Fortunately, there are several different treatment options for lung cancer, which we work hard to tailor to your individual wishes and needs. Standard treatment options include surgical resection, chemotherapy, and radiation therapy. However, there are newer and more advanced options that may be available. Typically, treatment options for lung cancer are based on the size, type, and stage of your lung cancer. 

Small Cell Lung Cancer

In addition to standard treatments, patients with SCLC may be able to be helped with treatments being tested in clinical trials (potential new treatments). 

A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Talk with your RMCC cancer care team to see if a clinical trial is right for you. 

There are six types of standard small cell cancer treatment, which include:

1. Surgery – Surgery may be used if the cancer is found in one lung and in nearby lymph nodes only. However, this type of lung cancer is usually found in both lungs; therefore, surgery alone is not often used.

Even if your oncologist removes all the cancer that can be seen at the time of the operation, chemotherapy or radiation therapy after surgery might also be necessary in order to kill any cancer cells that may remain. Treatment that is given after the surgery to lower the risk that the cancer will come back is called adjuvant therapy.

2. Chemotherapy – Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. 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.

The way the chemotherapy is given depends upon the type and stage of the cancer being treated.

  • When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
  • When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

3. Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The way radiation therapy is given depends upon the type and stage of the cancer being treated. Radiation therapy is a frequent component of treating NSCLC, most often along with surgery and sometimes chemotherapy.

  • Radiation therapy for NSCLC is used in the following ways:
  • Radiation can be used after surgery, sometimes along with chemotherapy, to kill any remaining cancer cells that were not removed during surgery.
  • Radiation therapy for NSCLC also can be used before surgery to shrink the size of the tumor.
  • Radiation therapy, usually in conjunction with chemotherapy, can be used as the main treatment for locally advanced non-small cell lung cancer that has not spread outside the lungs for patients who are not surgical candidates.
  • Radiation therapy, in the form of stereotactic body radiation therapy (SBRT) can be used for early non-small cell lung cancer in patients who are not surgical candidates.
  • Radiation therapy is used alone to relieve symptoms for advanced NSCLC that has spread outside the lungs.

4. Immunotherapy – 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 shown that certain patients can obtain a long-term response with immunotherapy.

5. Laser therapy – Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill the cancer cells.

6. Endoscopic stent placement – An endoscope is a thin, tube-like instrument used to look at tissues inside the body. It has a light and a lens for viewing and may be used to place a stent in a body structure to keep the structure open. Endoscopic stent placement can be used to open an airway blocked by abnormal tissue. In some cases, follow-up tests may be needed.

Non-Small Cell Lung Cancer

Depending on the stage of the non-small cell lung cancer, your treatment plan will be adjusted.  Below is an idea of what your treatment plans may look like for each of the stages: 

  • Occult Non-Small Cell Lung Cancer treatment depends upon where the cancer has spread. It can usually be cured by surgery.
  • Stage 0 treatment may include:
    • Surgery (wedge resection or segmental resection).
    • Photodynamic therapy using an endoscope.
    • Electrocautery, cryosurgery, or laser surgery using an endoscope.
  • Stage I treatment may include:
    • Surgery (wedge resection, segmental resection, sleeve resection, or lobectomy).
    • External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
    • A clinical trial of surgery followed by chemoprevention.
  • Stage II treatment may include:
    • Surgery (wedge resection, segmental resection, sleeve resection, lobectomy, or pneumonectomy).
    • External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
    • Surgery followed by chemotherapy.
  • Stage III non-small cell lung cancer treatment is divided into Stage IIIA, Stage IIIB, and Stage IIIC:
    • Stage IIIA: Non-small cell lung cancer that can be removed with surgery may include:
        • Surgery followed by chemotherapy.
        • Surgery followed by radiation therapy.
        • Chemotherapy and radiation therapy followed by surgery.
      • Stage IIIA non-small cell lung cancer that cannot be removed with surgery may include:
        • External radiation therapy alone for patients who cannot be treated with combined therapy.
      • Some Stage IIIA non-small cell lung tumors that have grown into the chest wall may be completely removed, and treatment of chest wall tumors may include:
        • Chemotherapy combined with radiation therapy.
        • Surgery
        • Surgery and radiation therapy
        • Radiation therapy alone
        • Chemotherapy combined with radiation therapy and/or surgery.
    • Stage IIIB and Stage IIIC treatment may include:
      • Chemotherapy combined with radiation therapy.
      • Chemotherapy and radiation therapy followed by immunotherapy.
      • External radiation therapy and/or laser therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
  • Stage IV treatment may include:
    • External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
    • Combination chemotherapy.
    • Combination chemotherapy and targeted therapy.
    • Laser therapy and/or internal radiation therapy using an endoscope.
    • Surgery.
    • Stereotactic radiosurgery for tumors that have spread. 

