Saturday, 29 October 2016

Types of treatment for lung cancer

The principle medicines 

Treatment relies on upon the sort of lung disease you have. The treatment for non little cell lung disease is not quite the same as the treatment for little cell lung tumor. 

Little cell lung malignancy is for the most part treated with chemotherapy. Surgery is just appropriate if there is no sign that the growth has spread to the lymph organs in the focal point of the mid-section (the mediastinal lymph organs). This is uncommon with little cell lung tumor. It has typically spread at the season of conclusion. So chemotherapy is generally the primary treatment. You may likewise have radiotherapy to treat this kind of lung tumor. There is data underneath about the treatment of little cell lung growth by stage. 

Non little cell lung malignancy can be treated with surgery, chemotherapy, radiotherapy or a blend of these, contingent upon the phase when the tumor is analyzed. A few people with cutting edge lung disease may have organic treatment. There is data underneath about the treatment of non little cell tumor by stage. 

How treatment is arranged 

Your disease master takes a gander at various elements that help them to arrange your treatment. These incorporate 

The kind of lung growth you have 

Where the tumor is inside the lung 

Your general wellbeing 

Whether the tumor has spread (the stage) 

Consequences of blood tests and sweeps 

Your own desires 

You may find that other individuals you meet are having diverse treatment from you. This might be on account of they have an alternate sort of lung growth. On the other hand it might be that a portion of alternate variables recorded above are distinctive. Try not to be hesitant to ask your specialist or pro medical attendant any inquiries you have about your treatment. 

Surgery, radiotherapy and chemotherapy are all used to treat lung tumor. They can each be utilized alone or together. Your specialist will arrange the best treatment for you. A few people with cutting edge non little cell lung growth may have organic treatment. 

Treatment by stage for little cell lung tumor 

On the off chance that you have early stage little cell lung malignancy you are well on the way to have chemotherapy and after that radiotherapy to the lung. Individuals who are genuinely fit may have chemotherapy and radiotherapy in the meantime (chemoradiation). It is very normal for this kind of disease to spread to the cerebrum. So specialists regularly prescribe radiotherapy to the mind for individuals whose lung disease shrivels with chemotherapy treatment. You generally have radiotherapy to the mind toward the end of the chemotherapy treatment. It intends to attempt to slaughter any malignancy cells that may have officially spread to the cerebrum however are too little to appear on outputs. Specialists call this prophylactic cranial light or PCI. 

For early stage little cell lung disease that has not spread to the lymph hubs in the focal point of the mid-section (the mediastinal lymph hubs), you may have surgery to evacuate the part of the lung containing the tumor (a lobectomy). The surgery is trailed by chemotherapy and in some cases radiotherapy. In any case, more often than not the disease has officially spread at the season of finding and surgery is not then conceivable. 

On the off chance that you have little cell malignancy that has spread to lymph hubs or different zones of the body you may have chemotherapy, radiotherapy or treatment to ease side effects. In the event that chemotherapy functions admirably to contract the lung tumor down and you are genuinely fit you may likewise have radiotherapy to the cerebrum to execute any disease cells that may have effectively spread there. 

Treatment by stage for non little cell lung malignancy 

You can get some answers concerning your treatment alternatives by noting the inquiries on this intuitive flowchart.

Stage 1

Stage 1 non small cell lung cancer is uncommon. You normally have surgery to remove part of the lung (a lobectomy) or all of the lung (a pneumonectomy). If you can't have an operation for other health reasons, your doctor may suggest targeted radiotherapy instead to try to cure the cancer. Another option for small tumours if you cannot have surgery is radio frequency ablation (RFA).

Stage 2

For stage 2 non small cell lung cancer, you may be offered surgery. Depending on the position of the tumour, your surgeon may remove part of the lung (a lobectomy) or all of the lung (a pneumonectomy). If the cancer is completely removed, your specialist may suggest chemotherapy. The chemotherapy aims to lower the risk of the cancer coming back. Doctors call this adjuvant chemotherapy. It is important that your doctor talks to you beforehand about the benefits and side effects of chemotherapy. If the surgeon could not remove all of the tumour you may have radiotherapy afterwards. 

If you can't have surgery due to other health concerns, your doctor may offer radiotherapy or combined radiotherapy and chemotherapy (chemoradiation). This treatment aims to try to get rid of the cancer completely.

Stage 3

For stage 3 non small cell lung cancer you may be able to have surgery, depending on where the cancer is in the lung. You may need to have the whole lung removed (a pneumonectomy). If the surgeon completely removes the cancer, you may then have chemotherapy to try to lower the risk of the cancer coming back. If the surgeon finds cancer cells in the lymph nodes during the surgery they are likely to advise you to have chemotherapy and possibly radiotherapy after the operation.

