Non-Small Cell Lung Cancer
How Is It Treated?
Different types of treatments are available for people with non-small cell lung cancer. Surgery, radiation therapy, chemotherapy, targeted therapy, laser therapy, photodynamic therapy, cryosurgery, electrocautery, and watchful waiting are the nine standard treatments used for this cancer.
Surgery Four types of surgery are used to treat lung cancer:
♦ Wedge resection is surgery to remove a tumor and some of the normal tissue around it. When a slightly larger amount of tissue is taken, it’s called a segmental resection.
♦ Lobectomy is surgery to remove a whole lobe of the lung.
♦ Pneumonectomy is surgery to remove one whole lung.
♦ Sleeve resection is surgery to remove part of the bronchus.
Even if the surgeon removes all the cancer that can be seen at the time of the surgery, some people may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Some people may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left.
Radiation therapy is the use of high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Types of Lung Cancer
In 2013, more than 228,000 Americans will be diagnosed with lung cancer. The two most common types of lung cancer are named for how the lung cancer cells look under a microscope:
♦ Small Cell The cells of small cell lung cancer look small under a microscope. About 1 of every 8 people with lung cancer has small cell lung cancer.
♦ Non-Small Cell The cells of non-small cell lung cancer are larger than the cells of small cell lung cancer. Most people diagnosed with lung cancer have non-small cell lung cancer. It doesn’t grow and spread as fast as small cell lung cancer, and it’s treated differently.
Radiosurgery is a method of delivering radiation directly to the tumor with little damage to healthy tissue. It does not involve surgery, and it may be used to treat certain tumors in people who cannot have surgery.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. It also depends on where the cancer is found. For tumors in the airways, radiation is given directly to the tumor through an endoscope.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, this is called systemic chemotherapy. The drugs enter the bloodstream and can then reach cancer cells throughout the body. When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, this is called regional chemotherapy. The drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibodies and tyrosine kinase inhibitors are two types of targeted therapy used to treat non-small cell lung cancer.
Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells, as well as normal substances that may help cancer cells grow. The antibodies attach to these substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
Protect Yourself from Smoke
Because some people who get lung cancer were smokers, you may feel like doctors and other people assume that you are or were a smoker (even if you aren’t or weren’t).
Whether or not you were a smoker, it’s important for you to protect your body now from tobacco smoke. Avoid secondhand smoke from smokers near you. If you smoke, talk with an expert about quitting. It’s never too late to quit. Quitting can help cancer treatments work better. It may also reduce your risk of getting another cancer.
If you need help quitting smoking …
♦ Go online to Smokefree.gov.
♦ Call NCI’s Smoking Quitline at (877) 448-7848.
♦ Sign up for the free mobile service SmokefreeTXT to get tips and encouragement to quit. To sign up, text the word QUIT to 47848 from your mobile phone, or go to Smokefree.gov/SmokefreeTXT.
Monoclonal antibodies used to treat non-small cell lung cancer include bevacizumab and cetuximab. Bevacizumab binds to the vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels that tumors need to grow. Cetuximab binds to the epidermal growth factor receptor (EGFR) and works to stop cancer cells from growing and dividing.
Tyrosine kinase inhibitors are targeted therapy drugs that block the signals needed for tumors to grow. Tyrosine kinase inhibitors may be used with other anticancer drugs as adjuvant therapy. Tyrosine kinase inhibitors used to treat non-small cell lung cancer include erlotinib and gefitinib. They are types of EGFR tyrosine kinase inhibitors. Crizotinib is a type of tyrosine kinase inhibitor that is used to treat non-small cell lung cancer with certain gene changes.
Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.
Photodynamic therapy uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. Fiberoptic tubes are then used to carry the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue. It is used mainly to treat tumors on or just under the skin or in the lining of internal organs. When the tumor is in the airways, photodynamic therapy is given directly to the tumor through an endoscope.
Cryosurgery is a method of treating cancer using an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy. For tumors in the airways, cryosurgery is done through an endoscope.
Electrocautery involves the use of a probe or needle heated by an electric current to destroy abnormal tissue. For tumors in the airways, electrocautery is done through an endoscope.
Watchful waiting is closely monitoring an individual’s condition without giving any treatment until symptoms appear or change. This may be done in certain rare cases of non-small cell lung cancer.
Clinical trials are part of the cancer research process and are done to find out if new cancer treatments are safe and effective or are better than the standard treatment. Many of today’s standard treatments for cancer are based on earlier clinical trials. For some people, taking part in a clinical trial may be the best treatment choice. People who take part in a clinical trial may receive the standard treatment or may be among the first to receive a new treatment.
Follow-up tests may be needed during and after treatment for non-small cell lung cancer. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called restaging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has come back.
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Source: National Cancer Institute
This article was originally published in Coping® with Cancer magazine, May/June 2013.