Lung cancer treatment

As the third most common type of cancer in the UK, there are many available treatments for lung cancer. Treatment usually combines two or more types of therapy.

Treatment depends on the stage and type of cancer, its position in your chest, your overall health, and of course, your treatment preferences.

Different types of lung cancer have their own treatment approaches:

• Non-small cell lung cancer (NSCLC) – the main treatments of early disease are surgery or radiotherapy, often combined with chemotherapy or immunotherapy. The treatment of more advanced disease is chemotherapy or immunotherapy which can be combined 
• Small cell lung cancer – the main treatments of early disease are chemotherapy, radiotherapy, or immunotherapy, which may be combined. The treatment of more advanced disease is chemotherapy or immunotherapy which can be combined.
• Mesothelioma – the main treatments are chemotherapy, radiotherapy, or immunotherapy, which may be combined

For lung cancers with a specific genetic mutation, targeted therapies can sometimes be effective. 

Surgery is most commonly used to treat non-small cell lung cancer at stages one, two or three. The aim of surgery is to remove as much cancer as possible.

Having lung surgery may sound frightening. But it’s possible to recover and live an active life afterwards, and your doctor can help you understand what to expect during and after surgery.

There are three main types of surgery for lung cancer:

• Lobectomy – taking out a large part of the lung (the lobe) 
• Wedge or segment surgery – taking out a small piece of the lung 
• Pneumonectomy – removing the whole lung although this is an uncommon treatment

Often, surgery is combined with chemotherapy to reduce the chances of your cancer coming back.

If you and your consultant agree surgery is best for you, we can arrange this for you at one of our locally and nationally renowned partner hospitals with expert lung cancer surgeons. You’ll be able to continue with any other treatment and care with us at GenesisCare.  

After your operation, you’ll likely remain in hospital for 3 to 7 days. It’s normal to have side effects such as pain, fatigue, and breathlessness during this time. They’re temporary but the time it takes to recover differs from person to person.

Your care team will help you manage any side effects during your stay and will provide the appropriate aftercare for when you’re ready to go home.

More serious side effects like an air leak or infection are less common and can be managed with a procedure called a chest drain and antibiotics.

Radiotherapy uses high-energy X-rays to destroy cancer cells and treat lung cancer. It may be offered to people with non-small cell lung cancer, small cell lung cancer, or mesothelioma.

Some ways radiotherapy can be used include:

• Instead of surgery to treat stage one non-small cell lung cancer
• After surgery to reduce the likelihood of the cancer returning (adjuvant radiotherapy)
• With, before, or after chemotherapy for stage two and three lung cancer treatment (chemoradiation)
• To give ablative radiotherapy to limited sites of metastatic disease (oligometastatic and oligoprogressive disease)
• To ease symptoms by controlling cancer growth and spread for stage four lung cancer treatment (palliative radiotherapy)
• To destroy any lung cancer cells that may have spread to the brain (prophylactic cranial radiotherapy) for people with small cell lung cancer

The treatment courses may be tailored to you and depend on the type of radiotherapy you’re having. Each treatment usually lasts a few minutes, but the whole appointment can take a few hours at the hospital. These appointments are usually spread across 3 to 7 weeks.

There are now more innovative radiotherapy techniques and technologies available that deliver radiotherapy over shorter treatment sessions, which we offer here at GenesisCare. We’re the leading provider of the most comprehensive stereotactic ablative radiotherapy (SABR) service in the UK.

SABR is an advanced radiotherapy technique that delivers focused, high-energy radiation beams to remove tumours in five or fewer sessions. It’s often used as alternative to surgery and in patients with advanced cancer to keep the cancer under control for longer or help with symptoms.

The MRIdian MR linac is an innovative radiotherapy technology that delivers MRI-guided SABR using live MRI imaging and powerful radiation to deliver targeted and precise treatment. With an automatic shut-off feature, treatment pauses if the tumour moves even slightly, such as when breathing, helping protect surrounding healthy tissue from radiation and minimise side effects. The radiotherapy can also be adapted before each treatment, by our team of experienced consultants, to deliver what’s called adaptive stereotactic radiotherapy.

