Treating Non-Small Cell Lung Cancer After Chemoradiation

When receiving treatment for non-small cell lung cancer (NSCLC), your doctor may mention something called chemoradiation. This may be an effective treatment when the cancer has spread beyond the original tumor site, such as stage III or IV NSCLC.

What Is Chemoradiation?

Chemoradiation simply refers to using both chemotherapy and radiation therapy together to get better results. Here’s how the two treatments work:

• Chemotherapy is a treatment that attacks all rapidly dividing cells, including cancer cells. Learn more about chemotherapy here.
• Radiation therapy uses a beam of radiation to target and attack cancer cells. Learn more about what radiation therapy is here.

These therapies can treat cancer on their own, but in some cases, they can work well together. Giving chemotherapy to a patient first can help make the cancer cells more sensitive to radiation therapy. As a result, chemoradiation therapy may kill more cancer cells than chemo or radiation therapy alone, for patients with NSCLC.

Chemoradiation is a good option for people who are not candidates for surgery. This is called unresectable NSCLC. Lung cancer is untreatable with surgery if the cancer is:

• Affecting both lungs
• Invading the chest wall
• Spreading into nearby lymph nodes

After Chemoradiation

People with stage III or IV NSCLC may need additional treatments after chemoradiation. Despite the effectiveness of chemoradiation, there may still be remaining cancer cells. One possibility is immunotherapy.

Immunotherapy is a category of treatments that use the body’s own immune system to attack cancer cells. To put it simply, cancer cells hide from the immune system, and immunotherapy helps find and attack them. There are two types of immunotherapy that can help treat stage III or IV NSCLC:

• Monoclonal antibodies: These are lab-made proteins that flag cancer cells so the immune system can find them and attack.
• Checkpoint inhibitors: Cancer cells turn on “checkpoints” on the immune cells that tell the immune system not to attack. Basically, the cancer makes the immune cells think the cancer cells are normal, healthy cells. Checkpoint inhibitors turn off those signals, helping the immune cells to recognize the cancer cells and attack.

Another treatment option after chemoradiation is surgery. Some people may become candidates for surgery after chemoradiation, even if they weren’t candidates before. Basically, the chemoradiation helps shrink the tumor, and then surgery to remove the remaining tumor may be effective.

Learn more about treatment options by stage for non-small cell lung cancer here.