immunotherapy.

This article provides a list of potential treatment options for lung cancer, including complementary and alternative treatments, and ways to seek emotional support. We also outline some of the latest research into cancer treatments.

The treatments for lung cancer include surgery, chemotherapy, radiation therapy, and other options.

Surgery

Surgery remains a standard treatment for cases of non-small cell lung cancer (NSCLC). The American Cancer Society notes that surgery provides the best chance of a cure for NSCLC.

Surgery may be an option in small cell lung cancer if the cancer is only in one lung and nearby lymph nodes.

Some different types of lung surgery include:

• Wedge resection: Surgery to remove an area of an affected lung lobe.
• Lobectomy: Surgery to remove the lung lobe that contains the tumor.
• Pneumonectomy: Surgery to remove the entire affected lung.
• Sleeve resection: Surgery to remove part of a large airway.

Doctors may also recommend treating some early stage tumors using video-assisted thoracic surgery (VATS). Since VATS uses smaller incisions, it may lead to fewer complications and a shorter hospital stay compared to other surgeries.

Following surgery, some people may also undergo additional treatment, such as chemotherapy or radiation therapy.

Chemotherapy

Chemotherapy drugs are medications that help to kill cancer cells or stop them from dividing. This helps to stop cancers from growing or spreading to other areas of the body.

A doctor may prescribe chemotherapy as a treatment for both small cell and non-small cell lung cancers.

Doctors may recommend chemotherapy as a standalone treatment or as an adjuvant therapy. An adjuvant therapy is one that a doctor prescribes before or after a primary cancer treatment to try to kill any remaining cancer cells.

The delivery method for chemotherapy will vary depending on the type of drug and the person's general health. Examples of delivery methods include:

• taking chemotherapy drugs orally
• receiving injectable chemotherapy into a vein or muscle tissue
• receiving chemotherapy directly into the target organ or area

There are many chemotherapy drugs. A doctor will work closely with a person to explore the most appropriate options.

Radiation

Radiation therapy uses high-energy X-rays or other sources of radiation to kill cancer cells and help prevent them from dividing.

Radiation therapy is either internal or external:

• Internal radiation therapy: Involves inserting a radioactive substance directly into or near the cancer.
• External radiation therapy: Involves using a machine to deliver radiation into the target area from outside the body.

A combination of radiation therapy and chemotherapy is a standard treatment for small cell lung cancer.

When treating NSCLC, a doctor may recommend radiation therapy alone or in combination with surgery or other cancer treatments.

Targeted therapy

Targeted therapies are drugs that aim to stop the growth and spread of cancer cells. They do this by interfering with molecules on cancer cells that encourage the cells to grow and increase.

Targeted therapy may be an option in cases where it is possible to identify and target changes to the cancer's DNA.

Targeted therapies have the following characteristics that help to differentiate them from standard chemotherapy drugs:

• Chemotherapy drugs destroy rapidly dividing cells, regardless of whether those cells are normal or abnormal. Targeted therapies target molecular markers specific to cancer, thereby destroying only cancer cells.
• Chemotherapy drugs are cytotoxic, meaning they kill tumor cells. Targeted therapies are typically cytostatic, meaning they prevent cancer cells from increasing.
• Targeted therapies may cause fewer side effects than non-targeted therapies.

The National Cancer Institute (NCI) notes that using targeted therapy along with other cancer treatments may improve survival rates in some cases.

However, targeted therapy may not be suitable for all types of cancer. A doctor will discuss all possible options with the person seeking treatment.

Immunotherapy

Immunotherapy is a cancer treatment that activates the body's own immune system to engage and kill cancer cells. It may be a treatment option for certain forms of lung cancer, such as advanced or recurring cancers.

Some immunotherapy drugs work by targeting molecules on immune cells, called "immune checkpoints" (ICs). The purpose of these ICs is to help the body identify and eliminate damaged or abnormal cells. Some cancers "trick" the ICs into letting them go undetected. Drugs called "immune checkpoint inhibitors" target ICs to help them identify and eliminate cancerous cells. Doctors give these drugs via an intravenous injection.

