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 often combine 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.

Lung cancer is often caught in its later stages and can be difficult to treat. But 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 led by our experts. If a trial is your best option, your care team will be well-placed to find 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 the treatment you need.

During lung cancer surgery, the surgeon will remove the 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, the surgeons may have to remove a lobe or even the entire lung itself.

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 can help patients with a sleeve resection, a novel procedure for cancers located in the main airways. To do this, they take out the cancerous portion of the bronchus and reconnect the ends.

We also offer minimally invasive and robotic procedures that reduce stress on the body and allow for quicker recovery.

Read about Siteman’s approach to robotic lung surgeries.

Radiation therapy for lung cancer

Radiation therapy for lung cancer can destroy or shrink the tumor. It may be given in the form of external radiation beams from outside the body. It can also come from 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 along with with surgery and/or chemotherapy.

Explore Siteman’s radiation therapy options.

Chemo for lung cancer

Chemotherapy kills cancer cells with drugs that can be given by mouth or by IV.

Many patients with lung cancer receive chemo, especially those with more advanced disease. Chemo can be crucial in the treatment of small cell lung cancer, since it often can’t be removed with surgery.

When will I receive chemo?

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

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

What is it like to receive chemo?

Lung cancer patients undergo chemotherapy in cycles that range in length from days to weeks. Each cycle consists of treatment days and rest days. On treatment days, the chemo is given. On rest days, the patient has time to recover and adjust to the medicine.

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

What are the side effects of chemo?

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

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

If you’re dealing with side effects, or if you’re concerned about potential side effects, 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 during chemo.

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 killing cancer cells, they help the immune system recognize and kill cancer 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 chemo..

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

Checkpoints a part of 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 are able to disable white blood cells by “turning on” these checkpoints. Checkpoint inhibitors block the checkpoints, letting the white blood cells carry out their function and destroy cancer cells.

While these drugs have become standard of care, Siteman offers clinical trials on other immunotherapies for lung cancer. These include 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 points of weakness in cancer cells. By attacking these targets, they aim to prevent the cancer from growing and keep it under control.

For targeted therapies to be effective, the tumor must be thoroughly tested for targetable genetic changes or features. Our physicians are leaders in tumor genomics and are studying better ways to target genetic changes in clinical trials. This research is especially important for lung cancer patients who have never smoked.

Patients usually receive targeted therapies as pills.