Lung cancer, according to the National Institutes of Health, NIH is the deadliest type of cancer in the U.S. It kills more people than breast cancer, colon cancer and prostate cancer combined each year in the U.S. There are two main types of lung cancer: the fast growing and spreading small cell lung cancer and the slower growing non-small cell lung cancer. Approach to treatment depends on the type, extent of spread and state of health of the patient.
Surgery
According to the American Cancer Society, ACS, surgery, where possible, offers the best treatment outcomes in early stages of lung cancer. During surgery, anywhere from the tumor and the immediate surrounding healthy tissue to the whole lung is removed. After surgery, usually patients receive chemotherapy and radiation therapy. The different types of lung surgery used in treating lung cancer include wedge resection, segmental resection, lobectomy, pneumonectomy and sleeve resection. A more recent approach, video-assisted thoracic surgery,VATS), minimizes hospital stay after lung surgery. Lobectomy is usually the treatment of choice in the few early stages of small cell lung cancer. Surgery performed during advanced and inoperable stages, can relieve discomfort and improve quality of life in some patients.
Radiation Therapy
Radiation therapy involves the use of high-energy radiation to kill the cancer cells. There are two approaches to radiation therapy in the treatment of lung cancer namely external beam radiation therapy, EBRT and internal radiation or brachytherapy. External beam radiation, according to the ACS, is the preferred approach in most cases of lung cancer. The standard EBRT are used less often, with newer technology like three-dimensional conformal radiation therapy, 3D-CRT, intensity modulated radiation therapy, IMRT and stereotactic body radiation therapy, SBRT providing better outcomes. Gamma Knife is a type of SBRT.
Brachytherapy or internal radiation involves the use of needles, catheters or wires to place the sources of radiation close to or within the cancer itself, usually with the help of a bronchoscope. Oncologists use radiation therapy before surgery, after surgery or without surgery in some cases. Brachytherapy relieves certain distressing symptoms especially in advanced cases.
According to the National Cancer Institute, NCI, in some cases, radiation therapy is delivered to the brain to prevent the spread of cancer to the brain. This is called prophylactic cranial irradiation, PCI.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells or stop them from growing. Chemotherapy is preferred in advanced cases and in small cell lung cancer where the possibility of a spread proves strong, no matter how early the stage. Oncologists usually combine two drugs for better outcomes used before or after surgery, in combination with radiation therapy, to relieve distressing symptoms like difficulty in breathing and pain. According to the ACS, drugs used in chemotherapy include etoposide, carboplatin, cisplatin, vinorelbine, gemcitabine, paclitaxel and irinotecan.
Targeted Therapy
According to MayoClinic.com, targeted therapy includes the use of newer drugs designed to target specific abnormalities in lung cancer cells. They have much fewer side effects than standard chemotherapy. The ACS reports that their use is currently restricted to combinations with chemotherapy or in cases where chemotherapy no longer works effectively. Drugs in this category include bervacizumab, erlotinib and cetuximab.
Other Treatment Methods
Other local treatment options, reserved for very small lesions or to relieve distress in advanced and inoperable cases, include laser treatment, photodynamic therapy and radiofrequency ablation, reports the ACS. A tube, called a stent, may be placed in a major airway to keep it open and allow the patient to breath easier. Complementary treatments including analgesics, food supplements and multivitamins, support the other different methods of treatment and alleviate discomfort and pain.
