A decade ago, chemotherapy was the only drug doctors could prescribe to someone with non-small-cell lung cancer (NSCLC). Not only does today’s chemotherapy work better than past versions, but there are also two new kinds of medications to treat this disease.
One group of drugs changes the way certain cancer cells grow or change in your body. This is called targeted therapy. Others boost your immune system to better fight cancer. This is called immunotherapy.
When you’re thinking about treatment for lung cancer, it helps to know as much about your disease as you can, especially the type you have. That helps you and your doctor know which therapies are more likely to help. Most people have non-small-cell lung cancer (NSCLC), but about 10% to 15% have small-cell lung cancer.
Once your doctor knows which type you have, she will recommend treatments based on:
Whether the disease has spread in your body
The side effects the treatment may cause
The word chemotherapy may make you think of unpleasant side effects like nausea and vomiting. Although some patients today have those symptoms, today's drugs cause less of them than in years past.
“Patients are tolerating chemotherapy better, partly because we have better supportive medication and better anti-nausea medication,” says Kenneth Ng, MD, chief of medical oncology at Memorial Sloan Kettering Cancer Center Rockville Centre in New York.
Sometimes chemo does cause fatigue, depression, nerve problems, memory problems, or hair loss. That’s because of the way that the drugs work.
“Chemotherapy actually kills the cancer cells, but it doesn't only kill cancer cells, it kills normal cells, as well,” says Shakun Malik, MD, at the National Cancer Institute's Cancer Therapy Evaluation Program.
But there is chemo for NSCLC that doesn't cause hair loss, and memory problems can be milder for some people. This applies to both the new drugs and updated versions of the old drugs. “It's better compared to before,” Ng says.
You’re likely to get more than one type of chemo drug to start with. That’s the new standard of care, and it packs a powerful punch. “Combining two to three different chemotherapy drugs works better than giving one chemotherapy drug,” Ng says.
A decade ago, doctors began to treat some NSCLC with these types of drugs. They target cells that have certain types of genetic information and kill these cancer cells without harming healthy ones around them.
Doctors will take a sample of your tumor through a biopsy or surgery. Then they’ll see if the cancer cells will respond to one of these drugs. About 15% to 20% of people with NSCLC can get targeted therapy. If you’ve never smoked, the odds are even better that it’ll work for you.