Treatment Options for Non-Small Cell Lung Cancer
Lung cancer is the second-most common type of cancer affecting men and women in the United States. There are two types of this disease: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Most diagnosed lung cancers—approximately 85%—are NSCLCs.
Non-small cell lung cancer usually progresses more slowly compared to small cell lung cancer. Either way, you’ll need to carefully understand your treatment options after you’ve received a diagnosis. Once you’ve explored your options, have a conversation with your doctor about which treatments may work best. In many cases, lung cancer treatment can be personalized, especially if you have certain genetic markers or mutations. That means having a precise treatment plan formulated specifically for you.
NSCLCs result when abnormal cells in the lungs multiply and grow out of control. There are three types of NSCLC:
- Large cell carcinoma
- Squamous cell carcinoma
Most cases of NSCLC are adenocarcinomas, which form in the outer areas of the lung, in the cells lining the bronchioles, or small airways.
- Environmental pollution
- Exposure to cancer-causing chemicals in the workplace
- Family history of lung cancer
- Previous infection with human immunodeficiency virus (HIV)
- Radiation exposure
Symptoms can vary depending on the extent of the cancer in the lungs. You may experience:
- A cough that won’t go away or gets worse over time
- Chest pain
- Coughing up blood
- Loss of appetite
- Swelling in the face or neck
- Trouble breathing and swallowing
- Unexplained weight loss
Doctors usually diagnose NSCLC using certain imaging tests to evaluate your lungs. Your doctor may recommend a computerized tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or a positron emission tomography (PET) scan.
If your doctor diagnoses NSCLC, you do have options for treatment. In general, your treatment is likely to be based on whether or not cancer has spread, or metastasized, throughout or outside of the lungs. Also, your overall health, the presence of any genetic mutations, and your goals for treatment can help direct your treatment plan.
For some, surgery is the best option for removing as much of the cancer as possible. Usually, surgery is followed by another treatment, like chemotherapy. But surgery may not be an option for everyone. Instead, your doctor may recommend another therapy.
In addition to being used after surgery, doctors may suggest treatment with chemotherapy (chemo) along with other forms of treatment, like radiation therapy. When used before surgery, chemo may shrink lung tumors. Chemo is also beneficial if lung cancer has spread elsewhere in the body.
These medications harness the power of your body’s own immune system to identify and destroy cancer cells. Many of these drugs work as checkpoint inhibitors—that is, they prevent cancer cells from using a molecular switch that renders them unrecognizable to the immune system.
Radiation therapy may be used as a main treatment for NSCLC, or before or after surgery to help shrink lung tumors and kill any cancer cells still present. Radiation is also beneficial if lung cancer has already spread, especially to areas like the brain or bones. In some cases, doctors recommend radiation therapy to help relieve the symptoms of advanced NSCLC, such as pain, trouble swallowing, or bleeding.
Radiofrequency Ablation (RFA)
This treatment is usually reserved only for people who have small lung tumors near the outer edges of the lungs. Many of the people receiving RFA can’t undergo surgery for various reasons. RFA focuses high-energy radio waves to generate heat that ultimately destroys cancer cells.
Targeted therapy drugs are newer medications that work on specific changes, or mutations, occurring within genes. In some cases, targeted drugs also work to prevent the development of new blood vessels which may feed lung tumors. Others interrupt critical pathways that allow the tumor to proliferate unchecked.
The type of treatment you receive depends on your goals for treatment, your overall health, the confirmation of informative biomarkers (genetic mutations) and the extent of the disease. If you receive a NSCLC diagnosis, be sure to talk with your doctor about which treatments may be most beneficial for you.