Treatment

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • Your type of cancer (the type of cells the cancer started in),
  • Where the cancer is,
  • Other health conditions that you have.

The stage of the cancer and these other factors can also give an idea of your outlook (prognosis).

Treatment might include one or more of the following:

  • Chemotherapy,
  • Radiotherapy,
  • Chemoradiation – chemotherapy with radiotherapy,
  • Surgery – to remove part or all of your lung,
  • Targeted cancer drugs,
  • Tadiofrequency ablation,
  • Symptom control treatment.

Treatment for lung cancer

The main treatments for lung cancer are:

  • Surgery,
  • Chemotherapy,
  • Biological therapy,
  • Immunotherapy,
  • Radiotherapy.

Your treatment will depend on the stage, grade and type of cancer cells you have. The stage looks at the size of your cancer and if it has spread from where it started.

The grade of the cancer can tell if your cancer grows quickly or slowly. You can have a low, moderate or high grade cancer.

Types of lung cancer

The are two main types of lung cancer:

  1. Non-Small Cell Lung Cancer (NSCLC),
  2. Small Cell Lung Cancer (SCLC).

Most lung cancers are non-small cell lung cancer (NSCLC). There are three main types of NSCLC. These include:

  • Adenocarcinoma,
  • Squamous cell carcinoma,
  • Large cell carcinoma.

Knowing which type you are helps your doctor decide what treatment is best for you.

Surgery

The aim of surgery is to remove the part of the lung containing cancer. Surgery is most commonly used for Non-Small Cell Lung Cancer (NSCLC).

Surgery is possible if the tumour is found in one lung or if the lymph nodes involved are close to the lung.

A lobe or a small section of the lung can be removed or even an entire lung.

Chemotherapy

Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy drugs can be given on their own or with each other (in combination). Many lung cancer patients receive a combination of two or three chemotherapy drugs.

Chemotherapy can also be given before or after radiotherapy and surgery. Chemotherapy drugs are either injected into your bloodstream or given in tablet form.

Biological or Targeted therapy

Biological therapy uses the body’s immune system to treat cancer. Every patient’s disease is different and doctors can now test your tumour following a biopsy to see whether it will respond to certain biological therapies.

Biological therapies are also called ‘targeted therapies’ or ‘personalised medicine’. Testing a tumour to see if it will respond to a particular biological therapy is called molecular testing.

Molecular testing allows your doctor to find out more detailed information about your tumour such as:

  • Particular changes (mutations) in the DNA of the tumour,
  • Particular proteins in the tumour.

Remember molecular testing is not recommended for everyone, your doctor will explain whether it is right for you and if these drugs would be helpful for your lung cancer.

If molecular testing shows that these drugs are not suitable for your lung cancer, your doctor will advise you about what other treatments you can have. Remember this does not mean that you are not getting the best treatment. Every patient with lung cancer is different and your doctor will advise you what drugs are best for you and your disease.

Immunotherapy

Immunotherapy is a new type of cancer drug being used to treat lung cancer. It uses the patient’s own immune system to help fight the cancer cells.

There are several immunotherapy drugs in clinical trials at the moment.

For more information on immunotherapy, please see this factsheet from the Global Lung Cancer Coalition.

Radiotherapy

Radiotherapy is the use of high-energy rays that are aimed directly at your tumour or to areas that cancer may have spread to, to kill or shrink the cancer cells. In lung cancer, external beam radiotherapy is the most common type used.

Newer types of radiotherapy are now being used for some lung cancer patients. Stereotactic radiotherapy uses smaller radiation beams than standard radiotherapy. The beams are targeted at the tumour from several different angles which combine to give a high dose of radiation to the tumour.

With stereotactic radiotherapy, smaller amounts of healthy tissue are treated compared to standard radiotherapy. Your doctor will advise you whether or not it is suitable for you.

Treatment for advanced cancer

Advanced cancer means that your cancer has spread from the area where it started. If it has spread to the area around the lung, it is called local spread. It can also spread to other areas of the body including the bones and brain. This is called secondary cancer or metastatic cancer.  It is usually not possible to cure advanced cancer. Treatment is given to control the cancer and to improve your quality of life. This can be done for a long time. Treatments can involve surgery, chemotherapy, radiotherapy and biological therapy.

You may also be seen by the palliative care team at this time. This team are there to help with any symptoms you have and to support you and your family throughout your treatment. Find out more information about palliative care.

Side-effects from treatment

The type of side-effects from treatment you get will depend on the type of treatment, the dose, the duration and your own general health. Some treatments may cause symptoms such as:

  • Less resistance to infection
  • Nausea
  • Loss of appetite
  • Hair loss

Many treatments for cancer can cause fatigue. Your doctor will discuss any likely side-effects before treatment. Remember most side-effects are temporary and will eventually go away after you finish your treatment.

Clinical trials for lung cancer

If a treatment looks like it might be helpful, it is given to patients in research studies called clinical trials. Trials may be taking place at the hospital you are attending.

If you are interested in taking part, talk to your doctor. He or she can tell you if the trial would suit you or not.

Clinical trials in Ireland

You can ask your doctor or nurse in your hospital and they will let you know about the availability of clinical trials. You can also find out what trials are available in Ireland by contacting Cancer Trials Ireland who co-ordinate cancer clinical trials. Cancer Trials Ireland has produced a short video on clinical trials in Ireland.

Sometimes clinical trials are run involving the hospital consultant and a pharmaceutical company directly. Ask your doctor about this.

Useful organisations and websites:

Note: Links to external websites listed on this page. The Marie Keating Foundation is not responsible for the contents of external websites.

Irish information

Cancer Trials Ireland
The organisation that brings cancer clinical research to Ireland
Tel: 01 6677211 / Email

Health Research Board
Tel: 01 234 5000
Fax: 01 661 2335 / Email

Health Products Regulatory Authority
Tel: 01 676 4971 / Email

The Irish Platform for Patient Organisations, Science and Industry (IPPOSI)
Clinical trial information, including information specifically for children.

Department of Health
Website: Department of Health

HSE
Website: Health Service Executive

International information:

IFPMA
Website: International Federation of Pharmaceutical Manufacturers Association

NCI
Website: National Cancer Institute clinical trials

EU Clinical Trials Register
Website: EU Clinical Trials Register