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Today's Treatment Options For Lung Cancer
Lung cancer develops when normal cell function becomes interrupted, causing cells to divide and multiply uncontrollably. These cancer cells clump together to form a mass called a tumor.The two main types of lung cancer, small cell and non-small cell, are named after what they look like under a microscope.
Lung cancer is treated in several ways depending on the type of lung cancer and how far it has spread.
Surgery is a treatment option where doctors cut out the tumor and surrounding cancer tissue. Depending on the size and location of the tumor, they may remove a small part of the lung, a lobe, lymph nodes, or even an entire lung.
Radiation therapy uses high energy rays similar to an X-ray to kill the cancer. These beams focus on a specific area of the body to maximize the effect on cancer cells while minimizing injury to normal cells.
While surgery and radiation are localized to one area, chemotherapy is taken as pills or through an IV. Chemotherapy searches the entire body for tumor cells and is designed to shrink or kill that. Radiation and chemo are sometimes used together as chemoradiation.
Targeted therapy is another treatment that searches for cancer cells in the body. It is taken by pills and can be taken at home to block the growth, survival, and spread of cancer cells.
Immunotherapy is a new cancer treatment that stimulates the immune system's natural defenses to recognize and destroy cancer cells.
Small cell lung cancer is usually treated with radiation therapy, chemotherapy, or immunotherapy.
Non-small cell lung cancer can typically be treated with surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, or a combination of these treatments.
Choosing the treatment option that is right for you can be difficult. Your doctor can explore the treatment options available for your type of cancer and explain the risk and benefits of each. ","publisher":"WebMD Video"} ]]>
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Lung cancer develops when normal cell function becomes interrupted, causing cells to divide and multiply uncontrollably. These cancer cells clump together to form a mass called a tumor.The two main types of lung cancer, small cell and non-small cell, are named after what they look like under a microscope.
Lung cancer is treated in several ways depending on the type of lung cancer and how far it has spread.
Surgery is a treatment option where doctors cut out the tumor and surrounding cancer tissue. Depending on the size and location of the tumor, they may remove a small part of the lung, a lobe, lymph nodes, or even an entire lung.
Radiation therapy uses high energy rays similar to an X-ray to kill the cancer. These beams focus on a specific area of the body to maximize the effect on cancer cells while minimizing injury to normal cells.
While surgery and radiation are localized to one area, chemotherapy is taken as pills or through an IV. Chemotherapy searches the entire body for tumor cells and is designed to shrink or kill that. Radiation and chemo are sometimes used together as chemoradiation.
Targeted therapy is another treatment that searches for cancer cells in the body. It is taken by pills and can be taken at home to block the growth, survival, and spread of cancer cells.
Immunotherapy is a new cancer treatment that stimulates the immune system's natural defenses to recognize and destroy cancer cells.
Small cell lung cancer is usually treated with radiation therapy, chemotherapy, or immunotherapy.
Non-small cell lung cancer can typically be treated with surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, or a combination of these treatments.
Choosing the treatment option that is right for you can be difficult. Your doctor can explore the treatment options available for your type of cancer and explain the risk and benefits of each.
Lung Cancer In Non-smokers: Causes, Symptoms And Treatment
Lung cancer is a serious health complication that can cause long-term harm and even fatality in fact, according to the World Health Organization, lung cancer is the leading cause of cancer-related death around the globe but although smokers are at the most significant risk of contracting lung cancer, it is increasingly observed in non-smokers. Moreover, for smokers their risk of lung cancer increases every time they choose to smoke.
Lung cancer in non-smokers: Causes, symptoms and treatment (Shutterstock) Lung cancers are usually categorised into two main types: non-small cell carcinoma (NSCLC) and small cell carcinoma (SCLC). NSCLC is more prevalent between the two and tends to develop over a significant period of time, while SCLC is less common, although it is pretty aggressive.
Wrap up the year gone by & gear up for 2024 with HT! Click here So, what exactly is lung cancer?In an interview with HT Lifestyle, Dr Trinanjan Basu, Senior Consultant-Radiation Oncologist at HCG Cancer Centre in Borivali, shared, "The lungs are part of a person's respiratory system and are on each side of the chest. These two spongy organs help inhale oxygen and release carbon dioxide. It is called lung cancer when cancerous cells form in this organ and then spread to other body parts."
What are the causes of lung cancer?Dr Trinanjan Basu revealed, "Although there is no specific reason as to why a person can be diagnosed with lung cancer in the future, there are some risk factors that can increase the likelihood of this disease." Some of these risk factors include the following -
Dr Trinanjan Basu answered, "Secondhand smoke is another significant risk factor for lung cancer. It is the smoke from other people's cigarettes or cigars and the smoke they exhale. When a person who does not smoke inhales this, it is called secondhand smoke, which is another risk factor for lung cancer. Although laws have reduced exposure to secondhand smoke in public, steps must be taken to avoid breathing in secondhand smoke at home and work as far as possible. Further, secondhand smoke can also increase the risk of cardiac issues and stroke as well."
