Treatment depends on the size, type and stage of the tumour and on your own personal health.
Your doctor will decide the most suitable treatment that has the least side-effects and works best for you.
In general, there are three types of treatment used in the management of lung cancer. These are surgery, radiotherapy (X-ray treatment) and chemotherapy (treatment using drugs).
When deciding on the type of treatment, doctors will make the following decisions about your lung cancer:
- Is there is a chance of curing your cancer - that is, treating your cancer so it is highly unlikely that it will ever come back (curative treatment).
- If this is not possible, then the doctor will try to shrink the tumour and stop it from re-growing for as long as possible. Hopefully by doing this, any symptoms that your cancer is causing will be reduced/delayed (palliative treatment).
The following factors are all taken into account when deciding what treatment approach will be right for you:
The lung tumour
- Size of tumour: Bigger tumours are often more difficult to treat.
- Position of tumour: If the tumour is very close to the windpipe, major blood vessels or another vital structure, curative treatment may be difficult.
- Stage of the tumour: Doctors have to perform a variety of tests to decide the stage of your tumour. It may seem to you that these tests are delaying the start of treatment, but it is very important that the doctors give the treatment most suited to your tumour. Remember that everyone is treated as an individual, therefore no two people with lung cancer at the same stage, will be cared for in the same way.
- Spread of cancer: If the cancer has spread to lymph glands in the mediastinum (the area in-between the lungs) or other structures outside of the chest then curative treatment may be difficult.
- Type of lung cancer (e.g. small cell or non-small cell): Different types of lung cancer respond to different treatments.
- Overall lung health: If there is damage to your lungs from other illnesses (e.g. Chronic obstructive pulmonary disease – COPD) then certain treatments may be ruled out as they could result in a worsening of breathlessness.
- Presence of other illnesses: The presence of other illnesses may make the risks of certain treatments higher and this can help guide the decision on which therapy is best for you.
- Current symptoms: Certain treatments require a reasonable level of fitness to reduce the risk of side-effects. If general fitness is poor then these treatments may not be advisable for you.
- Acceptability of side-effects: There may be side-effects of treatment that would be unacceptable to some patients e.g. hair-loss. You should discuss possible side effects of therapy with your doctor before a decision on treatment is made.
Note: Age should not be a deciding factor when the above assessments are made.
Lung Cancer treatment options
Surgery: If the cancer has not spread widely (stages I and II), removing the tumour by surgery is the most common and effective form of treatment for non-small cell lung cancer. Surgery should be considered in all such patients and if surgery is not an option, patients should be offered an explanation as to why it is not possible. If the cancer has spread and surgery is not possible (this is more common in small cell lung cancer) then radiotherapy and chemotherapy are used (alone or in combination) to control symptoms by reducing the size of the tumour. In patients who develop collections of fluid within the chest, surgery can be used to control the fluid and improve breathlessness.
Chemotherapy is the general term for the treatment of cancer using drugs. The drugs that are used are designed to kill off cancer cells while causing less damage to normal cells. There are many different types of chemotherapy drugs which can be used on their own or, more commonly, in combinations. Patients with different types of lung cancer are likely to receive different combinations of chemotherapy drugs.
Radiotherapy is a general term for the treatment of cancer using x-rays. It is done by directing painless high-energy beams at the areas of the lung that need treatment. Radiotherapy works by killing cancerous cells and can be used either on its own or in combination with surgery and/or chemotherapy.
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