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Lung Cancer Center

Lung Cancer Treatment

Lung cancer treatment
You and your doctor will choose a cancer treatment regimen based on a number of factors, such as your overall health, the type and stage of cancer, and your own preferences. Treatment options typically include one or more treatments, including surgery, chemotherapy, radiation therapy or targeted drug therapy. Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.

The choice of treatment depends mainly on the type of lung cancer and its stage. However, cancer treatment is defined as either of these therapies:

  1. Local therapy - Local therapies (surgery and radiation therapy) remove or destroy cancer in the chest. When lung cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas. For example, lung cancer that spreads to the brain may be controlled with radiation therapy to the head.
  2. Systemic therapy - Chemotherapy and targeted therapy are systemic therapies. The drugs enter the bloodstream and destroy or control cancer throughout the body.
  3. Targeted therapy - Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. These abnormal proteins are present in unusually large amounts in certain lung cancer cells.

Adjuvant therapy
Adjuvant therapy is treatment that is given after surgery to lower the risk of the lung cancer returning. Adjuvant therapy includes radiation therapy, chemotherapy, and targeted therapy. This type of lung cancer treatment aims to eliminate any lung cancer cells that may be lingering in the body. Adjuvant therapy may decrease the risk of recurrence, but does not necessarily eliminate it.

Alternative treatments
If your doctor has told you that your lung cancer can't be cured, you may be tempted to turn to complementary and alternative medicine for answers.
Rather than forgoing mainstream cancer treatments, using complementary and alternative treatments along with care from your doctor may be a reasonable option. Your doctor can help you weigh the benefits and risks of complementary and alternative treatments such as the following:

Acupuncture - During an acupuncture session, a practitioner inserts small needles into precise points on your body. Acupuncture may help relieve pain and ease cancer treatment side effects, such as nausea, vomiting and dry mouth, but there's no evidence that acupuncture has any effect on cancer. Acupuncture is not an appropriate therapy if you are diagnosed with low blood counts or take blood thinners.

Hypnosis - Hypnosis is typically performed by a licensed therapist who leads you through relaxation exercises and aims to reduce anxiety, nausea and pain in people with cancer, and it may improve appetite.

Massage - Pressure to the skin and muscles can help relieve anxiety, distress, fatigue and pain in people diagnosed with cancer. Some massage therapists are specially trained to work with people who have cancer. Ask your doctor for names of massage therapists in your community

Meditation - Meditation is a time of quiet reflection in which you focus your mind on something, such as an idea, image or sound. Meditation may reduce stress and improve quality of life in people diagnosed with cancer.

Yoga - Yoga combines gentle stretching movements with deep breathing and meditation. Yoga may help people with cancer sleep better. Yoga is generally safe when taught by a trained instructor, but don't attempt any moves that hurt or don't feel right.

Chemotherapy
Chemotherapy has been shown to improve both the length and quality of life in people with lung cancer of all stages. Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Most chemotherapy used for lung cancer is injected into a vein (called intravenous, or IV injection).

The side effects of chemotherapy vary by individual and dose, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea.
Chemotherapy may also damage normal cells in the body, including blood cells, skin cells, and nerve cells. This may result in low blood counts, an increased risk of infection, hair loss, mouth sores, and/or numbness or tingling in the hands and feet. These side effects usually go away once treatment is finished.

Clinical trials
Lung cancer is hard to control with current treatments. For that reason, many doctors encourage patients with this disease to consider taking part in a clinical trial. Clinical trials are an important option for people with all stages of lung cancer.

Extra oxygen
Some doctors may recommend extra oxygen that is delivered from small, portable tanks. This type of treatment can help make up for the lung’s reduced ability to extract oxygen from the air.

Lifestyle
There's no sure way to prevent lung cancer, but you can reduce your risk if you follow these suggestions:

Don't smoke - If you've never smoked, don't start. Talk to your children about not smoking, so they can understand how to avoid this major risk factor for lung cancer. Many current smokers began smoking in their teens. Begin conversations about the dangers of smoking with your children early, so they know how to react to peer pressure.

Drink alcohol in moderation, if at all - Limit yourself to one drink a day if you're a woman or two drinks a day if you're a man. Anyone age 65 and older should drink no more than one drink a day.

Eat a diet full of fruits and vegetables - Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as there may be unknown harms.

Exercise - Aim for at least 30 minutes of exercise on most days of the week. Start out slowly and continue adding more activity such as biking, swimming and walking. Or add exercise throughout your day — park farther away from work and walk the rest of the way or take the stairs rather than the elevator.

