Lung Cancer Care

Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. These abnormal cells do not carry out the functions of normal lung cells and do not develop into healthy lung tissue. As they grow, the abnormal cells can form tumors and interfere with the functioning of the lung, which provides oxygen to the body via the blood.

According to the American Cancer Society, lung cancer is the second most common cancer in both men and women and accounts for about 27% of all cancer related deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.

Although smoking is the main cause of lung cancer, lung cancer risk also is increased by exposure to secondhand smoke; environmental exposures, such as radon, workplace toxins (e.g., asbestos, arsenic), and air pollution. The risk of lung cancer can be reduced by quitting smoking and by eliminating or reducing exposure to secondhand smoke and environmental and workplace risk factors.

Lung Tumor Treatment Options

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 (EBRT). 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. IMRT 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 (IRT), 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.

Stereotactic Body Radiation Therapy (SBRT)

Stereotactic Body Radiation Therapy (SBRT), another form of External Beam Radiation Therapy (EBRT), 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. SBRT for lung cancer is pain-free and requires no sedation so you can return to your normal activities right away.

Chemotherapy

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.

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