We’re the first UK healthcare provider to exclusively offer this innovative treatment to lung cancer patients across the UK at our centres in Oxford and London. With treatment completed in five sessions or less, there’s little disruption to your everyday routine.

The MRIdan can also be used to deliver SABR reirradiation (repeat SABR) to treat lung cancer that has previously been treated with radiotherapy and has since returned. 

Volumetric modulated arc therapy (VMAT) is another highly precise and effective treatment option. It delivers a continuous beam of radiotherapy in an arc, which helps limit side effects by targeting tumours while avoiding healthy tissue. Together with image-guided radiotherapy (IGRT), it precisely targets areas of cancer, adjusting the beam and intensity to allow for movement, such as when you breathe.

If you choose to have your radiotherapy with us, your treatment will be overseen by our expert multidisciplinary teams (MDTs), consisting of oncologists, radiotherapists and medical physicists. They’ll work together to ensure sure you receive the best possible care.

If you’d like to find out more about our treatments and services, or would like to make an appointment, talk with one of our friendly team members today.

Pancreas surgery side effects can be short-term, including pain and nausea You may have some side effects of radiation treatment for lung cancer during and after your treatment. These will be explained to you by your doctor and care team. They’ll also provide support and any medication if necessary.

Many side effects tend to be temporary and short-term, such as:

• Feeling weak and tired
• Nausea and vomiting
• Breathlessness and a dry cough
• Redness or darkening of the treatment area
• Hair loss in the treatment area
• Trouble swallowing
• Slight chest pain

Other side effects may appear months after you’ve finished your treatment. They’re rare but may include an oesophageal stricture, where your food pipe becomes rigid and narrow, or a tightness in your chest from inflammation to your heart lining. 

At GenesisCare, we use innovative techniques to help minimise the impact of side effects on our lung cancer patients. As part of your radiotherapy, you may be supported to perform deep inspiration breath hold (DIBH) or have abdominal compression during treatment –  these simple but effective techniques are proven to reduce radiation exposure to healthy tissues like your heart, lowering the risk of side effects.

By combining these techniques with our specialist radiotherapy and CT scanners, we can make sure you’re receiving precise and accurate treatment every time.

Chemotherapy uses medicines that destroy cancer cells. It’s the main treatment for small-cell lung cancer. You may receive chemotherapy on its own or with other therapies such as surgery, radiotherapy (chemoradiation), or immunotherapy. 

If you have non-small cell lung cancer, you may choose to have chemotherapy if your cancer is stage one or stage four. 

• Stage one – before or after surgery (adjuvant chemotherapy), or alongside radiotherapy (chemoradiotherapy)
• Stage four – to slow cancer progression and relieve symptoms (palliative chemotherapy). This is often given with immunotherapy

Generally, chemotherapy is given in cycles at the hospital with breaks between each treatment period. For example, you might have a single day of chemotherapy followed by three weeks of rest to give you and your body time to recover.

At GenesisCare, we offer the most recent drugs in chemotherapy, immunotherapy, and targeted therapies. As a group, they’re known as systemic anti-cancer therapies. Some require in-person sessions that can last several hours. That’s why we’ve invested in a comfortable and relaxing environment with private chemotherapy suites at our state-of-the-art Macmillan accredited treatment centres.

Our 24/7 on-call service with our compassionate chemotherapy nursing teams also means you’ll be cared for no matter the time or place. 

Everyone reacts slightly differently to chemotherapy. Side effects often depend on the chemotherapy drugs you’re taking, how much you’re taking, and your general health.

Some common side effects include:

• Nausea and vomiting
• Appetite and weight loss
• Fatigue
• Reduced immunity
• Easily bruising or bleeding
• Diarrhoea or constipation
• Hair loss

For many people, side effects are mild and pass a few weeks after treatment ends. It’s possible they’ll get worse before going away. If you have side effects, your radiotherapy team can offer you medication to help.