Stop smoking - Stop smoking now. Quitting reduces your risk of lung cancer, even if you've smoked for years. Talk to your doctor about strategies and stop-smoking aids that can help you quit. Options include nicotine replacement products, medications and support groups.

Medications
Medications prescribed for the treatment of lung cancer aim to treat different symptoms of the cancer and attempt to block the growth of cancer. Most doctors will individualize a medication program to control pain and address particular symptoms.

Bisphosphonates - Medications called bisphosphonates strengthen bones, lessen bone pain, and can help prevent future bone metastases.

Blood vessel blockers – This class of lung cancer medicines block the formation of new blood vessels (also called angiogenesis), which is necessary for a tumor to grow and spread

Improved breathing - Medications can also help treat the symptoms of lung cancer. Medications can be used to suppress cough, open closed airways, or reduce bronchial secretions. Prednisone or methylprednisolone (multiple brand names) can reduce inflammation caused by lung cancer or radiation therapy and improve breathing.

Monoclonal antibodies - A monoclonal antibody is a drug made in the laboratory that blocks a receptor on the cell surface, which is like the doorway of the cell.

Pain medicines - Most hospitals and cancer centers have pain control specialists that design pain-relief treatments even for very severe cancer pain. Many drugs used to treat cancer pain, especially morphine, can also relieve shortness of breath caused by cancer.

Protein blockers – Some drugs target locally advanced and metastatic non-small cell lung cancer. These drugs block the epidermal growth factor receptor (EGFR), a protein that helps lung cancer cells grow and multiply.

Prevention
Most lung cancer deaths could be prevented. That's because smoking accounts for nearly 90 percent of lung cancer cases. The risk of lung cancer increases with the length of time and number of cigarettes you smoke. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer. Protecting yourself from other risk factors for lung cancer also decreases risk (minimize exposure to asbestos, radon and second hand smoke). Here are some additional tips:

Avoid carcinogens at work - Protect yourself from exposure to toxic chemicals at work. Follow employer's precautions. For instance, if you're given a face mask for protection, always wear it. Ask your doctor what more you can do to protect yourself at work. Your risk of lung damage from any carcinogens increases if you smoke.

Avoid second hand smoke - If you live or work with a smoker, urge him or her to quit. At the very least, ask him or her to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and seek out smoke-free options.

Test your home for radon - Have the radon levels in your home checked, especially if you live in an area where radon is known to be a problem. High radon levels can be remedied to make your home safer. For information on radon testing, contact your local department of public health or a local chapter of the American Lung Association.

Radiation therapy
Radiation therapy is the use of high energy x-rays or other particles to kill cancer cells. Radiation therapy cannot be used to treat widespread cancer. Radiation only kills cancer cells directly in the path of the radiation beam. It also damages the normal cells caught in its path, and for this reason, it cannot be used to treat large areas of the body.

Radiation therapy may also be used to treat metastases that are causing pain or other symptoms. Small tumors can be treated with a type of radiation therapy called stereotactic radio surgery that focus radiation only on the tumor and minimize side effects. Likewise, a surgeon can use a laser to burn away a tumor or place a mechanical stent (support) to prop open an airway passage.

Radiation therapy is supervised by a specialist called a radiation oncologist. Radiation oncologists carefully plan treatments using CT scans of the chest to minimize the amount of normal lung tissue exposed to the radiation beam and to decrease permanent scarring. Although side effects of this treatment are common, most side effects go away soon after treatment is finished.

Surgery
The lungs have five lobes, three in the right lung and two in the left lung. The goal of lung cancer surgery is the complete removal of the lung tumor and the nearby lymph nodes in the chest. Thoracic surgeons are specially trained to perform this type of lung cancer surgery. The time it takes to recover from lung surgery depends on how much of the lung is removed and the health of the patient before surgery. The following surgeries may be recommended according to stage, type, size and location of a tumor:

Bone implants - Bone metastases that weaken important bones can be treated with surgery and reinforced using metal implants.

Bronchoscopy - During a bronchoscopy, lung passages blocked by cancer can be opened to improve breathing.

Lobectomy - A lobectomy (removal of an entire lobe of the lung) has been shown to be the most effective type of surgery for treating lung cancer, even when the lung tumor is very small.

Pneumonectomy - If the tumor is close to the center of the chest, the surgeon may have to perform a pneumonectomy (surgery to remove the entire lung).

Wedge – Surgeons perform this procedure if they cannot remove an entire lobe of the lung during which a tumor is removed and surrounded by a margin of normal lung.

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