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Lung cancer | LUMC

What treatments are possible?

If you have been diagnosed with lung cancer, we will provide you with tailor-made treatment. Which treatment is best for you depends on the form and stage of the disease. Your age and condition also play a role.

Consultation between patient and doctor

Doctors with different specialties work together to come up with an optimal treatment plan. We will discuss with you the considerations we will make in this regard. You are involved in the choice of treatment. Treatment for lung cancer can be drastic. That’s why we only start treatment if you insist.

What treatments are there?

The choice of treatment depends on, among other things, the type of lung cancer you have (non-small cell, small cell, mesothelioma) and the stage of the disease. The stage of the disease indicates how far the cancer has spread in the body. Doctors determine the stage of the disease by looking at:

  • The location and size of the tumor
  • Whether and how far the tumor has grown into the surrounding tissue
  • If there are metastases in the lymph nodes
  • If there are metastases in other parts of the body.

Below are the most common treatments for different types of lung cancer. Treatment often consists of a combination of treatment methods. For example, you will receive chemotherapy and radiation therapy at the same time, or chemotherapy before or after an operation.

Non-small cell lung cancer

  • Operation
  • Radiotherapy
  • chemotherapy
  • Endobronchial therapy
  • Immunotherapy

Small cell lung cancer

  • Radiotherapy
  • chemotherapy
  • Endobronchial therapy

Mesothelioma

Below we explain the different treatment options in more detail. Also explain what the risks are. It is difficult to predict what side effects will occur in your personal situation. Your doctor will always discuss with you in detail what to expect and what can be done about possible side effects. The risk of side effects is higher when treatment methods are combined.

Operation

During the operation, the thoracic surgeon removes a part of the lung (lobectomy/segment resection/wedge resection) or an entire lung (pneumonectomy). Some of the surrounding tissue is also removed. This happens because during the operation it is not possible to see whether the tissue immediately adjacent to the tumor area is free of cancer cells. A pathologist examines the tumor and the edges of the removed tissue and lymph nodes for the presence of cancer cells. The results of this provide important information about the stage of the disease and help determine if further treatment is needed.

The most common side effect of surgery is that your condition decreases and, in some cases, your breathing becomes more difficult.

Radiotherapy

In radiotherapy, the radiation oncologist treats the tumor with X-rays. The aim is to destroy the cancer cells while sparing healthy cells as much as possible. Radiation therapy is a local treatment: only the part of the body where the tumor is located is irradiated.

Radiation to the lungs can cause a burning sensation or pain behind the breastbone when swallowing food. This is because the esophagus is often in the irradiated area. Sometimes radiation pneumonitis develops as a result of radiation treatments. This can occur up to 12 months after stopping treatment.

chemotherapy

Chemotherapy is treatment with drugs (cytostatics). These drugs kill cancer cells or inhibit cell division. Drugs are usually administered through an IV according to a certain schedule – a course of cytostatics. This means that you will receive medication for a period and not for a period.

Chemotherapy affects healthy cells as well as cancer cells. As a result, side effects such as diarrhea, nausea and vomiting, irritation of the mucous membrane of the mouth and throat, a decrease in the number of white blood cells and thus an increased risk of infections, hair loss, decreased appetite and fatigue may occur.

Endobronchial therapy

With this treatment, a tumor growing in the airways can be removed with imaging tools. The surgeon may also place a stent to prevent or relieve narrowing of the airways. The treatment takes place under anesthesia.

Targeted therapy

A small number of patients receive targeted therapy. These are patients in whom a mutation has been found in the DNA of the tumor cells. Targeted therapy is treatment with drugs that inhibit cell division of cancer cells or kill cancer cells. Targeted therapy causes less damage to healthy cells than conventional chemotherapy.

Immunotherapy

Immunotherapy consists of drugs that stimulate the body’s natural defense system to kill cancer cells. The treatment is intended for patients who are terminally ill, as an adjunct to chemotherapy. In some patients, immunotherapy can slow or stop the disease for a while.

How can you prepare for treatment?

Lung cancer diagnosis and treatment can be devastating. That’s why it’s good if you orient yourself. You can read the condition and talk to family or friends.

You can always ask questions in a conversation with your doctor or by telephone by calling the Lung Outpatient Clinic, telephone number: 071-526 37 42 (available every day from 8:30 to 24:00).

What is the prognosis?

With lung cancer it is difficult to determine if someone has truly been cured. The disease can recur even after treatment aimed at healing. If the disease returns, it is usually within 5 years. If a cure is not possible, sometimes the disease can be stopped for a period of time. The length of this period depends mainly on the extent of the disease.

The chance of recovery varies from patient to patient. Because lung cancer is often diagnosed when the disease has already spread, the cure rate is low. However, the prognosis for a group of patients cannot simply be translated into one’s own situation. What to expect for the future is best discussed with your doctor.

The outlook for a patient with mesothelioma is poor. Long-term cure or survival is not actually possible. Our team of healthcare professionals works to inhibit, reduce or prevent the ailments associated with mesothelioma. The goal is to improve the patient’s quality of life. This is called palliative treatment.

Participate in scientific research

The LUMC conducts scientific research on the treatment of lung cancer. Depending on your situation, you may be asked to participate.

Also, regular meds may not work enough for you, and you may be eligible for an experimental medicine. In this case the doctor will inform you in detail about this.

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