Lung Cancer Treatments and Medications

What is lung cancer?

Lung cancer is a cancer of the lungs, the chest organs responsible for breathing in oxygen and breathing out carbon dioxide. It is the third most commonly diagnosed cancer in the United States and the leading cause of cancer-related deaths. More people die of lung cancer than prostate, breast, brain, and colon cancer combined.

How is lung cancer diagnosed?

Diagnosing lung cancer is a complex, multi-step procedure that involves identifying the cancer, determining the type of cancer, the stage it has advanced to, and a functional evaluation to determine the patient’s suitability for treatment. The result will be a complete treatment plan, so arriving at a diagnosis involves a team of cancer center doctors, including a pulmonologist (lung doctor), radiation oncologist, medical oncologist, radiologist, pathologist, and a thoracic surgeon.

Lung cancer screening

Patients at high risk for lung cancer will be regularly screened. The highest-risk group are smokers over the age of 55, but smokers with other risk factors, such as exposure to environmental toxins, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, or exposure to environmental toxins will also be screened. Screening consists of a low-dose computed tomography (CT) scan of the lungs to catch a tumor in its earliest stages.

Lung cancer symptoms

The majority of patients, however, are diagnosed at more advanced stages when symptoms begin to appear. There are no specific lung cancer symptoms, but a healthcare provider will suspect lung cancer if the patient has:

• Coughing
• Coughing up blood
• Chest pain
• Difficulty breathing
• Hoarseness

• Loss of appetite
• Involuntary weight loss
• Shoulder pain
• Muscle weakness
• Arm pain
• Bone pain
• Drooping eyelid
• Pinpoint pupil in one eye
• Severe headache
• Confusion
• Loss of coordination
• Vision problems

Diagnosis

Once lung cancer is suspected, a team of doctors will work on the diagnosis. An initial chest X-ray may be performed, but the doctor is more likely to use a CT scan of the chest. Several blood tests will be performed. If you are coughing up sputum, then a sample of sputum will be examined under the microscope to identify cancer cells, a procedure called sputum cytology.

Evaluation

The next step is to nail down the nature of the cancer and how far it has advanced, called staging. Here are the steps:

• A positron emission tomography (PET) scan will evaluate the metabolic activity of the cancer cells to help determine how to treat the cancer. An MRI (magnetic resonance imaging) scan may also be performed to get a full picture of the cancer within the lungs or the rest of the body, such as the bones or brain.
• A sample of the cancerous tissue, called a biopsy, will be removed to be studied by a pathologist to determine the type of lung cancer. This tissue can be removed through bronchoscopy, in which a long flexible tube is inserted through the mouth into the lungs to remove sample tissues, or through needle aspiration, in which a needle is inserted through the chest to draw out cancerous tissues.
• A lymph node biopsy will often be required. To get a sample lymph node, a thoracic surgeon will perform a mediastinoscopy. Surgical tools are inserted through a tiny cut to remove lymph node tissues.
• Finally, doctors will evaluate the patient’s fitness for surgery, radiation treatment, and chemotherapy.

Staging

The cancer care team uses diagnostic information to determine the cancer’s stage and the most appropriate treatment. Lung cancer is assigned to one of five stages. Stage 0 is a tumor that has just formed while stage IV is advanced lung cancer that has spread to other organs in the body. Small cell lung cancer, however, is typically divided into two stages: limited stage and extensive stage.

Surgery

Surgical removal of the cancer by a thoracic surgeon is the first-line therapy for early-stage lung cancer. Surgery may involve removal of a small, early-stage tumor (wedge resection or segmentectomy), removal of one lobe of a lung (pulmonary lobectomy), or removal of an entire lung (pneumonectomy). Lung cancer surgery may be preceded by radiation therapy to reduce the size of the tumors. Additional treatment often given after the surgery—called adjuvant treatment—will involve chemotherapy and possibly radiation therapy to eradicate any remaining cancer cells.

Radiation therapy

Radiation therapy kills cancer cells by bombarding them with high-energy X-rays, gamma rays, or charged particles. A certain type of oncologist, or cancer doctor, known as a radiation oncologist will perform radiation therapy to shrink tumors before surgery or eradicate any remaining cancer cells after surgery. Most lung cancer patients will also receive radiation therapy to keep the cancer from spreading to the brain or other parts of the body.

Medications

Chemotherapy—medicines that kill fast-growing cells like cancer cells—is the standard adjuvant treatment after surgery for early-stage non-small cell lung cancer. Chemotherapy along with radiation treatment is the first-line treatment for limited small cell lung cancer. In cases where the cancer cells have a particular genetic mutation, targeted therapy or immunotherapy drugs may be used in addition to chemotherapy. Later stage lung cancer is treated with drugs alone or in combination with radiation treatment.

Lung cancer medications

Lung cancer medications are used either as a follow-up to surgery or as the primary treatment for inoperable lung cancer. Chemotherapy is the standard drug treatment, but newer cancer drugs that specifically target cancer cells or use the immune system against cancer cells may be used in certain cases.

