Controlling symptoms of non-small cell lung cancer

Apart from the symptoms which led you to see your doctor in the first place, new symptoms can sometimes develop during your illness, such as breathlessness  |or a cough. These may be caused by the growth or spread of the lung cancer to other parts of the body, but they may have another cause. For example, some lung cancer cells produce hormones which can upset the body’s chemical balance. If you have any new symptoms, tell your doctor straight away so that you can be given treatment for them, or perhaps be reassured that they are nothing to worry about.

Occasionally, cancer in the lung can cause fluid to build up between the layers that cover the lung (pleural effusion|). Your doctor can usually drain the fluid by inserting a needle (cannula) into the area. The needle is attached to a tube and the fluid passes into a drainage bag or bottle. Sometimes it’s possible to seal the two layers of the pleura together again using drugs or sometimes talc. This is known as pleurodesis.

Some people with lung cancer experience pain|. This can usually be well controlled using painkillers and other methods of pain control. People may have pain if the cancer has spread to the bones. A study is looking at the use of a drug, ibandronate, with radiotherapy to see if it helps relieve bone pain.

In addition to the treatments already mentioned in this section, there are some other treatments that can help to relieve symptoms.

Laser therapy Back to top

Lung cancer sometimes causes breathlessness by blocking the windpipe (the trachea) or one of the main airways that take air from the windpipe into the lungs. If the blockage is caused by a tumour within the airway, it can often be relieved by laser therapy, which burns the tumour out of the airway. Laser therapy does not destroy the tumour completely, but it can help to reduce or get rid of the symptoms.

Laser therapy is usually carried out under a general anaesthetic. A bronchoscopy| is done while you are asleep, and a flexible fibre is passed through the bronchoscope to aim the laser beam at the tumour. The laser beam burns away as much of the tumour as possible. The bronchoscope is removed and you are brought round from the anaesthetic. Usually the anaesthetic is a liquid given into a vein, and recovery from it is very quick.

There are not usually any side effects from laser therapy. If the treatment has been straightforward you may be able to go home the same evening or, more often, the next day. If you’ve had an infection in your lung, you may need to stay in hospital for a few days for antibiotic treatment and physiotherapy.

If the blockage in the airway comes back, laser treatment can be used again. Sometimes radiotherapy  |is given as well, to try to make the relief given by the laser therapy last longer.

Airway stents Back to top

Sometimes an airway can become blocked by pressure on it from the outside, which makes it close. This can sometimes be relieved using a small device, called a stent, which is put inside the airway to hold it open. The most commonly used stent is a small wire frame. It is inserted through a bronchoscope in a folded up position and as it comes out of the end of the bronchoscope it opens up, like an umbrella. This pushes the walls of the narrowed airway open.

Airway stents are usually put in under a general anaesthetic. When you wake up you will probably not be able to feel that it’s there, but you will be able to breathe more easily. The stent can stay in your lung permanently and should not cause any problems.

Blood vessel stents Back to top

Stents may also be used if a large blood vessel, called the superior vena cava, has become blocked by the cancer, causing a feeling of pressure in the upper body. This can usually be relieved by radiotherapy, or by putting a stent in the blood vessel to keep it open. In this case the stent is a small tube which is inserted through a small cut in the groin and passed up through the blood vessels to the chest. The stent can usually be put in under local anaesthetic, while you are awake.