Lung Cancer Treatment Options

The first goal of lung cancer treatment is to remove the tumor, or tumors, from the body. The second goal is to make sure the cancer won’t return. Washington University Physicians at Siteman frequently use a combination of surgery, radiation, and chemotherapy to achieve this. Some patients with recurrent or metastatic lung cancer may be treated with targeted therapies and immunotherapies as well.

Though lung cancer is often caught in its later stages and can be difficult to treat, patients who come to Siteman have a number of advantages in their favor.

Lung cancer patients find hope through clinical trials examining new drugs or forms of treatment. Siteman offers more clinical trials than any other center in the region, many of them organized and led by Washington University Physicians and scientists. This means that if a trial is your best option, your care team will be well-placed to find one that is a match for you.

In addition, our exceptional Washington University surgeons use sophisticated methods that are less risky for you.

Surgery for lung cancer

Many patients with non-small cell lung cancer undergo surgery to remove the cancerous tissue. Depending on the stage and extent of your cancer, surgery may be all that is needed to treat you.

During lung cancer surgery, the surgeon will remove the cancerous tumor from your lung. You’ll undergo a procedure that best matches the size and extent of your tumor. A wedge resection, for instance, removes only the tumor and a clear margin of tissue around it. If the cancer has spread further, the surgeons may have to remove a lobe of the lung (a procedure called a lobectomy) or even the entire lung itself (a pneumonectomy).

The dedicated chest surgery unit at Siteman Cancer Center sees more patients than many other facilities in the country. Our surgeons are skilled at using advanced techniques to limit the amount of tissue they have to remove. Sometimes, they may be able to help patients by performing a sleeve resection, a novel procedure for cancers located in the main bronchus, or air tube. To do this, they take out the cancerous portion of the bronchus and reconnect the ends.

Importantly, we also offer minimally-invasive and robotic procedures that reduce the amount of stress on the body and allow patients to recover more quickly.

Read about Siteman’s approach to robotic lung lobectomies.

Radiation therapy for lung cancer

Radiation therapy for lung cancer can eliminate or shrink the tumor.  It can be delivered as external radiation beams from outside the body, or through a radiation source implanted in the tumor. Sometimes, radiation is given to control a tumor that can’t be cured in order to increase the patient’s comfort.

In some cases, radiation therapy is the only treatment that patients will need. However, it may also be given in combination with surgery and/or chemotherapy.

Explore Siteman’s radiation therapy options.

Chemotherapy for lung cancer

Chemotherapy kills cancer cells with drugs that can be administered either orally or intravenously.

Many patients with lung cancer receive chemotherapy, especially those with more advanced disease. Chemotherapy can be critical in the treatment of small cell lung cancer, since it often cannot be removed surgically.

When will I receive chemotherapy?

The timing of chemotherapy differs for every patient. If a patient’s tumor is larger, he or she might receive chemotherapy to shrink the tumor before undergoing surgery. This is called “neoadjuvant chemotherapy,” and it can make surgery more successful. It can also lead to better outcomes overall because the chemotherapy helps eliminate any cancer cells that have spread beyond the tumor, reducing the chance that the cancer will come back.

In other cases, patients receive chemotherapy after surgery, or “adjuvant chemotherapy.” The goal of adjuvant chemotherapy is to kill any cancer cells remaining in the body. This makes it more difficult for the cancer to return.

What is it like to receive chemotherapy?

Lung cancer patients undergo chemotherapy in cycles that range in length from days to weeks. Each cycle consists of treatment days, when the chemotherapy is administered, and rest days, which give the patient time to recuperate and adjust to the medicine.

Many lung cancer patients receive chemotherapy as an IV infusion at a treatment center. At Siteman, specialist nurses will make sure you are comfortable during your treatment sessions and monitor you for any side effects.

What are the side effects of chemotherapy?

Chemotherapy drugs have to be very strong in order to attack cancer cells. This can lead to a number of challenging side effects for patients, including:

  • Fatigue
  • Nausea and/or vomiting
  • Diarrhea
  • Weight loss
  • Loss of hair
  • Sores in the mouth

If you are experiencing any side effects, or are concerned about potential side effects, it’s important to speak to your care team. Many of these symptoms can be treated or prevented with medications.

At Siteman, your comfort is our priority. We want to know if you are feeling unwell so we can help you feel better.

Chemotherapy can also disrupt the production of blood cells in your bone marrow, leading to low blood counts. This makes chemo patients more susceptible to infections, bleeding, and bruising. It’s important to be careful with yourself and reduce your exposure to germs as much as possible while receiving chemotherapy. Your care team will let you know what precautions to take.

Immunotherapy for lung cancer

Immunotherapies are a new type of cancer treatment. Instead of attacking cancer cells, they help the immune system learn to recognize and kill malignant cells on its own. They are medications and are given as IV infusions.

Because immunotherapies don’t target cancer cells directly, they tend to be easier for patients to take than chemotherapy.

There are several different kinds of immunotherapy. The immunotherapy drugs currently approved to treat lung cancer are a particular type called “checkpoint inhibitors.”

Checkpoints are molecules on white blood cells, the immune system’s main line of defense. When triggered, they hold the white blood cells in check, stopping them from attacking other cells.  Some lung cancer cells use checkpoints to their advantage and disable white blood cells by turning on or engaging these checkpoints. Checkpoint inhibitors block the checkpoints, allowing the white blood cells to carry out their function and destroy cancer cells.

While checkpoint inhibitors have become standard of care for lung cancer patients, Siteman also offers clinical trials exploring other types of immunotherapy for use against lung cancer, including bi-specific antibodies and T cells.

Siteman Cancer Center is a national leader in immunotherapy research and development. Learn more about immunotherapy at Siteman.

Targeted therapy for lung cancer

As their name implies, targeted therapies attack specific vulnerabilities in cancer cells. By attacking these vulnerabilities, they aim to prevent the cancer from multiplying and keep it under control.

For targeted therapies to be effective, the tumor must be thoroughly tested for targetable genetic changes or features. Washington University Physicians at Siteman are leaders in understanding tumor genomics and are examining how genetic changes could be better targeted in clinical trials. This research is particularly important for lung cancer patients who have never smoked.

Patients usually receive targeted therapies as pills.