There are three major categories of lung cancer, and the use of chemotherapy depends on the type of lung cancer you have as well as many other factors, including stage, your age, and your overall health. In general, chemotherapy is used for each type of lung cancer as follows:
Non-Small Cell Lung Cancer
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for about 85 percent of all lung cancer cases. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of NSCLC. Chemotherapy is used to treat NSCLC:
- Before surgery (called neoadjuvant) to shrink the tumor
- After surgery (adjuvant) to help kill any remaining cancer cells
- Along with radiation therapy to treat tumors that can’t be surgically removed
- Alone, or with radiation therapy, as the primary treatment for advanced NSCLC
Small Cell Lung Cancer
Small cell lung cancer (SCLC) accounts for about 10-15 percent of lung cancer cases. This type of cancer tends to spread quickly throughout the body, so chemotherapy is typically part of the treatment plan to kill cancer cells throughout the body. Chemotherapy for SCLC also can be administered as:
- Chemoradiation: Chemotherapy is used along with radiation therapy for patients with limited stage SCLC.
- Primary Treatment: Chemotherapy is used alone as the main treatment for some patients with advanced stage SCLC.
Carcinoid tumors are the rarest type of lung cancers. Chemotherapy is typically not used to treat carcinoid tumors as they do not respond well to the drugs. Since most carcinoid tumors tend to grow slowly and do not tend to spread, chemotherapy drugs are not an ideal treatment. Chemotherapy is sometimes used for carcinoid tumors that have spread or are causing severe symptoms, or for unusual carcinoid tumors that are growing rapidly.
How Chemotherapy For Lung Cancer Is Administered
There are many different chemotherapy drugs available to treat lung cancer. Rocky Mountain Cancer Centers oncologists look at many factors when determining whether chemotherapy should be part of your treatment, what types of drugs to use, when to use them, and how long to use them. The type and stage of lung cancer is an important determinant in your treatment plan.
Chemotherapy for lung cancer is administered in cycles made up of treatment days and rest days. Depending on the type of drugs being used, your cycle may range from three to four weeks with treatments taking place the first one to three days and then about three weeks of rest. The number of treatment cycles you’ll need will depend on your individual cancer and treatment plan.
Chemotherapy for advanced lung cancer is usually repeated for four to six cycles, depending on how effective the treatment is and how well your body responds. Your doctor may recommend a different combination of drugs after that to keep the cancer from becoming resistant to treatment.
Your doctor also may recommend continuing chemotherapy after the initial cycles, even if your cancer has responded well to the chemotherapy. This type of chemotherapy is called maintenance therapy and some studies have found it to be effective in preventing recurrence.
Chemotherapy for lung cancer can be administered intravenously at one of our centers, or you may be given a type of chemotherapy that can be orally taken in pill or liquid form. If this is the case, you can have your prescription filled at Rocky Mountain Cancer Centers’ in-house pharmacy. Our specially trained pharmacists assist with prior authorizations, financial assistance, counseling, dispensing the drugs, following up, and refills.
Targeted Therapy For Lung Cancer
Some lung cancer patients treated at Rocky Mountain Cancer Centers may receive targeted therapies. Standard chemotherapy acts against all rapidly growing cells in the body including non-cancerous cells. In contrast, targeted therapies interfere specifically with the biological mechanisms driving the growth or spreading of only cancer cells. Targeted therapy drugs may be given alone as the primary treatment, or in combination with chemotherapy and/or radiation therapy as part of an all-out coordinated attack on the cancer.
Not all lung cancer patients are candidates for targeted therapy because targeted therapy drugs are specific to particular genetic characteristics in the cancer. To determine if a patient is a candidate, Rocky Mountain Cancer Centers tests patients to understand the unique genetic components of each patient’s cancer.
Immunotherapy For Lung Cancer
The use of immunotherapy has revolutionized the way we treat cancer. Immunotherapy drugs are used to help the body’s immune system kill cancer cells. There are several classes of immunotherapy drugs that work in different ways. The immunotherapy currently available to treat lung cancer all belong to a class called checkpoint inhibitors.
