Getting a lung cancer diagnosis today is much different than it was 15, 10, even five years ago. “We have seen an explosion of new treatment modalities that have become available for the treatment of lung cancer,” says Kevin Sullivan, MD, a lung oncologist at Monter Cancer Center, Northwell Health. “For patients that have received a lung cancer diagnosis, they have every reason to be hopeful.”
How Lung Cancer Is Treated
There are many effective therapies for treating lung cancer. Choosing the right treatment depends on the stage of your cancer and what course of treatment works best for your lifestyle.
Here are the five main lung cancer treatment types:
The goal of surgery for lung cancer is to remove the tumor from the body. Surgeons do this by removing part of the lung (segmentectomy), a lobe of the lung (lobectomy), or the entire lung (pneumonectomy).
Lung cancer surgery is considered the best option when the cancer is localized to one area and has not spread. “If the tumor is the only site of disease in the body, [surgery] could potentially cure,” says Jorge Gomez, MD, a lung oncologist at Mount Sinai Hospital.
2. Radiation therapy
Radiation therapy aims to kill cancer cells via high-energy rays (such as X-rays) or particles. Radiation therapy—when used in combination with chemotherapy—can potentially cure patients with locally advanced disease that has not spread outside the chest, says Dr. Gomez.
Treatments for Advanced Lung Cancer
The following three therapies are generally used to treat advanced lung cancer (stage 3B or stage 4) or metastatic disease (when lung cancer has spread to other parts of the body). “All three [treatments] try to shrink the disease,” says Dr. Gomez.
Chemotherapy is a type of anti-cancer treatment that enters the bloodstream (by injection or by mouth) and kills rapidly dividing cells (which tend to be cancer cells). Chemotherapy for lung cancer may be used in conjunction with radiation therapy, before or after surgery, or as the main treatment.
4. Targeted therapy
“In the past 15 years, lung cancer has changed significantly,” says Dr. Gomez. “The first thing that happened was the discovery of targeted therapies.”
As researchers have learned more about the changes in cancer cells that help them grow, they have developed targeted therapies to target those changes specifically. “Targeted therapies are really going after the specific cause, the specific molecule that’s abnormal and producing the cancer,” says Dr. Gomez.
Targeted therapies work differently from standard chemotherapy drugs. Chemotherapies are designed to kill any rapidly dividing cell, but because they don’t have a specific target, they kill healthy cells as well.
The only drawback to targeted therapies, however, is that they can’t help all lung cancer patients. “There is a group of patients, approximately 15 to 20 percent of patients with lung cancer, who have a special type of lung cancer that can be treated with targeted therapies,” says Dr. Gomez.
“Immunotherapies are drugs that activate the body’s immune system to attack the cancer,” says Dr. Gomez. “They don’t attack the cancer themselves the way chemotherapy does.”
Various types of immunotherapy are being developed to help the immune system recognize a tumor as something different than the normal tissues in the body. One of these immunotherapy approaches is a class of medications called checkpoint inhibitors.
Here’s how they work: An important characteristic of the immune system is to keep itself from attacking normal cells in the body. To do this, it uses “checkpoints”—which are proteins on immune cells that must be turned on (or off) to trigger an immune response.
Cancer cells sometimes use these checkpoints to essentially hide from and avoid being attacked by the immune system. “Cancer has an incredible ability to evade immune detection,” says Dr. Sullivan. “The cancer can interact with those proteins and shut off the immune response.”
That’s where the immunotherapies come into play. “These immune checkpoint inhibitors are actually antibodies that get infused into the bloodstream, and the antibody has a very specific target,” says Dr. Sullivan. The antibodies target and block the interaction between the cancer cells and the immune cells that allows the cancer to “hide” from the immune response.
“So by blocking that immune checkpoint, the immune system is now able to recognize the cancer as something foreign and attack it,” says Dr. Sullivan. “It’s basically an unleashing of the immune system against our cancer cells.”
The goal of treatment in patients with advanced disease is to prolong life and to improve quality of life. “We improve quality of life by illuminating the symptoms of the disease and all of those three therapies can do that,” says Dr. Gomez.