Surgery, radiotherapy and chemotherapy may be used separately or together, to treat lung cancer. If you have non-small cell cancer and it has not spread, it may be possible to remove it with surgery, but the type of operation chosen will depend upon the size and position of the tumor. Removal of a lobe of the lung is called a lobectomy. Removal of a whole lung is called a pneumonectomy. If a very small amount of the lung is removed. This is called a wedge resection.
In small cell lung cancer surgery is very rarely used, as the cancer has usually spread to other parts of the body before being diagnosed. Chemotherapy and radiotherapy are usually more effective in treating small cell lung cancer. Radiotherapy treats cancer by using high-energy rays that destroy the cancer cells, while doing as little harm as possible to normal cells.
In non-small cell lung cancer, radiotherapy may be used as the main treatment, particularly where the cancer cannot be removed with an operation but has not spread. In small cell lung cancer when the cancer has not spread beyond the chest, giving radiotherapy after chemotherapy may improve the results. Radiotherapy may also be given to the head to reduce the risk of the cancer spreading to the brain.
Radiotherapy is given by aiming rays from outside the chest onto the lung. It can also be done internally by endobronchial radiotherapy or brachytherapy. This form of radiotherapy may be given if a tumor is blocking one of the airways or has made a lung collapse.
Another type of radiotherapy is called CHART (continuous hyperfractionated accelerated radiotherapy). A daily dose of radiotherapy is divided so that more than one treatment, or fraction, is given each day.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. In non-small cell lung cancer, chemotherapy may shrink the cancer for some people. Recently, in non-small cell lung cancer, chemotherapy has been used before surgery and radiotherapy to try and improve the results. This is called neo-adjuvant chemotherapy. It is also sometimes used at the same time as radiotherapy. This is called concomitant chemotherapy. Research trials are now going on to find out how best to use this combination of treatments. Chemotherapy is also sometimes used after surgery to reduce the risk of the cancer coming back.
Chemotherapy is the main treatment for small cell lung cancer. In many cases chemotherapy for small cell lung cancer will enable people to live for longer with better control of symptoms. Chemotherapy may be given on its own, or before radiotherapy.
Sometimes lung cancer causes breathlessness by blocking the windpipe (the trachea), or one of the main airways which take air from the windpipe into the lungs. If the blockage is caused by a tumor in the airway it can often be relieved by laser therapy, which burns the tumor out of the airway. On other occasions an airway can become blocked by pressure on it from the outside, causing it to close. This can be relieved using a small device called a stent, that is placed inside the airway to hold it open. The most commonly used stent is a little 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, pushing the walls of the narrowed airway open.
New ways to treat cancer of the lung are currently being researched, and this site should in no way be used as a definitive or complete guide to information and/or treatment. One new method being tried is the use of drugs which prevent the development of new blood vessels. A tumor needs a blood supply to grow and if a drug can prevent new blood vessels forming, this may stop the tumor growing. Drugs which have this effect are called angiogenesis inhibitors. One drug which is now being considered as a form of cancer treatment because it may have this effect, is thalidomide and trials using thalidomide are in progress.
Another new way of treating cancer which may be important in the future is gene therapy. This involves changing the genetic makeup of the cancer cell to alter its behavior so that it will no longer multiply to form a tumor. Work is at an early stage in the laboratory, but over the next few years this type of treatment may begin to be used to treat patients.
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