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Receiving a lung cancer diagnosis can be devastating. Unlike
some cancers like breast cancer or skin cancer, lung cancer is often not
detected until it’s advanced, which makes it harder to treat. This is often
because symptoms could be easily brushed off as something less serious like an
infection or for smokers, a smoker’s cough.
If you are diagnosed with lung cancer, your oncologist not
only needs to know what type of lung cancer you have, but what stage the
disease has reached. This can range from Stage 1, where the cancer is still
confined to one lung, to Stage 4, where it has metastasized or spread to other
parts of the your body, including your lymph nodes. Although later stage lung
cancer is the most difficult to treat, oncologists are increasingly optimistic
because there have been major advances in research over the past few years, resulting
in newer and more effective treatments.
Immunotherapy
Traditionally, many type of cancers are treated with
chemotherapy, which attacks the cancer cells. But chemotherapy affects other
non-cancer cells as well as the cancer cells, causing potentially serious side
effects. Chemotherapy is also not as effective in treating lung cancer as it is
for some other types. So while chemotherapy is still used, researchers have
been turning their attention to a new therapy called immunotherapy, treatment
for patients with advanced lung cancers that haven’t responded to chemotherapy.
It may also be used in some cases, as first-line, or initial treatment.
Immunotherapy uses specific proteins to stimulate your own
immune system to find and destroy cancer cells. One of the advantages of
immunotherapy is the treatment attacks only cancer cells and not the healthy
cells in your body, reducing the risk of unpleasant side effects.
Currently, there are three immunotherapy medications used to
treat advanced non-small cell lung cancer (NSCLC): Nivolumab (Opdivo),
pembrolizumab (Keytruda) and atezolizumab (Tecentriq). Patients may get one
alone, or a combination of the medications, which are given by intravenous
(IV).
Like all medications, immunotherapies may have side effects.
The most common one include:
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Constipation
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Cough
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Diarrhea
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Fatigue
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Itching
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Joint pain
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Loss of appetite
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Nausea
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Skin rash
There are more serious side effects that could affect your
organs, such as your lungs, intestines, liver, and kidneys, but they are rare.
Targeted Therapy
Another breakthrough treatment for advanced cancer is targeted
therapy. Unlike immunotherapy which works with your immune system, targeted
therapy focuses on the cancerous tumors themselves in one of three ways. Angiogenesis
inhibitors prevent the tumors from growing new blood vessels. These blood
vessels are essential to the tumors, providing them with the oxygen and
nutrients they need to keep growing. Epidermal growth factor receptor (EGFR)
inhibitors keep cancer cells from dividing and growing. A third group of
medications target a tumor cell gene called ALK, which can produce a protein
that causes cancer cell growth.
Targeted therapy is not available for all cancers yet. The targeted
therapy found to be most effective in treating late-stage lung cancer are
generally the EGFR inhibitors, although angiogenesis inhibitors and those that
target the ALK gene have been used for certain types of lung cancer. These
medications can be taken by IV or by pill, depending on the particular drug.
Targeted therapy can be very specific, affecting only one type of cancer cell
and making one change only, or it can be broader, making several changes in the
cancer cells.
Researchers have found cancers can become resistant to targeted
therapies. To reduce the risk of this occurring, oncologists are combining more
than one targeted therapy for a combination therapy, or they are combining targeted
therapy with more traditional chemotherapies. They believe by targeting more
than one part of the cancer cell, treatment has a greater chance of being
successful.
The most common side effects of targeted therapies are
similar to immunotherapy but make also include bleeding, headaches, high blood
pressure, low white blood cell counts (increasing risk of infection) and mouth
sores.
Vaccines
Researchers have been looking for different ways to boost
the body’s immune response to many types of cancer. While not yet available to
the general public, there are clinical trials testing different types of
vaccines to treat lung cancer. These vaccines, called therapeutic vaccines, are
meant to treat lung cancer not prevent it, unlike vaccines for diseases like measles
or chicken pox, for example.
Early studies show the therapeutic vaccines given alongside
chemotherapy are promising, but more research is still needed before they can
be readily available.
As
more treatments for advanced lung cancer become available, people with advanced
lung cancer are living longer and with a better quality of life. Speak to your
doctor about these advanced options to see if they may be helpful for you.