If you can't have surgery due to other health concerns, your doctor may offer radiotherapy or combined radiotherapy and chemotherapy (chemoradiation). This treatment aims to try to get rid of the cancer completely.

If your scans showed that there are cancer cells in the middle area of the chest (the mediastinum), your doctor may suggest radiotherapy instead of surgery. The cancer may be too close to your heart to operate safely. Or your doctor may advise that you have a course of chemotherapy followed by radiotherapy. Some people who are fairly fit and have small tumours have radiotherapy at the same time as chemotherapy (concomitant chemoradiotherapy). Concomitant chemoradiotherapy causes more side effects than the treatments given alone. So you need to be well enough to cope with the increased side effects.

If scans show signs of cancer in the lymph nodes on the opposite side of your chest, surgery is not possible. But you may have a course of chemotherapy. After the chemotherapy you might need further treatment with radiotherapy. If you are fairly fit you may have radiotherapy at the same time as chemotherapy. 

Stage 4

Treatment for stage 4 non small cell lung cancer aims to control the cancer for as long as possible and to shrink the tumour down to reduce symptoms. Many trials have used chemotherapy in this situation and we know that it can help people to live longer as well as relieving symptoms. 

People whose cancer cells have particular proteins (receptors) may have treatment with biological therapy drugs called erlotinib (Tarceva), gefitinib (Iressa) or crizotinib (Xalkori).

If you have had chemotherapy and it is no longer controlling the cancer, you may have further chemotherapy if you are well enough. If your cancer has EGFR receptors your doctor may offer erlotinib treatment. Or you may choose to have no further active treatment but to control your symptoms with medicines.

You may have radiotherapy to control symptoms such as pain or a cough. As well as radiotherapy, other treatments can relieve a blockage and reduce symptoms if you have a tumour in one of the main airways (the left or right bronchus). These treatments include

  • Internal radiotherapy (brachytherapy)
  • Laser treatment
  • Freezing the tumour (cryotherapy)
  • Using a rigid tube (a stent) to keep the airway open
  • Light therapy (photodynamic therapy – PDT)
  • There is detailed information about treatments to relieve an airway blockage in the advanced lung cancer treatment section.

Being cared for by a multidisciplinary team
NHS guidelines state that everyone diagnosed with lung cancer should be under the care of a multi disciplinary team (MDT). This is a team of health professionals who work together to discuss your case and how best to manage your treatment and care. The team includes 

  • Specialist surgeons
  • Doctors who specialise in using drugs to treat cancer (medical oncologists)
  • Doctors who specialise in chest conditions
  • Doctors who specialist in symptom control
  • Doctors who specialist in radiotherapy and chemotherapy treatment (clinical oncologists)
  • Specialist lung cancer nurses
  • Doctors specialising in diagnosis from tissue specimens (histopathologists)
  • Physiotherapists
  • Occupational therapists
  • Psychologists
  • Social workers
  • Dieticians
  • Other health professionals or specialists

Discussing things with your doctor
An appointment where you are given your diagnosis and told about your treatment options is very important. You are likely to be shocked and might find it hard to take in information or make decisions. When you go to see the doctor it often helps to write down a list of questions you want to ask. There may be more than 1 treatment option that is suitable for you. 

It's important that you feel OK about the treatment your specialist recommends. Most people feel more comfortable about this if they understand why a particular treatment decision has been made. Doctors expect patients to want to ask questions and they appreciate that you need things explained in a way you can understand. It is important that your doctor fully explains all options to you and their benefits and possible problems.

Your doctor won't give any treatment without your permission (consent). In some situations you may feel that you don't want to have treatment, for example if the treatment has only a small chance of helping you and may cause bad side effects. Your doctor can explain what will happen if you don't have the treatment and they will go along with your wishes.

Support during appointments

You could take a close friend or relative with you to the appointment. They can help you to remember what is said. If you feel that you need more time to think things through or discuss the options, you can ask your specialist to see you again. Then you can discuss things more fully before you make a decision. There are also lung cancer specialist nurses you can talk to. They can answer questions about your cancer and its treatment.

Second opinions

Some people feel they would like to get an opinion from a second doctor before they decide on their treatment. Most doctors are happy to refer you to another specialist for a second opinion if you would find this helpful. You can discuss this with your GP or cancer specialist, who can make the referral for you. 

Getting help and support

Our lung cancer organisations page gives details of people who can provide information about your choice of treatment. Some organisations can put you in touch with a cancer support group. 

You can find details of counselling organisations in our counselling section. Our lung cancer reading list has information about books and leaflets on lung cancer treatments.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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