What are the symptoms of lung cancer?In many cases, lung cancer does not show any symptoms. According to Dr Trinanjan Basu, some classical early symptoms can include shortness of breath, a lingering or worsening cough, coughing up phlegm or blood, chest pain that worsens when breathing deeply, laughing or coughing and hoarseness. He added, "It also includes wheezing, weakness, fatigue, loss of appetite and weight loss, and even recurrent respiratory infections such as pneumonia or bronchitis. Once the lung cancer spreads to other parts of the body, additional symptoms may occur, which include lumps in the neck or collarbone, bone pain, especially in your back, ribs, or hips, headaches, dizziness, balance issues, numbness in arms or legs, jaundice, drooping of one eyelid and shrunken pupils, lack of sweat on one side of your face, shoulder pain and muscle weakness. Further lung cancer can also lead to other health problems like high blood pressure, high blood sugar and seizures."
How is lung cancer treated?The main goal of lung cancer treatment is to remove the tumour and cancer cells causing the disease. These can include surgery to remove the tumor and chemotherapy and radiation treatments to kill cancer cells. Depending on the specific case, specialists also recommend cancer treatments like targeted therapy and immunotherapy, although this happens at a later stage.
Dr Trinanjan Basu highlighted that the treatment for NSCLC varies from patient to patient, depending on the specific details of their overall health and stage of cancer at the time of diagnosis. The treatment options, depending on the stage of the lung cancer, include -
In most cases, cancer is entirely curable if detected at this stage.
Treatment For Lung Cancer
Treatment for lung cancer includes surgery, chemotherapy, radiotherapy, immunotherapy and other targeted therapy drugs. People may be offered one or more different treatments depending on the stage and type of lung cancer as well as their general health.
Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 87% of cases. NSCLCs can be broken down into 2 major sub-types: adenocarcinoma (sometimes referred to as non-squamous) and squamous cell carcinoma. With recent advances in scientific evidence, treatment for these subtypes is becoming increasingly different, with the identification of mutations in tumours being of particular importance in adenocarcinomas.
Small cell lung cancer (SCLC) is less common, accounting for around 12% of lung cancers. SCLC is an aggressive cancer which spreads at an early stage and so is nearly always advanced at the time of diagnosis, leading to limited curative-intent treatment options.
Adenocarcinoma is a cancer that starts in glandular cells, for example, ones that secrete mucus. These are often found in alveoli, the tiny air sacs in the lung.
Squamous cell carcinoma is a cancer that starts in squamous cells, which are thin, flat cells that line the airways.
SurgerySurgery for NSCLC has proven to be effective, with National Cancer Registration and Analysis Service (NCRAS) data showing that 45% of people with NSCLC were still alive 5 years post-surgery. Five-year survival rates for people with NSCLC who do not have surgery was 3%.
Over the last 10 years, surgery rates in NSCLC have doubled, from around 9% in 2006 to over 18% in 2017, exceeding the target of 17% set by the National Lung Cancer Audit (NLCA).
NICE recommends that people with non-small-cell lung cancer (NSCLC), who are well enough and for whom treatment with curative intent is suitable, should be offered a lobectomy (either open or thoracoscopic). It is encouraging that data from the National Lung Cancer Audit show that surgery rates for people with stage 1 to 2 lung cancer and a good performance status have increased from almost 52% in 2015 to almost 61% in 2017, though there does appear to be significant regional variation.
An open lobectomy (thoracotomy) is the removal of a lobe of the lung through a cut made around the side of the chest.
A thoracoscopic lobectomy is keyhole surgery, where a lobe of the lung is removed using several small incisions, guided by a camera. This is normally more suitable for smaller tumours.
Surgery rates for people with stage 1 to 2 lung cancer vary across the countryOverall surgery rates for NSCLC are increasing, but there is variation across the country
Chemoradiotherapy for NSCLCFor more advanced NSCLC, surgery or radiotherapy alone is often not appropriate as the cancer has spread too far for it to be possible or effective. Even for advanced cancers that have not spread too far the curative potential of radiotherapy alone is low. A chemotherapy regimen is often added to radiotherapy to control small clusters of cancer cells that have spread to other parts of the body. Additionally, many chemotherapy agents make the cancer more sensitive to the radiotherapy.
NICE recommends that chemoradiotherapy should be considered for people with stage 2 or 3 NSCLC when surgery isn't suitable or is declined.