Researchers are currently working to identify other forms of immunotherapy.

Immunotherapy may not be an appropriate treatment option for all people or all types of cancer. Doctors will discuss all treatment options with the person who is seeking treatment.

Radiofrequency ablation

Radiofrequency ablation is a procedure where doctors use high-energy radio waves to heat the tumor and kill the cancer cells. To do this, they insert a needle-like probe into the tumor through the skin using CT scans to guide it.

This procedure typically occurs in an outpatient setting. It involves the use of local anesthesia to numb the area where the doctor inserts the probe.

Doctors may decide to use radiofrequency ablation to treat people with small NSCLC tumors situated at the outer edge of the lungs, particularly if they are unable to have surgery.

Research into treatment for lung cancer and other types of cancer is ongoing. Clinical trials may reveal new drugs or drug schedules that will help in the fight against cancer.

Developments in immunotherapy practices may also lead to new treatments. Examples include:

• cancer vaccines that may help the body eliminate certain cancer-specific proteins
• adoptive T-cell therapy, which alters a type of immune cell called a "T cell" to help the body fight cancer

The American Lung Association notes that research into these treatments is still underway, and the drugs are not yet FDA-approved. Future research may help explore their possible use in lung cancer treatment.

The NCI provides a search tool to explore current clinical trials by cancer type. This may be beneficial for people who have received a recent diagnosis or have not responded to standard treatments.

Complementary treatment is a type of treatment a person may use alongside standard cancer treatment. Examples include using acupuncture or dietary supplements to reduce side effects from chemotherapy or radiotherapy.

Alternative treatments are treatments a person may use instead of standard cancer treatment. Examples include:

• restrictive diets
• megadoses of certain vitamins or herbal preparations
• other therapies, such as magnet therapy

If a person is curious about complementary or alternative therapies, they should talk with their doctor for further advice. The NCI notes that researchers may not have scientifically tested many complementary and alternative treatments. As such, it is not clear whether some treatments are safe or effective, or whether they may interfere with standard cancer treatments.

A person's individual outlook with any cancer treatment can vary according to the following factors:

• their general health
• the type of cancer they have
• the stage of the cancer
• how well the person responds to treatment
• whether the person experiences side effects or other complications

Some cancers are more treatable if a person detects and treats them in their early stages. As such, it is important that people receive regular check-ups from their healthcare professional, especially if they are experiencing concerning symptoms.

According to a 2021 review of cancer statistics, new methods of cancer detection and treatment have helped improve survival rates for NSCLC. Between 2009 and 2016, 2-year survival rates increased from 34% to 42%. Small cell lung cancer survival rates remained about the same, between 14–15%.

Lung cancer can be a difficult diagnosis for a person to come to terms with. According to the NCI, some common emotions a person may experience after receiving a cancer diagnosis include:

• denial
• anger
• fear and worry
• stress and anxiety
• sadness and depression
• loneliness
• guilt
• hope
• gratitude

Doctors may recommend talking therapy or support groups to help a person process the emotional impact of a cancer diagnosis. Support may also be available for the person's family and close friends.

If therapy or support groups are not an option, a person may benefit from reaching out to a close friend or family member. Talking to another person may help to ease the emotional load of a cancer diagnosis. Another person may also be able to offer practical support.

The NCI provides the following tips on coping with a cancer diagnosis:

• Find ways to aid relaxation, such as reading or meditation.
• Take part in enjoyable hobbies.
• Perform gentle exercises, such as walking or yoga.
• Focus on things a person can control, such as:
  • Attend appointments.
  • Make lifestyle changes.
  • Set a daily schedule.

Lung cancer treatment can vary according to the type and stage of the cancer, as well as the person's overall health. The way a person responds to or reacts to treatment will also play a role in the treatment options available to them in the future.

As with many cancers, detecting and treating lung cancer in its early stages may improve treatment outcomes.

Research is continually underway to explore new cancer treatments and treatment methods. Some people may be eligible to enroll in a clinical trial. People should work closely with their healthcare professional to determine the treatments that are best suited to their individual needs.

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