Chemotherapy

Chemotherapy uses drugs that kill fast-growing cells in the body, such as cancer cells. Both the type of drug and regimen will depend on the type of lung cancer, its stage, and the patient’s ability to tolerate the drugs. Chemotherapy may be used before surgery to shrink the size of a tumor or after surgery to eradicate any remaining cancer cells.

Targeted therapy

Targeted therapy drugs focus on specific proteins on cancer cells that trigger their growth. These drugs only work on cancer cells with specific genetic mutations. Not all lung cancer cells have these mutations, so targeted therapy doesn’t work for all lung tumors. For this reason, identifying mutations is a critical part of a lung cancer diagnosis. In addition to chemotherapy, patients who have lung cancer with the EGFR mutation will also be given Tarceva (erlotinib), Gilotrif (afatinib), or Iressa (gefitinib), while patients with the ALK mutation will get Xalkori (crizotinib), Zykadia (ceritinib), or Alecensa (alectinib). All are powerfully effective cancer drugs that “turn off” proteins, called tyrosine kinases, that signal tumor cells to grow.

Monoclonal antibodies

Monoclonal antibodies are a type of targeted therapy that uses synthetic antibodies. For lung cancer of all stages, Avastin (bevacizumab) is commonly used along with chemotherapy. Avastin blocks a protein called VEGF that signals healthy cells to grow blood vessels. As tumors grow, they need blood vessels to feed them oxygen and nutrients. Avastin blocks the growth of new blood vessels, so tumor cells die from lack of oxygen.

Immunotherapy

For later-stage lung cancers, intravenous immunotherapy agents are used in addition to chemotherapy. These drugs, which include Opdivo (nivolumab), Keytruda (pembrolizumab), and Tecentriq (atezolizumab), are called “checkpoint inhibitors.” Immune cells are an important part of the fight against cancer. They normally attack and kill cancer cells. However, immune cells have an “off” switch called a checkpoint. Cancer cells can produce substances that attach to checkpoints and essentially put the immune cells to sleep. Checkpoint inhibitors are synthetic antibodies that attach to the “off” switch on immune cells. By keeping immune cells “on,” these drugs fire up the immune system to kill cancer cells.

What is the best medication for lung cancer?

Lung cancer medications are determined by the type of cancer, the cancer’s stage, response to treatment, and tolerance of side effects. Physicians follow well-established medication guidelines, so there is no “best” medication for lung cancer, just the most appropriate combination of drugs for the situation.

What are the common side effects of lung cancer medication?

Side effects are commonly experienced by people taking lung cancer medications. These side effects can be severe. Cancer medication side effects vary both in type and severity, depending on the medication and the unique situation of the patient. This is not a complete list of possible side effects, so consult with a healthcare professional about any concerns with possible side effects.

What is the best home remedy for lung cancer?

Lung cancer can only be treated with surgery, radiation treatment, and medications. Unfortunately, there are no natural or home remedies. On the other hand, lung cancer treatment is difficult, so the right kind of home treatment can help patients succeed with medical treatment.

Follow the discharge instructions

The most important home remedies are listed on discharge instructions. A printed version always accompanies release after surgery or radiation treatment, but a healthcare professional will go over every aspect of these instructions. Follow these instructions. They will make treatment easier to bear and more likely to succeed.

Avoid infections

Nearly all lung cancer treatments—including surgery—leave you vulnerable to infections. Here are some ways to avoid infection:

• Practice safe hygiene
• Wash your hands regularly
• Take daily showers
• Avoid people who are sick
• Wear a mask and practice social distancing when outside
• Wash and cover any surgical wounds
• Check surgical wounds for any signs of possible infection including redness, swelling, or drainage

Keep all follow-up appointments

Lung cancer treatment is a long-term, and possibly a lifelong, project. Your cancer care team will schedule treatment and monitoring appointments over several months or even years. These appointments and treatments are key to getting through the illness.

Eat a nutritious diet

Loss of appetite, nausea, diarrhea, and weight loss are common effects of lung cancer treatment. Do the following to keep the body healthy through treatment:

• Eat highly nutritious foods
• Eat small meals spaced evenly throughout the day
• Bland foods are best
• Consider eating pureed or liquefied foods if it’s too hard to keep down solid foods

Drink fluids and replace electrolytes

Both diarrhea and vomiting are experienced by most people after surgery, radiation treatment, or during chemotherapy. Dehydration and loss of electrolytes will only make the situation worse, so drink fluids throughout the day. Drinking small amounts of fluids may be easier to keep down than big helpings. To make up for lost electrolytes, include broth or electrolyte drinks as part of your daily fluid intake.

Can you be cured of lung cancer?

Early-stage lung cancer can be cured with surgery, radiation therapy, or medications.

Can lung cancer be cured naturally?