Chemoradiotherapy for people with stage 3 NSCLC is steadily increasing. The National Lung Cancer Audit reports that 34% of people with stage 3A NSCLC and good performance status received treatment with chemotherapy and either radical radiotherapy or surgery in 2017.
Chemotherapy, radiotherapy and chemoradiotherapyChemotherapy is a whole-body treatment where drugs are used to kill cancer cells by disrupting their growth. For early stage cancer, it can be used to shrink a tumour before surgery, making it easier to remove or it can be used after surgery to reduce the risk of the cancer coming back.
For people with advanced lung cancer, chemotherapy can be used to stop the cancer from spreading further and help people live longer.
Radiotherapy uses high energy x-rays to destroy cancer cells to stop them growing and spreading.
Radiotherapy can be used in early stage NSCLC for people who cannot have surgery.
It can also be used after surgery if it was not possible to remove all the cancerous tissue. In late stage lung cancer, radiotherapy can be used to manage symptoms.
Chemoradiotherapy is a combination of chemotherapy and radiotherapy. This is generally offered to people with stage 2 or 3 NSCLC who are reasonably well as it can be difficult to tolerate the side effects of both treatments.
Systemic anti-cancer treatment for NSCLCSystemic anti-cancer treatments (SACT) include all treatments that are administered to the whole body, for example chemotherapy, immunotherapy and other medicines that disrupt the behaviour of the cancer cells. These treatments are more often used to treat advanced NSCLC. Clinical trials have demonstrated that people with advanced and incurable NSCLC can benefit from SACT, delivered to improve quality of life and to extend survival.
NICE has produced a number of recommendations relating to the treatment of NSCLC using targeted SACT and in March 2019 we published 2 algorithms for the treatment of squamous and non-squamous stage 3B and 4 NSCLC.
Baseline data from the NLCA show rates of SACT for people with advanced stage lung cancer (3B to 4) who have a good performance status are increasing, from almost 63% in 2016 to 66% 2017.
The Innovation scorecard estimates report is produced by NICE and published by NHS Digital. The report shows the trend in prescribing of NICE recommended first-generation (gefitinib and erlotinib) and second-generation (afatinib and osimertinib) tyrosine kinase inhibitors, which are indicated for the treatment of adults with locally advanced or metastatic epidermal growth factor receptor (EGFR) mutation-positive NSCLC.
Prescribing data indicates that the second-generation medicines have become a more popular treatment choice once available. Emerging evidence suggests that the second-generation medicines may be better in terms of prolonging progression free survival.
For the last 2 years, approximately 1,700 people in England received treatment each year with one of the EGFR targeted medicines.
Treatment for small cell lung cancerAround 30% of SCLC cases are detected at stage 1 to 3. For those detected early enough, treatment with curative intent is an option. NICE recommends that twice-daily radiotherapy with concurrent chemotherapy should be offered to people with limited-stage disease SCLC. NICE also says that surgery should be considered in people with early-stage SCLC.
The NLCA shows that treatment with curative intent for people with SCLC has increased. In 2017, 42% of people with stage 1 to 3 SCLC with PS 0 to 2 received multi-modality treatment with chemotherapy and radical radiotherapy or occasionally surgery, which is a year on year increase since 2015.
For SCLCs that are detected at a late stage, chemotherapy and radiotherapy can be used to improve quality of life and chances of medium-term survival.
NICE recommends that people with limited-stage SCLC should be offered 4 to 6 cycles of cisplatin-based combination chemotherapy and that people with extensive-stage SCLC should be offered a platinum-based combination chemotherapy.
Data from the NCLA show that the proportion of people with SCLC who receive chemotherapy has remained steady for the last few years at around 70%, which meets the NLCA's audit standard.
Changes in commissioningStereotactic ablative radiotherapy (SABR) is a type of radiotherapy used to treat cancers by directing narrow beams of radiation at the cancer from different angles. The tumour gets a high dose of radiation and the surrounding healthy tissues get a low dose, reducing the risk of damage to healthy tissue.
Oligometastatic disease occurs when cancer cells from the original (primary) tumour travel and form a small number of new (metastatic) tumours. SABR is not routinely commissioned for the treatment of oligometastatic disease and was selected by NHS England for the Commissioning through Evaluation (CtE), which is part of its Evaluative Commissioning Programme.
CtE enables a limited number of patients to access treatments that are not funded by the NHS but show significant promise for the future, while new clinical and patient experience data are collected. NICE is commissioned by NHS England to oversee individual CtE schemes. The updated policy which will contain a summary of the results of the CtE scheme will be published on the NHS England Specialised Commissioning document library once a decision has been made.
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