Lung Cancer Clinical Trials

Rocky Mountain Cancer Centers participates in more than 150 clinical trials through US Oncology Research, one of the nation’s largest community-based oncology research programs that has helped develop over 90 FDA-approved cancer therapies. 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.

Types of Radiation Treatments Used for Lung Cancer Treatment

There are two types of radiation therapies:

  1. External radiation therapy, which uses a machine outside the body to send radiation toward the cancer.
  2. Internal radiation therapy, which uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Prophylactic cranial irradiation (radiation therapy to the brain to reduce the risk that cancer will spread to the brain) may also be given.

Lung cancer is typically treated using external beam radiation therapy (EBRT), a process in which a machine is used to aim high-energy beams at the cancer tumor from outside the body. External beam radiation, EBRT, is performed completely outside of your body and feels similar to getting an X-ray.

Treatments are usually administered once or twice a day, five days a week, for five to seven weeks, depending on your cancer’s stage and treatment goal.

External Beam Radiation Therapy for Lung Cancer

Rocky Mountain Cancer Centers uses two types of external beam radiation therapy, EBRT, depending on your type of cancer and many other factors. These technologies help minimize damage to surrounding health tissue. The two EBRT technologies used at Rocky Mountain Cancer Centers are:

  1. 3-dimensional conformal or Intensity-modulated radiation therapy (IMRT) uses specialized computer equipment to break radiation beams into smaller beamlets that can be individually adjusted for intensity. They’re then aimed at the tumor from various angles as the machine moves around your body in order to deliver the most possible radiation per treatment while limiting the dose to healthy tissue, especially that of important nearby structures, such as the spinal cord.
  2. Stereotactic body radiation therapy (SBRT) uses computed tomography (CT) and magnetic resonance imaging (MRI) to pinpoint the exact location and shape of a lung cancer tumor during radiation therapy. Microbeams, focused to within a fraction of a millimeter, are then aimed at the tumor from various angles while the patient lies in a body frame to reduce the movement of the tumor during breathing. Using this technique, our radiation therapy experts can deliver very high doses of radiation to the lung cancer tumor in just a few treatments. SBRT is most often used in patients who are not eligible for surgery and can be administered in just one to five treatments. Read more about SBRT in this Rocky Mountain Cancer Centers blog post.  

Follow-up Tests or Check-Ups for Lung Cancers 

Sometimes, certain tests that were done to diagnose the cancer, or to find out the stage of the cancer, may be repeated. In some cases, it’s to see how well the treatment is working. In others, the results are used to help make decisions about whether to continue, change, or stop treatment altogether. This process is sometimes called re-staging.

Even after treatment has ended, some of the tests will continue to be done from time to time. The results of these tests, sometimes called follow-up tests or check-ups, can show if your condition has changed or if the cancer has returned.

As you go through this cancer journey, know that we will be here every step of the way. Do not hesitate to reach out to your RMCC cancer care team in times of need. We want to ease your mind by addressing any questions or concerns you may have to the best of our ability.