What Is The Best Treatment For Lung Cancer?

Lung cancer is serious. It is one of the most common types of cancer worldwide and the leading cause of cancer deaths. 

It affects your ability to breathe, reducing the amount of air you can take in and distribute to the rest of your body. Once it has taken hold of your lungs, it easily moves to the rest of your body. 

Lung cancer presents with coughing, wheezing, shortness of breath and chest pain. As the condition progresses, it can lead to a loss of appetite, weight loss and persistent fatigue. Because these symptoms are also associated with many other respiratory conditions, lung cancer can often go undetected - which is unfortunate because the earlier it is diagnosed, the better the chances of treating it. 

What Is Lung Cancer?

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common type, accounting for the majority of lung cancer cases. SCLC is less common, but more aggressive, with diagnosis typically occurring after the cancer has spread and most commonly found in smokers.

It is called small cell lung cancer because of the way the cells look under a microscope. They are smaller than non-small cell lung cancer and they have different growth patterns. 

It is important to make the distinction between non-small cell lung cancer and small cell lung cancer during diagnosis because their treatment is approached differently. SCLC typically responds well to chemotherapy and radiation therapy, while NSCLC may also be treated with targeted therapies and immunotherapies, depending on the specific characteristics of the tumour.

How Is Lung Cancer Diagnosed?

During diagnosis and staging, where your care team assesses the severity of the disease, your doctor will request a series of tests, including: 

• Lung function tests
• Blood tests
• Imaging tests (such as a chest x-ray, CT scan, or PET scan)
• Sputum cytology
• Bronchoscopy
• Mediastinoscopy, or thoracoscopy
• Biopsy 

If you have non-small cell lung cancer, your doctor might want to test for certain gene mutations, as these mutations could respond to targeted cancer drugs. 

How Is Lung Cancer Treated?

There isn't a one-size-fits-all approach for treating lung cancer - your treatment will be tailored to your condition. Your care team will consist of doctors from different departments, including pulmonologists, surgeons, and oncologists, all working together to give you the best possible outcome. 

Surgery For Lung Cancer

Surgery is often the preferred treatment for early-stage NSCLC. Patients who have advanced-stage lung cancer or other medical conditions may not be candidates for surgery. There are several types of surgical treatments for lung cancer, all of which will be conducted by a specialist surgeon.  

• Segmental or Wedge Resection: Removing a small part of the lung when the tumour is limited to one area.
• Sleeve Resection: Removing a piece of the bronchus and reattaching the lung to the remaining bronchus. 
• Lobectomy: Removing an entire lobe of the lung, when the cancer is restricted to only one section of the lung.
• Pneumonectomy: Removing an entire lung when the cancer has spread extensively through the lung or is located centrally. If the remaining lung is healthy, it is possible to breathe normally with just one lung.
• Nearby lymph nodes might also have to be removed (lymphadenectomy, or lymph node dissection) if the cancer is believed to have spread to them. 

Radiation Therapy For Lung Cancer

Radiation therapy, or radiotherapy, is a type of cancer treatment that uses high-energy radiation to kill cancer cells in a specific area. In the treatment of lung cancer, radiotherapy is often given with or after chemotherapy. The most commonly used type of radiotherapy for lung cancer is external radiation, which is delivered via a machine outside of your body. 

Depending on whether it is a safe and appropriate option, prophylactic cranial irradiation may be recommended for some patients with small cell lung cancer. Because small cell lung cancer is so aggressive, it commonly metastasises (spreads to) the brain. Prophylactic cranial irradiation destroys cancer cells that may have spread to the brain, or more commonly as a preventative measure to prevent this from happening.

Chemotherapy For Lung Cancer 

Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. In SCLC, chemotherapy is the most common treatment approach, often with radiotherapy if the stage is not advanced, or with immunotherapy as a palliative approach in advanced cases.  In NSCLC, chemotherapy is also one of the main treatment options, alongside targeted therapy and immunotherapy.

Targeted Therapy For Lung Cancer

Targeted therapy is a treatment that interferes with how cancer grows and spreads, and can be used to treat non-small lung cancers that have certain genetic mutations or abnormalities. Your doctor can find out if the mutation is present by doing a biopsy.

Immunotherapy For Lung Cancer

Immunotherapy involves using the patient's immune system to fight cancer, using drugs to help the immune system identify and attack cancer cells. A few immunotherapy drugs have been approved for certain non-small lung cancers. 

If a patient does not have a mutation that can be targeted by targeted therapy, immunotherapy with or without chemotherapy is usually the recommended treatment approach.

What Can I Do?

Quit smoking. 

Any amount of smoking increases your risk of getting lung cancer. Quit, even if you have already been diagnosed. Smoking damages your lungs and it is important to have the best lung function possible before and after receiving treatment. Treatment can cause further lung damage, and there is a higher chance of recurrence if you smoke. 

If you suspect that something might be wrong, consult with your doctor. Early detection of lung cancer can save your life.