Chemotherapy once was the only medicine doctors could prescribe to someone with non-small-cell lung cancer (NSCLC). Times have changed. There are not only advances in the chemotherapy itself, but there are new kinds of medications to treat this disease.
One group of the drugs changes the way certain cancer cells grow or change in your body. Doctors call this targeted therapy. The other boosts your immune system to better fight cancer. It's called immunotherapy.
Just the word may make you think of unpleasant side effects like nausea and vomiting. Although that can still happen, there are better medicines to tame it, says Kenneth Ng, MD, chief of medical oncology at Memorial Sloan Kettering Rockville Centre in New York.
Sometimes chemo does cause fatigue, depression, nerve problems, memory problems, or hair loss. They happen because of the way 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. That’s true for newer chemo drugs and updated versions of older ones. “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 routine now. “Combining two to three different chemotherapy drugs works better than giving one chemotherapy drug,” Ng says.
In 2016, the FDA gave hope to patients with advanced NSCLC whose tumors carry a genetic mutation called ROS-1 by approving the drug (Xalkori). The oral medication acts as a protein inhibitor, blocking ROS-1’s activity, which potentially could prevent NSCLC from growing and spreading.
These drugs target cancer cells based on certain types of genetic information and kill them without harming healthy ones around them.
Doctors will take a sample of your tumor. 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 better that it’ll work for you.