Treatments and drugs

By Mayo Clinic Staff

You and your doctor choose a cancer treatment plan based on a number of factors, such as your overall health, the type and stage of your cancer, and your preferences. Options typically include one or more treatments, including surgery, chemotherapy, radiation therapy or targeted drug therapy.

In some cases you may choose not to undergo treatment. For instance, you may feel that the side effects of treatment will outweigh the potential benefits. When that's the case, your doctor may suggest comfort care to treat only the symptoms the cancer is causing, such as pain or shortness of breath.

Surgery

During surgery your surgeon works to remove the lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include:

  • Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue
  • Segmental resection to remove a larger portion of lung, but not an entire lobe
  • Lobectomy to remove the entire lobe of one lung
  • Pneumonectomy to remove an entire lung

If you undergo surgery, your surgeon may also remove lymph nodes from your chest in order to check them for signs of cancer.

Lung cancer surgery carries risks, including bleeding and infection. Expect to feel short of breath after lung surgery. If a portion of your lung is removed, your remaining lung tissue will expand over time and make it easier to breathe. Your doctor may recommend a respiratory therapist who can guide you through breathing exercises to aid in your recovery.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be given through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that you can recover.

Chemotherapy is often used after surgery to kill any cancer cells that may remain. It may also be used before surgery to shrink cancers and make them easier to remove. In some cases, chemotherapy can be used to relieve pain and other symptoms of advanced cancer.

Radiation therapy

Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy can be directed at your lung cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy).

Radiation therapy can be used after surgery to kill any cancer cells that may remain. It may also be used as the first treatment for lung cancers that can't be removed during surgery. For people with advanced lung cancer, radiation therapy may be used to relieve pain and other symptoms.

For people with lung cancers that are very small, one option may be stereotactic body radiotherapy. This form of radiation aims many beams of radiation from different angles at the lung cancer. Stereotactic body radiotherapy treatment is typically completed in one or a few treatments. In certain cases, it may be used in place of surgery for small tumors.

Targeted drug therapy

Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Targeted therapy options for treating lung cancer include:

  • Bevacizumab (Avastin). Bevacizumab stops a tumor from creating a new blood supply. Blood vessels that connect to tumors can supply oxygen and nutrients to the tumor, allowing it to grow.

    Bevacizumab is usually used in combination with chemotherapy and is approved for advanced and recurrent non-small cell lung cancer. Bevacizumab carries a risk of bleeding, blood clots and high blood pressure.

  • Erlotinib (Tarceva). Erlotinib blocks chemicals that signal the cancer cells to grow and divide.

    Erlotinib is approved for people with advanced and recurrent non-small cell lung cancer that has a specific genetic mutation. Cells taken from your lung cancer will be tested to see whether this medication is likely to help you.

    Erlotinib side effects include a skin rash and diarrhea. Smokers are less likely to benefit from erlotinib than are nonsmokers.

  • Crizotinib (Xalkori). Crizotinib blocks chemicals that allow cancer cells to grow out of control and live longer than normal cells.

    Crizotinib is approved for use in people with advanced non-small cell lung cancer whose cancer cells have a particular genetic mutation. A special laboratory test using your cancer cells determines whether your cells have this certain genetic mutation.

    Crizotinib side effects include nausea and vision problems, such as double vision or blurred vision.

Clinical trials

Clinical trials are studies of experimental lung cancer treatments. You may be interested in enrolling in a clinical trial if lung cancer treatments aren't working or if your treatment options are limited.

The treatments studied in a clinical trial may be the latest innovations, but they don't guarantee a cure. Carefully weigh your treatment options with your doctor.

Your participation in a clinical trial may help doctors better understand how to treat lung cancer in the future.

Palliative care

People with lung cancer often experience signs and symptoms of the cancer, as well as side effects of treatment. Supportive care, also known as palliative care, is a specialty area of medicine that involves working with a doctor to minimize your signs and symptoms.

Your doctor may recommend that you meet with a palliative care team soon after your diagnosis to ensure that you're comfortable during and after your cancer treatment.

In one study, people with advanced non-small cell lung cancer who began receiving supportive care soon after their diagnosis lived longer than those who continued with treatments, such as chemotherapy and radiation. Those receiving supportive care reported improved mood and quality of life. They survived, on average, almost three months longer than did those receiving standard care.

You may be concerned that receiving palliative care means you can't undergo aggressive treatment for your cancer. But rather than replace curative treatments, palliative care complements your cancer treatment and may make it more likely that you can complete your treatments.

Mar. 19, 2014

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