Treatment for lung cancer

In this video Dr Ranj is joined by Dr David Gilligan to take an in-depth look at lung cancer, exploring its symptoms, testing, stages and treatment options.

Treatment for lung cancer can include:

• surgery
• chemotherapy
• radiotherapy
• targeted therapy drugs
• immunotherapy drugs.

You may have more than 1 type of treatment. Some treatments may be given together, for example chemotherapy and radiotherapy. Or you may have different treatments, given one after the other.

The treatment you have will depend on:

• the stage of the cancer
• the type of the lung cancer
• the results of tests on the lung cancer cells
• your general health
• your treatment preferences
• how able you are to do everyday things – this is called your performance status.

When deciding on the best treatment for you, your cancer doctor checks your overall health. They also measure how well you can do ordinary daily activities. This is sometimes called your performance status. It helps you and your doctor think about how a treatment may affect your:

• ability to take care of yourself
• quality of life
• ability to do things that are important to you.

Doctors use different scales to help them to measure your performance status. They usually give a grade or performance score between 0 and 4.

A score of 0 means you are fully active and can do all the things you did before your cancer diagnosis. A score of 4 means you are spending most of your time in bed, needing full care.

You and your doctor can make decisions about which treatments are best for you, based on your performance score.

Your healthcare team want to make sure you get the most effective treatment. They need to make sure it is right for you, and that the risks do not outweigh the possible benefits.

Your cancer doctor and nurse will involve you in treatment decisions, so you can talk about your choices. They can also help if you need to make decisions about treatment.

Newer treatments are being developed. Your cancer doctor may talk to you about having treatment as part of a clinical trial.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

• Call the Macmillan Support Line for free on 0808 808 00 00.
• Chat to our specialists online
• Visit our lung cancer forum to talk with people who have been affected by lung cancer, share your experience, and ask an expert your questions.

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells. Most chemotherapy drugs are carried in the blood. This means they can reach cancer cells anywhere in the body.

Chemotherapy is used for both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). It is often the first treatment used for SCLC.

If lung cancer has not spread to other parts of the body, chemotherapy may be given with radiotherapy. This is called chemoradiation. You need to be well enough to have chemoradiation to cope with the side effects of both treatments.

Chemotherapy may be given before or after surgery for NSCLC. Some people may have chemotherapy with an immunotherapy drug before surgery.

Chemotherapy can be given together with radiotherapy (chemoradiation) for people who are unable to have or do not want to have surgery. It can also be given before or after radiotherapy.

If lung cancer is more advanced chemotherapy can be given with, or before or after targeted or immunotherapy drugs.

Chemotherapy can also be given to control lung cancer and relieve symptoms.

Targeted therapy uses drugs that target something in or around the cancer cell that is helping it grow and survive. There are different types of targeted therapy.

They may be used to treat locally advanced or advanced non-small cell lung cancer (NSCLC). The lung cancer cells will be tested to see if a targeted therapy may be suitable for you.

You might have a targeted therapy drug:

• on its own
• after or with chemotherapy
• after lung cancer surgery to reduce the risk of the cancer coming back – this is called adjuvant therapy.

You usually have targeted therapy drugs for as long as they are controlling the cancer. Some drugs might be given for a set length of time.

Tumour ablation treatments destroy cancer cells using:

• heat – this is called radiofrequency ablation
• microwaves – this is called microwave ablation
• laser light – this is called photodynamic therapy.

Doctors sometimes use these treatments to treat very early-stage lung cancers. They also use them to relieve breathlessness if the cancer is blocking an airway.