Your body’s immune system is programmed to attack any cells it perceives as foreign, or not normal. Cancer cells have found ways around this system by hiding from your body’s natural immune system or by weakening the immune system itself. Immune checkpoint inhibitors are medications that are given to allow the immune system to recognize and destroy the cancer cells.
Within the last few years, there has been rapid development of immunotherapies specifically for lung cancer. They have been demonstrated to be effective alone and in combination with chemotherapy or radiation. Recent studies have showed that certain patients can obtain a long-term response with immunotherapy. At Rocky Mountain Cancer Center, we send all lung cancer tissue for advanced testing to see if patients are a candidate for immunotherapy medications.
Side Effects Of Chemotherapy For Lung Cancer
Cancer cells are a type of cell that divide quickly—that is why cancer can spread throughout the body. Chemotherapy is designed to kill cells that divide quickly. Unfortunately, there are healthy cells that also divide quickly that are affected by chemotherapy, such as in the mouth, intestines and hair follicles.
When the chemotherapy attacks these healthy cells, it causes side effects. Not all patients will experience all side effects and everyone will experience differing levels of severity. It’s important to know that side effects have no relationship to how well the drugs are working. It’s also a relief for most patients to know that side effects end quickly after treatment stops.
The type of side effects and the timing are often quite predictable. And developments over the past several decades now allow us to combat side effects before they start and lessen the severity once they start. Our specially trained chemotherapy teams and supportive care staff can help you prepare for side effects.
In general, chemotherapy for lung cancer may cause these side effects:
- Chemobrain, which can include feeling forgetful or having trouble concentrating
- Nausea and vomiting
- Hair loss (Read about the scalp cooling method we offer to limit hair loss.)
- Loss of appetite
- Dry mouth, sore throat, and difficulty swallowing
- Dry skin
- Constipation or diarrhea
Targeted therapy is designed to spare healthy cells and usually causes fewer and less-severe side effects than chemotherapy. The most common side effects of targeted therapy for lung cancer are diarrhea and liver problems. Others include:
- Skin changes, including rash, dry skin, and brittle nails
- Blood clotting problems and slow-healing wounds
- Elevated blood pressure
Immunotherapy side effects also tend to be less severe but are similar to those of traditional chemotherapy. Immunotherapy for lung cancer side effects can include fatigue, cough, nausea, itching, skin rash, loss of appetite, constipation, joint pain, and diarrhea. Because these drugs unleash the immune system, they also have the rare chance of attacking healthy organs and functions, so your physician will use them cautiously. You should report any severe or unexpected side effects to your doctor immediately.
Adequate rest along with good nutrition and light physical activity have been proven to help with chemotherapy-related fatigue. Your cancer team will discuss side effects and treatments before your chemotherapy begins. If you struggle with side effects or they become severe, talk to your chemotherapy nurse or your oncologist. If it is after normal clinic hours, we have a 24-hour call line to respond to any urgent requests.
If you are a patient and are experiencing worsening symptoms from your treatment, such as those listed below, our medical professionals are available 24 hours a day, 7 days a week to help. We can assess signs and symptoms, schedule you for an in-office, same or next day appointment and help you avoid a trip to the Urgent Care, ER or unplanned hospitalization. In the event of a life-threatening emergency always call 911. Call us if you are experiencing:
- Chills or fever greater than 100.4
- Burning with urination, frequency, urgency, lower back pain (UTI)
- Productive cough with green, yellow, red, brown sputum
- Unmanaged diarrhea, constipation, nausea, vomiting
- Unmanaged pain
- Swelling, redness and pain on extremities
- Shortness of breath/chest pain
- Dizziness with changing position or lightheadedness
- Dark urine, less urine than normal, thirst, dry mouth (dehydration)
- Mouth sores, difficulty swallowing, frequent or sever heartburn
- Severe fatigue
Clinical Trials For Lung Cancer
Rocky Mountain Cancer Centers participates in more than 100 clinical trials through US Oncology Research, one of the nation’s largest community-based oncology research programs. These trials help provide access to the latest, most promising drugs and treatments for many types of cancer. We currently have several clinical trials open for lung cancer patients diagnosed at various stages of the disease. Talk with your medical oncologist about whether you are eligible to participate in a clinical trial. Learn more about our clinical trials program.