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Non-Small Cell Lung Cancer: When You Need More Than One Treatment

Radiation Therapy for Lung Cancer continued...

External beam radiation therapy will not make you radioactive. However, some healthy tissue may be harmed along with cancer cells during treatment, so you may notice some side effects. These include:

  • Sunburn-like redness on the skin where the radiation is focused
  • Irritation of the esophagus
  • Fatigue

Most of these side effects go away after treatment ends.

A new form of radiation therapy, called stereotactic body radiation (SBRT), is becoming widely used in patients with early stage cancer who are not able to have surgery. This treatment uses highly targeted, high-dose radiation that kills cancer cells while sparing normal tissue. “SBRT is a more precise therapy, and it has few side effects. It’s becoming a standard of care for early stage NSCLC,” says Schild.

Chemotherapy for Lung Cancer

Chemotherapy uses drugs to kill cancer cells. Usually given by injection, the drugs travel throughout the body in the bloodstream, so chemo is useful for metastasized cancers.

“In the last 6 or 7 years, there has been a revolution in how chemotherapy is used for treatment of NSCLC,” says Azzoli. “In 2003, studies first reported the benefits of using chemotherapy as adjuvant therapy. Prior to that, chemotherapy was not routinely given to patients with stage I or stage II cancer. Now medical oncologists see more early stage lung cancer patients. We discovered that by adding chemotherapy to surgery or to radiation treatment at earlier stages, more patients can be cured.”

Depending upon a person’s health, the stage of lung cancer, and the type of cancer, chemotherapy may be used in several ways:

  • After surgery as adjuvant therapy to help kill any remaining cancer cells
  • Before surgery to control the disease prior to surgery. This is called neoadjuvant therapy.
  • With radiation therapy, either one after another or at the same time. Chemotherapy given simultaneously with radiation therapy is called chemoradiation.
  • As a single therapy
  • With a targeted therapy (drugs that inhibit cancer growth and development)

Chemotherapy treatment should begin within two months after lung cancer surgery. The decision about which chemotherapy drugs to use is based on a number of factors. Usually, two chemo drugs are used together. This is called combination chemotherapy. For people in poor health, only one drug may be used. For patients with advanced cancer who meet certain requirements, a targeted therapy may be added to combination chemotherapy treatment.

Chemotherapy is given in cycles of 3 to 4 weeks, with time off between cycles to allow your body to recover. In general, you will receive 4 to 6 cycles of chemotherapy.

Chemotherapy works by killing rapidly growing cancer cells. But the drugs can’t tell the difference between cancer cells and other cells in the body that also divide quickly. These types of cells occur in hair follicles, bone marrow, and the lining of the intestines and mouth. As a result, these healthy cells may become damaged, leading to side effects such as:

  • Loss of appetite
  • Nausea
  • Fatigue
  • Increased risk of infection

Advances in chemotherapy drugs and in the drugs used to treat side effects have eliminated certain side effects for people receiving chemotherapy for NSCLC. In many cases, you won’t lose your hair. Tell your doctor if you feel nauseous, as there are effective treatments to help. Often, patients receiving chemotherapy can continue to work and remain active. In most cases, side effects from chemotherapy go away after therapy has stopped.

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