Lung cancer does not naturally go away on its own. Natural and herbal remedies have not been shown to have any effect on lung cancer.

Is lung cancer curable if caught early?

Early-stage lung cancer can be cured. However, lung cancer typically has no symptoms until the cancer has reached advanced stages. If lung cancer is caught early enough, however, a little more than half of people survive for five years with treatment.

Is banana good for lung cancer?

Getting proper nutrition and sufficient calories is a challenge for people undergoing radiation treatment, lung surgery, and chemotherapy. The best advice is to consume high-calorie drinks, eat highly nutritious bland foods such as bananas, and consume several small meals a day rather than two or three big ones.

How long can you live after being diagnosed with lung cancer?

The earliest stage (IA) of non-small cell lung cancer has a five-year survival rate of 78% while the next earliest stage (IB) has a five-year survival rate of 53%. Less than half of patients diagnosed with stage II lung cancer will survive for five years. Stage IV non-small cell lung cancer, the most advanced stage, is incurable; only 1% to 3% of patients survive for five years. The five-year survival rate for extensive small cell lung cancer, the fastest-spreading lung cancer, is close to zero.

What food kills cancer cells? / What are the best foods to fight lung cancer?

No food can fight or cure lung cancer. By the time cells in the lung are cancerous, the cancer-fighting substances in many foods such as cruciferous vegetables, ginger, and garlic accomplish little in fighting off the tumor. However, all of these foods may be effective at preventing cancer, since they contain substances that can shut down precancerous cells before they become a problem.

What are the short-term and long-term effects of lung cancer?

Lung cancer treatment typically causes digestive system problems, bleeding problems, fatigue, weight loss, and infections in the short term. Major organs, such as the liver, kidney, and digestive system may be damaged. Most importantly, lung cancer treatment significantly reduces lung function. Look at it this way. If you could roll out all the surfaces in the lungs that absorb air into the bloodstream, you would get a flat sheet about 240 square feet in size . . . about the size of a bedroom floor. The standard surgical procedure for early-stage lung cancer, a lobectomy, will eliminate about 50 square feet of that surface. A more radical pneumonectomy will remove 120 square feet (which is half). Radiation will burn and kill off more. Because 90% of lung cancer patients are long-term smokers, much of the lung’s surface is already ruined. That is what lung cancer treatment does.

What is the most effective treatment for lung cancer?

For early-stage lung cancer, the central treatment is to remove cancer surgically by removing a part of a lung (lobectomy) or an entire lung (pneumonectomy). Radiation treatment or chemotherapy may be used before the surgery to reduce the size of the tumors. In any case, both radiation treatment and chemotherapy will be used after the surgery to ensure all cancer cells have been eliminated.

How bad is chemo for lung cancer?

Chemotherapy is difficult. There is no gentle way to say it. Chemotherapy drugs target fast-growing cells. Cancer is caused by fast-growing cells, so that’s good. However, the digestive system, hair follicles, and blood-making cells in the bone marrow are also fast-growing cells, so they get strongly affected by chemotherapy, too. Nearly every patient will experience digestive system problems, such as diarrhea, vomiting, and abdominal pain. Most people find it hard to eat and many lose their appetite. Because hair follicles cause hair to grow, chemotherapy damaging the follicles results in hair loss. Finally, bone marrow makes our blood cells. White blood cells are particularly hard hit. These are the blood cells that fight off bacteria and viruses, so people on chemotherapy are vulnerable to infections. Anemia and bleeding problems also result from bone marrow suppression. However, as hard as it is, thousands of people get through chemotherapy and beat lung cancer.

How do you get rid of lung cancer?

Lung cancer is treated by some combination of surgery, radiation treatment, chemotherapy, targeted therapy, and immunotherapy. The best way to get rid of lung cancer, however, is to never get it in the first place. In nine out of ten cases, lung cancer is avoidable. Just don’t smoke. People who don’t smoke can further reduce their risk by buying a radon detector for their home and keeping their windows open.

How do you starve cancer?

It is well-known that cancer cells use a lot of sugar to support their hyperactive metabolism. However, no research has definitively shown that sugar-free, carbohydrate-free, or ketogenic diets affect cancer survival. However, some diets may help make certain chemotherapy drugs more effective. On the other hand, it is equally true that most patients do not get enough nutrition during cancer treatments, a result of side effects such as diarrhea, vomiting, and loss of appetite. Poor nutrition and involuntary weight loss can significantly affect cancer survival for the worse. Unless an oncologist or dietitian on your cancer care team advises or prescribes a specific diet, the best diet for cancer is a highly nutritious one.

Related resources for lung cancer

• Beyond Sugar: What Cancer Cells Need to Grow
• Cancer, Lung
• Lung Cancer (American Cancer Society)
• Lung Cancer (CDC).
• Lung Cancer: Diagnosis, Treatment, Principles, and Screening
• Lung Cancer Fact Sheet