Throughout the treatment process, your doctor and chemotherapy team will discuss side effects with you and how to manage them. Most side effects go away once treatment is complete.

We’re here to support you throughout your chemotherapy and that includes any side effects. From day one, you’ll have access to our complementary therapies proven to help, and sometimes prevent, side effects of chemotherapy. They include:

• Hilotherm ChemoCare – a cooling therapy to reduce nerve damage to the hands and feet from chemotherapy
• Paxman scalp cooling – a cool cap system to reduce hair loss during chemotherapy 
• Wellbeing services – counselling, mindfulness meditation and more through our unique partnership with the national charity Penny Brohn UK

Find out more about the services we provide to support you through chemotherapy side effects.

Immunotherapy involves medicines that help our immune system recognise and destroy cancer cells. The main immunotherapy drugs used in treatment for lung cancer are checkpoint inhibitors. They prevent cancer cells from switching off the immune system, which helps immune cells recognise and destroy the cancer.

Each dose typically takes 30 to 60 minutes as a drip, and may be scheduled every 2 to 4 weeks. If you respond well to the treatment and side effects are managed, you might keep taking immunotherapy for up to 2 years.

Currently, immunotherapy is available in stage two to stage four lung cancer treatment for non-small cell lung cancer. This could be given before and/or after surgery or after radiotherapy for people with early-stage cancers. As single treatment or in combination with chemotherapy for patients with advanced cancers.

It may also be used in small cell lung cancer treatment alongside chemotherapy or following radiotherapy.

At GenesisCare, we use Immune Checkpoint inhibitors to block immune checkpoint proteins on cancer cells from binding with partner proteins on immune cells to manage and treat lung cancer.

Find out more about immunotherapy at GenesisCare 

Side effects depend on the type of immunotherapy drug you’re taking, but are generally manageable. They usually stop once treatment has ended.

• Fatigue
• Nausea and vomiting
• Appetite loss and diarrhoea
• Joint or muscle pain
• Shortness of breath
• Dry or itchy skin

Sometimes, immunotherapy may cause your immune system to attack other parts of your body, such as the lungs or other organs, which can be serious. If this happens, your doctor will stop the treatment, and you’ll receive steroids to stop your immune system temporarily.

If you choose to have immunotherapy treatment at GenesisCare, your specialist or one of our expert nurses will explain the potential side effects and provide advice on how to manage these.

Targeted therapy is typically used to treat stage four non-small cell lung cancer where the cancer has spread to other parts of the body. This is called metastatic or advanced lung cancer. However, it can also be used after surgery or radiotherapy in some patients with early lung cancer.

Your doctor will perform a specialised test on the cancer cells taken during your biopsy or from a blood test to look for ctDNA. The results can show whether the cancer cells have certain mutations or produce certain proteins. Your doctor can use this information to choose the most suitable drugs that target these specific traits and processes.

For lung cancer, there are several drugs available as tablets or capsules that target abnormal proteins made by lung cancer cells. For example, EGFR inhibitors can block a growth factor some lung cancer cells rely on to grow.

At GenesisCare, our targeted therapies include monoclonal antibodies, angiogenesis inhibitors, proteasome inhibitors and signal reduction inhibitors. Some types of targeted therapy also include immunotherapy, and some may be referred to as biological therapy.

Find out more about our targeted therapies

Different targeted drugs cause different side effects. Your doctor and care team will make sure you know about the possible side effects of the specific drugs you’re taking, and how to effectively manage them.

Some general side effects you may feel include:

• Skin changes e.g. a rash or dry, itchy skin
• Sore mouth and throat e.g. ulcers
• Diarrhoea and constipation
• Nausea and being sick
• Anaemia e.g. low energy, dizziness
• Increased risk of infections

If you experience any of these symptoms, it’s important to notify a member of your treatment team so they can support you through any concerns you may have.