Chemotherapy for non-small cell lung cancer

Why chemotherapy is given Back to top

Chemotherapy |is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of cancer cells.

In the treatment of non-small cell lung cancer, chemotherapy is sometimes given after surgery to reduce the risk of the cancer coming back. It also may help shrink tumours before surgery| or relieve symptoms if surgery is not possible.

How chemotherapy is given Back to top

Each cycle of chemotherapy may last a few days. After having chemotherapy you will have a rest period of a few weeks, which allows your body to recover from any side effects of the treatment.

Chemotherapy may be given to you in the outpatient department by injection into a vein (intravenously), or as tablets to take at home, but sometimes you will need to spend a night or two in hospital.

Doctors are always looking to improve the treatment of lung cancer, so you may be asked to take part in a clinical trial|.

The drugs used Back to top

There are over 60 different chemotherapy drugs. Those most commonly used to treat non-small cell lung cancer include:

• cisplatin
• carboplatin
• gemcitabine (Gemzar®)
• vinorelbine (Navelbine®)
• paclitaxel (Taxol)
• docetaxel (Taxotere®)

The drugs are often given in combination. For example:

• carboplatin and Taxol
• vinorelbine and cisplatin or carboplatin
• gemcitabine with cisplatin or carboplatin
• MIC (mitomycin, ifosfamide and cisplatin)

Side effects Back to top

Chemotherapy can cause unpleasant side effects. However, many people have few side effects, and those that occur can often be well controlled with medicine. The main side effects are described here, along with some of the ways they can be reduced.

Lowered resistance to infection

Chemotherapy can reduce the production of white blood cells by the bone marrow, making you more likely to get an infection|. This effect can begin seven days after treatment and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal before your next course of chemotherapy is due.

Contact your doctor or the hospital straight away if:

• Your temperature goes above 38ºC (100.5ºF)
• You suddenly feel unwell (even with a normal temperature).

You will have a blood test before each cycle of chemotherapy, to make sure that your blood cells have recovered. Occasionally it may be necessary to delay your treatment if your blood count is still low.

Bruising or bleeding

The chemotherapy can also reduce the production of platelets, which help the blood to clot. Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.

Anaemia (low number of red blood cells)

While having chemotherapy, you may become anaemic. This may make you feel tired and breathless|.

Feeling sick

Some of the drugs used to treat lung cancer may cause nausea (feeling sick) and vomiting. There are now very effective anti-sickness drugs (anti-emetics) to prevent or reduce nausea and vomiting|. Your doctor will prescribe these for you.

Sore mouth

Some chemotherapy drugs can make your mouth sore| and cause mouth ulcers. Regular mouthwashes can help to keep your mouth clean and relieve any soreness. Your nurse will show you how to use these properly. If you don’t feel like eating, you could try a diet of soft food or replacing some meals with nutritious drinks. Our section on eating well| might be of some help.

Hair loss

Hair loss| is another common side effect of some – but not all – chemotherapy drugs. Ask your doctor if the drugs you are taking are likely to make your hair fall out. Most patients are entitled to a free wig from the NHS and your doctor or nurse will be able to arrange for a wig for you. Some people prefer to use hats or scarves rather than a wig. If your hair does fall out, it will grow back over a period of 3–6 months.

Tiredness

You may feel tired| and have a general feeling of weakness. It is important to allow yourself plenty of time to rest.

Although they may be hard to bear at the time, these side effects will gradually disappear once your treatment is over.

Chemotherapy affects people in different ways. Some find they are able to lead a fairly normal life during their treatment, but many find they become very tired and have to take things much more slowly. Just do as much as you feel like and try not to overdo it.