Lung cancer treatment varies greatly depending on the results of the diagnosis, tumor size and the stage of the cancer. In addition, your oncologist can consider your age and overall health to determine the treatment the most appropriate and effective to fight the cancer. In general, lung cancer treatment includes surgery, radiotherapy, chemotherapy and targeted drug therapy. If he thinks it can be helpful, your doctor can use a combination of all the therapies.
If you have a non advanced lung cancer, your doctor can consider surgical treatment. For the surgical therapy to be considered, the cancer must be localized or detected at an early stage. The surgery will be excision of a small section of lung that contains the tumor (wedge resection), one or two lobes of the diseased lung (lobectomy) or the complete removal of the lung (pneumonectomy) if the tumor has already exceeded boundaries of the lobes. In case surgery is not an option, your oncologist will recommend other methods: radiotherapy, chemotherapy, radiotherapy and / or targeted drug therapy.
Surgical treatment offers the best long-term results provided that a complete resection is performed. However, there can be complications such as:
- shortness of breath
- muscle pain in your chest and arms
- Bleeding and infection.
Your oncologist may use radiation therapy if the cancer has invaded other tissues or seat too close to the trachea. Radiotherapy is also used to treat aggressive lung cancers to prevent the tumor from growing. In these cases, the treatment aims at preventing complication or reduce bone pain syndrome, compression of the vena cava and compression of nerves in the spinal cord. Unlike surgery, radiation therapy can be used:
- with radiation therapy
- with surgery
- in advanced or metastatic lung cancer
- In all stages of small cell cancer.
Unlike surgery and radiation therapy, chemotherapy is a systemic treatment. It consists of using very strong chemical substances that travel the body through the bloodstream to destroy cancer cells. These drugs kill cancer cells of the lung and those outside the region of the lung (metastasis). The chemotherapy drugs can be taken by mouth, intravenous or intramuscular injection; however, intravenous injection is the most common method use in the treatment of lung cancer.
The most common drugs used in chemotherapy for lung cancer include:
- Platinum alkylators
- podophyllin alkaloids
- vinca alkaloids
- topoisomerase inhibitors
- tyrosine kinase inhibitors
- Folate antagonists.
However, besides cancer cells, normal cells are also affected by the chemotherapy drugs. This may lead to side effects:
- hair loss
- nausea and vomiting
- nerve pain
- kidney problems
- And more.
Targeted drug therapy
This is a new therapeutic method used to treat lung cancer; it is very promising. Targeted drug therapyincludes a group of drugs that target, at a specific level, the development of tumor cells. They are mainly involved in signal transduction of receptor tyrosine kinases (RTK)s by targeting abnormalities in cancer cells. By acting on specific receptors, these drugs can:
- block the growth of cancerous cells, thus preventing their proliferation in healthy tissues;
- prevent the tumor to transform normal cells into cancerous cells;
- strengthen the immune system to turn against the cancer cells;
- Commend the death of the cancer cell. Cancer cells do not obey to the apoptosis, the natural death of the cell; targeted drug therapy works by forcing them to commit suicide naturally.
Some drugs widely used to treat lung cancer
Erlotinib: this drug is used in the treatment of advanced by non-recurrent small cell lung cancers, which were not previously treated with chemotherapy. It intervenes in the chemical activities of cancer cells to prevent them from growing and dividing. Side effects may include:
- diarrhea darkening of skin
- hair loss depression
- anxiety headache
- loss of appetite nausea and vomiting
- heartburn and gas constipation
- stomach pain mouth sores
- weight loss extreme tiredness
- bone or muscle pain
- numbness, burning, or tingling of the hands or feet
- swelling of the arms, hands, feet, ankles, or lower legs.
Bevacizumab (Avastin) – this drug works by blocking vascular endothelial growth factor A (VEGF-A), thus reducing the growth of new blood vessels, a process that is essential for the growth of any tumor development and metastases. Bevacizumab is used to treat advanced and recurrent non-small cell lung cancer. Unlike Erlotinib, Avastin is always used in combination with chemotherapy.
Avastin side effects may include:
- weakness and dizziness fainting
- nosebleeds bleeding gums
- loss of appetite heartburn
- change of taste diarrhea
- weight loss dry mouth
- voice changes headache
- neck pain slow or difficult speech
- sores on the skin or in the mouth.