Lung Cancer Symptoms & Treatment Options

What is Lung Cancer?

Lung cancer is the development of abnormal cells that collect as a tumour in the lungs, usually it begins in the wall of the bronchi.

There are two main types of lung cancer Non-small cell lung cancer (NSCLC) and Small cell lung cancer (SCLC). Most cases of lung cancer are of the Non-small cell (NSCLC) type. There are three types of NSCLC:

  1. Adenocarcinoma
  2. Squamous cell carcinoma
  3. Large cell carcinoma

What are the symptoms of Lung Cancer?

While many cases of lung cancer do not show any symptoms until the disease is more advanced there are signs and symptoms that can indicate the presence of lung cancer. These include:

  • A cough that does not go away or gets worse
  • Coughing up blood or bloody phlegm
  • Chest pain particularly when coughing
  • Shortness of breath
  • New onset of wheezing
  • Hoarseness
  • Weight loss and loss of appetite
  • Feeling tired or weak
  • Persistent chest infections that don’t go away or keep coming back

Treatments for Lung Cancer

Treatment for lung cancer will be dependent on how advanced the cancer is when discovered and the type of lung cancer it is.

Surgery

Most NSCLC, particularly early stage cases, are treated with surgery in advance of other types of treatment. A surgeon will remove the lobe or section of the lung with the tumour. In some cases, video-assisted thoracoscopic surgery (VATS) can be used to remove the tumour. In this type of surgery there is only a small incision in the chest as a tube, known as a thoracoscope is inserted and assists the surgeon locating and removing the tumour.

Surgery is not as common for SCLC and only a small percentage of patients with this type of lung cancer will benefit from surgery in advance of having other treatments.

Chemotherapy

Chemotherapy are drugs given for cancer and are either injected into the blood stream or given in tablet form. For patients with NSCLC, who have had surgery, chemotherapy is often given to prevent the cancer returning. This is known as adjuvant chemotherapy.

For those with inoperable tumours chemotherapy will be often given in combination with radiotherapy to try to treat the cancer.

Chemotherapy can also be used before surgery to shrink a tumour enough to operate.

There are many drug options for treating lung cancer and very often a patient will receive a combination of a few different drugs. Some of the drugs include:

  • Carboplatin
  • Cisplatin
  • Docetaxel (Taxotere)
  • Etoposide (Vepesid, VP-16)
  • Gemcitabine (Gemzar)
  • Paclitaxel (Taxol)
  • Pemetrexed (Alimta)
  • Topotecan (Hycamtin)
  • Vinblastine (Velbe)
  • Vincristine (Oncovin)
  • Vinorelbine (Navelbine)

Radiotherapy

Radiotherapy or radiation involves high energy waves directed at the tumour itself. In lung cancer, the most common type is external beam radiation however newer forms such as stereotactic radiation is being used also.

Radiation, as outlined above, is often used in combination with chemotherapy, particularly where surgery is not an option.

For SCLC, the cancer in about 50% of cases spreads to the brain and so preventative radiation treatment is often given to the brain to prevent the spread of the disease.

Biological therapy

Biological therapy, also known as targeted treatment, uses the bodies’ own immune system to treat the tumour.

Extensive testing on the tumour can be carried out to see if biological therapy will work for that individual case of lung cancer. If it is decided to use biological therapy one of the following drugs will likely be used:

  • Afatinib (Giotrif)
  • Bevacizumab (Avastin)
  • Cetuximab (Erbitux)
  • Crizotinib (Xalkori)
  • Iressa (Gefitinib)
  • Tarceva (Eroltinib)
  • Thalidomide

Immunotherapy

Immunotherapy is a new treatment option emerging to treat lung cancer. Like biological treatments it uses the patient’s own immune system to fight the tumour. There are many drugs in clinical trial at this time. These drugs fall into four categories of how they will work to treat the cancer:

  • Monoclonal antibodies 
  • Checkpoint inhibitors 
  • Therapeutic vaccines 
  • Adoptive T-cell transfer 

Alternative treatments for Lung Cancer

Alternative therapies will not be able to cure cancer however there are several alternative treatments that the American College of Chest Physicians recommends people with lung cancer should consider including acupuncture, hypnosis, massage, meditation and yoga.