Knowledge is power when it comes to coping with a cancer diagnosis. If you or someone you love has been diagnosed with lung cancer, you’ll probably find yourself doing a lot of research to learn about treatment methods.
At Parkview, we want to help you find information you need as you and your care team make choices about treatment. This section provides some overview information on lung cancer and available treatment options.
What is lung cancer?*
Lung cancer is the abnormal growth of cells in the lung, resulting in a lung tumor. If the abnormal cells originated as lung cancer cells, the resulting collection of cells is called a primary lung tumor. If the abnormal cells originated in another part of the body – such as the colon or liver – and were carried to the lungs by the blood or other bodily fluids, then the collection of cells is considered a metastatic lung tumor.
Lung cancer is the leading cause of cancer death in both men and women in the U.S. About 13 percent of primary lung tumors are considered small cell, including oat cell cancer, mixed small cell/large cell carcinoma and combined small cell carcinoma. The remaining 87 percent of lung tumors are classified as non-small cell, which includes squamous cell carcinoma, large cell carcinoma and adenocarcinoma.
How is lung cancer detected?
Lung cancer typically develops without early symptoms, so when symptoms do occur, the cancer is often advanced. A patient may see his or her physician for a persistent cough, coughing up blood, painful breathing or coughing, shortness of breath or other symptoms. Unfortunately, most primary lung cancers are diagnosed at late stages since symptoms do not usually appear in the early stages.
How is lung cancer treated?
Lung cancer treatment depends on the type and stage of cancer. Lung cancer can be treated with surgery, radiation and chemotherapy, and these are often combined to offer the most effective treatment. Options for treating a metastatic tumor depend on the stage of the primary cancer. The various lung cancer treatments are described in detail below.
Surgery, or surgical resection, is often used to remove a tumor. For early-stage lung cancer, the preferred treatment for otherwise healthy patients is a lobectomy, in which the surgeon removes the affected lobe of the lung. Lobectomies can be performed in two ways. One method is called a thoracotomy, in which the ribs are cut and spread to allow the surgeon to access the lobe of lung that needs to be removed. The second type of lobectomy is less invasive and is performed using video-assisted thorocoscopic surgery (VATS). During this procedure, small incisions are made so a camera can be placed in the chest to guide the actions of the surgeon. Some patients with early-stage lung cancer may not require that an entire lobe be removed. They undergo a procedure called a wedge resection, or segmentectomy, which can reduce the amount of normal lung tissue removed.
Radiation therapy, also referred to as radiotherapy, is a non-invasive procedure that uses radiation to kill lung cancer cells. Five-year survival rates for early-stage primary lung cancer patients undergoing this type of treatment have been reported in the range of 10-30 percent, which is lower than the survival rates of patients treated with surgery.
Respiratory gating is a technique in which radiation is delivered when the tumor is thought to be in a certain location during a patient’s breathing cycle. Gating makes a number of assumptions about the location of the lung tumor, such as: it is always in that same location during a specific point in a patient’s breathing pattern; a patient’s breathing pattern does not change throughout a treatment; and a patient is breathing the same during a treatment as he or she was breathing during the planning phase. In reality, many patients breathe differently throughout the treatment, particularly if they are nervous or fall asleep. These changes in breathing patterns may result in errors in radiation delivery.
Breath holding involves a patient’s taking a full breath and then holding it for several seconds. As the patient holds their breath, the radiation beam is switched on and then turned off just before the patient begins to breathe normally again. Breath holding assumes a tumor will be in a certain location when the patient inhales. This may not always be the case, depending on the depth of a patient’s breath. Breath holding also may be very difficult for patients with advanced lung disease.
Frames enable physicians to apply pressure to a patient’s abdomen to decrease the movement of the diaphragm and the chest cavity. Although frames reduce tumor movement within the chest, they do not completely eliminate it. This technique also can be uncomfortable and may be very restrictive for patients who have baseline breathing problems or advanced lung disease.
Chemotherapy is used when cancer cells are thought to be located throughout the body or they are present in a patient’s blood or other fluids (often the case with metastatic lung tumors and advanced-stage lung cancer). Chemotherapy medication is delivered orally or through an IV (into a vein), and is given to a patient either as the sole treatment or in combination with surgery or radiation. Chemotherapy affects both normal tissue and the cancer cells, so patients may experience side effects, such as severe nausea and vomiting, infections, fatigue and weight loss. Based on randomized clinical trials, chemotherapy is recommended in addition to local treatment for patients with later-stage disease. Disease-free five-year survival rates for patients treated with chemotherapy following surgery range from 48 to 89 percent, depending on how advanced the disease is.
Radiosurgery, such as treatment using the CyberKnife® Robotic Radiosurgery System, offers patients a different option for the treatment of lung cancer. The CyberKnife System is used to treat lung cancer patients who cannot tolerate surgery, have an inoperable tumor or are seeking an alternative to surgery. Unlike traditional radiation therapy, the CyberKnife System is able to precisely identify the tumor location as the patient breathes normally during treatment, and can be used, in some cases, to treat lung tumors non-invasively.
Learn more about CyberKnife for lung cancer treatment.
*Source material drawn from www.cyberknife.com. Please refer to that website for a complete listing of references used in the original information sections.
CyberKnife® is a registered trademark of Accuray Incorporated.