Advances in radiation therapy offer patient’s new lung cancer treatment options to manage their disease while maintaining their quality of life.
Lung Cancer Overview
The lungs are part of your respiratory system. When you breathe, air passes from your nose or mouth into your windpipe (trachea) and through the bronchi before entering your lungs. The most common types of lung cancer, small and non-small cell, typically start in the cells of the central bronchi.
More than 226,000 Americans will be diagnosed with lung cancer in 2012. Most will be 65 years of age or older. 85-90% of lung cancers are non-small cell.
While smoking is the primary cause of lung cancer, it can also be caused by second hand smoke, asbestos, radon gas and air pollution. Family history may be another risk factor for lung cancer. Early stage lung cancer typically does not have symptoms, but as the cancer advances, symptoms may include trouble breathing, coughing, chest pain, coughing up blood, unexpected weight loss and fatigue.
Lung Cancer Treatment Options
Surgery, chemotherapy targeted therapy and radiation therapy may be used alone or in combination as lung cancer treatments.
Surgical options include a wedge resection (removing a portion of one lobe), a lobectomy (removal of one lobe), or a pneumonectomy (removal of an entire lung). After either surgical technique, a chest tube allows the fluid and air that may collect in the pleura to drain.
Chemotherapy is a systemic treatment that distributes drug dosage throughout the body by the bloodstream. This is why it is often the preferred recommendation when tumors have spread outside the lungs. Chemotherapy may be given as pills, as an intravenous infusion, or as a combination of the two. Chemotherapy of the lung typically uses two chemotherapy drugs simultaneously.
Tumors need new blood vessels for nourishment and to continue growing. Bevacizumab is a monoclonal antibody that targets a protein that helps new blood vessels to form. By interfering with the blood supply, the cancer cells can no longer grow and divide, slowing or stopping the cancer’s growth. Targeted Therapy may have fewer side effects than chemotherapy.
Lung Cancer Radiation Therapy
Radiation is often prescribed in addition to surgery or in combination with chemotherapy. While there are different forms of lung cancer radiation therapy, only the highly targetable are used against lung cancer since it is so important to avoid the healthy, functioning tissue surrounding the tumor sites. One of several highly sophisticated forms of External Beam Radiation Therapy or Internal Radiation Therapy may be recommended depending on the size and location of the tumor or tumors.
Radiation Therapy For Lung Cancer
Radiation is often prescribed in addition to surgery or in combination with chemotherapy. While there are different forms of radiation therapy for lung cancer, only the highly targetable are used since it is so important to avoid the healthy, functioning tissue surrounding the tumor sites. One of several highly sophisticated forms of External Beam Radiation Therapy or Internal Radiation Therapy may be recommended depending on the size and location of the tumor or tumors.
3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT)
3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT) are two forms of External Beam Radiation Therapy. During 3D-Conformal treatments, a device called a "multi-leaf collimator" will shape the individual radiation beams to “conform” to the shape of your tumor according to the data and instructions it receives from the system computer. IMRT uses thousands of radiation “beamlets” from many different angles to deliver a single dose of radiation. The intensity of the “beamlets” can change during the treatment session to modulate the dose, so that the tumor receives a very precise high dose of radiation, while minimizing damage to surrounding, normal tissue.
Before each session, a Radiation Therapist will carefully position you on the treatment table using a body immobilizer for precise body placement. Image guidance will be used to confirm the location of the tumor before the therapy begins. During your treatment sessions, the radiation delivery system will revolve around you, delivering the radiation according to the plan set by your Radiation Oncologist. Each treatment session lasts from 10 to 30 minutes. Typically, you will be scheduled for five sessions a week for five to eight weeks. Intensity-Modulated Radiation Therapy for lung cancer is pain-free and requires no sedation so you can return to your normal activities right away.
Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Body Radiation Therapy (SBRT), another form of External Beam Radiation Therapy, effectively treats cancers in high-risk locations. It is so precisely targetable that Radiation Oncologists can use it to shrink and destroy tumors without damaging vital, nearby tissue. As you undergo therapy, the system’s imaging technology tracks the tumor in real-time and makes adjustments as you breathe, a process called respiratory gating. SRBT provides such precise targeting that Radiation Oncologists can increase the radiation dosage and deliver it over a shorter period of time. You will typically have one to five treatment sessions rather than the standard five to eight weeks of traditional EBRT treatment. During each session, a Radiation Therapist will carefully position you on the treatment table using a full body immobilizer. Image guidance will be used to confirm the location of the tumor before the therapy begins. Stereotactic Body Radiation Therapy for lung cancer is pain-free and requires no sedation so you can return to your normal activities right away.
Internal Radiation Therapy (Brachytherapy)
Internal Radiation Therapy, also known as Brachytherapy, targets tumors with radiation delivered through a catheter directly to the tumor site through a bronchoscope. High-Dose Rate (HDR) Brachytherapy is most often used with more advanced stages of lung cancers to improve breathing. During HDR treatment, a computer-controlled machine sends tiny radioactive pellets down each catheter to deliver the radiation at multiple depths and varying times. The overall treatment time at the tumor site is 10 to 20 minutes. Your lung cancer treatment plan may require one session or multiple sessions. The catheters are then removed so that no radioactive material remains in the body.
Occasionally Low-Dose Rate (LDR) Brachytherapy is used as a lung cancer treatment. During LDR treatment radioactive seeds, the size of a rice grain, are implanted at the tumor site through the catheters. The seeds remain near the tumor. Over time, the seeds become non-radioactive. You are free to resume normal activity with either treatment.