Lung cancer occurs when cells in the lungs are damaged or become cancerous and begin to grow uncontrollably. While lung cancer can occur in both smokers and non-smokers, smoking greatly increases your risk of developing the disease, as does exposure to secondhand smoke. Unfortunately, most cases of lung cancer are advanced by the time they’re discovered, which means there aren’t many treatment options to halt the spread of the disease. In some instances, patients are diagnosed early enough that surgery or radiation can cure them completely or at least delay their symptoms significantly until they decide on additional treatment options like chemotherapy or immunotherapy.
Treatment for advanced non-small cell lung cancer.
Advanced lungs cancer means the cancer has grown across lungs and may also involve other parts of body. At this stage, curative surgery and radiotherapy are not always possible.
However, although curative cancer treatment can be difficult to achieve in advanced stages of cancer, they’re not necessarily impossible. There are several innovative and promising studies underway looking at new treatments designed to improve quality of life while extending life expectancy in non-small cell lung cancer patients. Currently these new types of cancer drugs like targeted therapy and immunotherapy are only available in limited extent but many experts predict that they will become a standard part of care in years to come.
Biologics, targeted therapies, and immunotherapy.
Our last few remaining treatment options are immunotherapy, targeted therapies, and biologics. Immunotherapy uses a patient’s own immune system to fight cancer; it is showing promise in treating patients with advanced lung cancer. Targeted therapies focus on one specific protein or receptor that is key to the growth of cancer cells, which means they have fewer side effects than traditional chemotherapies do. A good example of a targeted therapy is gefitinib, which prevents tumors from producing extra blood vessels.
Chimeric Antigen Receptor T-Cell Therapy also called CAR-T cells are perhaps our most exciting potential treatment option because they take out tumors by enabling modified T cells to recognize and kill tumor cells expressing a tumor-specific antigen
Adjuvant treatment after surgery.
If a tumor is very small and has been entirely removed by surgery, adjuvant therapy is not generally recommended. But if there are still cancer cells in your lungs after surgery (called residual disease), your doctor will most likely recommend a combination of chemotherapy drugs. The goal is to eradicate any remaining cancer cells and reduce your risk of recurrence. This type of treatment, called adjuvant chemotherapy, is also often given after chemotherapy alone if you have had advanced lung cancer or are at high risk for recurrence.
Lung cancer screening tests.
A lung cancer screening test like a low-dose computed tomography (LDCT) scan is a first step to detect lung cancer earlier. The United States Preventive Services Task Force recommends are as below:
Target Population for Lung cancer screening:
Adults aged 50 to 80 years who have a 20 pack-year smoking history. Is current smoker or have quit within the past 15 years:
Screen for lung cancer with low-dose computed tomography (CT) every year.
Stop screening once a person has not smoked for 15 years or has a health problem that
Radiation therapy.
Modern radiation therapy includes a range of techniques from surgical brachytherapy to intensity-modulated radiation therapy (IMRT) and stereotactic body radiotherapy (SBRT). IMRT is one of these precision techniques that allows doctors to more accurately deliver radiation therapy directly to tumors without affecting surrounding tissue. In addition, scientists have found that certain drugs used in lung cancer treatments can be combined with radiation treatment to improve outcomes.
Chemotherapy, Immunotherapy, and targeted therapies.
Advances in medical treatment have led to new options for lung cancer patients. One of these is immunotherapy, a form of treatment that uses targeted drugs to stimulate or enhance our own immune system in order to fight disease. The two primary types of immunotherapy are checkpoint inhibitors and adoptive cell therapy. Immunotherapy has proven effective against a number of cancers, including lung cancer.
Based on today’s understanding of cancer biology, if a certain cancer cell has a mutation, targeted therapy drugs can be designed to treat those cells. This method is called targeted therapy and it helps doctors treat certain types of cancer more effectively. Targeted therapy helps doctors target specific mutations that occur in certain cancers. If a cancer cell develops a mutation that switches off its pathway for controlling DNA activity (which slows or stops genetic mutations) and instead turns on pathways for DNA activity (to allow rapid and multiple changes in genes), it’s likely that tumor cells will develop resistance to targeted therapies.
More than one in five people with stage 4 lung cancer will have a mutation in EGFR (epidermal growth factor receptor). . A new oral tablet called TKI were created for patients who have had no success using older treatment options. The drug works by targeting specific genetic mutations associated with tumors. Studies show that just over 50 percent of patients treated with these TKI showed tumor shrinkage within three months, compared to less than a quarter of those on standard chemotherapy. They also have less side effects compared to chemotherapy.
Palliative care and hospice care.
One of your most important treatment options is to focus on quality of life. Palliative care can help you manage pain and other symptoms, as well as provide guidance and support. And hospice care providers can offer valuable long-term services that can help you and your family cope with advanced lung cancer.
If you live in Nepal and are diagnosed with advanced lung cancer, talk to our team about palliative care options available.
