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Lung Cancer

Lung Cancer Treatment for Patients in Hampton Roads and Eastern North Carolina

The specialists at Virginia Oncology Associates want patients diagnosed with lung cancer to feel confident about their treatment plan and the care provided throughout their journey. We develop a personalized lung cancer treatment plan that is best for each patient based on the lung cancer type, stage, biomarkers, and overall health condition.

The most significant indicators of treatment options are the type of lung cancer and the stage

Non-Small Cell Lung Cancer Treatments

People with non-small cell lung cancer (NSCLC), the most common type of lung cancer, can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. Those with stage IV (metastatic) lung cancer are eligible for biomarker testing to determine if there is a genetic mutation causing the cancer cells to grow. The results of these tests tell your oncologist if there is a targeted therapy that would work well.

Small Cell Lung Cancer Treatments

People with small cell lung cancer (SCLC) are usually treated with radiation therapy and chemotherapy. 

Learn About Lung Cancer Treatments 

Treatments for lung cancer may include one or more of the following: 

Advancements in the Treatment of Lung Cancer

In recent years, significant strides have been made in treatments approved for lung cancer. This has allowed oncologists to offer patients more approaches to treating lung cancer and more treatment options. Watch the video below to learn how immunotherapy, targeted therapies, and clinical trials have progressed for lung cancer treatment.

Chemotherapy for Lung Cancer

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or stopping them from dividing. In some cases, chemotherapy may be given alone as the primary treatment. In other cases, it may be given in combination with radiation (chemoradiation) or immunotherapy. 

Chemo for Non-Small Cell Lung Cancer

There are several ways chemo may be used for NSCLC:

  • Before surgery to shrink a tumor (or tumors) before they’re removed. This reduces the number of cancer cells that can spread throughout the body during surgery.
  • After surgery to kill cancer cells left behind or kill cancer cells that have already moved into the lymph nodes and lymphatic system.
  • For advanced NSCLC, surgery may not be possible, making chemotherapy and radiation the primary treatments. 
  • When non-small cell lung cancer has spread to other organs in the body, chemotherapy is used to kill the cancer cells. 

Chemo for Small Cell Lung Cancer

There are two primary stages of small cell lung cancer. The use of chemotherapy varies based on this. 

  • In limited-stage SCLC, chemo is often given with radiation therapy. 
  • For people with extensive stage SCLC, chemo may be combined with immunotherapy as the primary treatment. In some cases, radiation therapy is also an option. 

Radiation Therapy for Lung Cancer

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The way radiation therapy is given depends upon the type and stage of the cancer being treated.

There are two types of radiation therapies:

  • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Prophylactic cranial irradiation (radiation therapy to the brain to reduce the risk that cancer will spread to the brain) may also be given to patients with SCLC.

Surgery to Remove Lung Cancer

Surgery is most commonly used to treat the early stages of non-small cell lung cancer. Some cases of early-stage SCLC may benefit from surgery; however, it’s not typically used since SCLC has usually spread past the lungs at the time of diagnosis. Lung cancer surgery can involve removing a portion of the lung or the entire lung through procedures such as lobectomy, segmentectomy, wedge resection, and pneumonectomy.

Even if the doctor removes all of the cancer seen at the time of the operation, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that may remain. Treatment given after surgery to lower the risk of cancer coming back is called adjuvant therapy.

Immunotherapy for Lung Cancer

Immunotherapy, also called biologic therapy, is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.

There are several types of immunotherapy drugs that work in different ways. The immunotherapies currently available to treat NSCLC and some patients with advanced SCLC all belong to a class called checkpoint inhibitors. Immune checkpoints are molecules on the immune cells that can start or stop an immune response. Your body’s immune system uses these molecules to help determine what cells are foreign or not normal. Cancer cells have found ways around this system by hiding from your body’s natural immune system or by weakening the immune system itself. These medications allow the immune system to recognize and destroy cancer cells.

Immunotherapies for lung cancer have developed rapidly over the last few years, proving to be effective alone and in combination with chemotherapy or radiation. Recent studies have shown that certain patients can have a long-term response to immunotherapy.

Cancer vaccines and adoptive T-cell therapy are other types of immunotherapy being studied in clinical trials. 

Targeted Therapy Based on Biomarkers for Metastatic Non-Small Cell Lung Cancer

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. This precision leaves healthy cells alone and reduces the side effects that often come with other types of treatment, such as chemotherapy and radiation therapy. Three types of targeted therapy being used to treat certain types of lung cancer are monoclonal antibodies, tyrosine kinase inhibitors, and mammalian target of rapamycin (mTOR) inhibitors.

Non-small cell lung cancer patients may go through testing for genetic mutations in the cancer cells, called biomarker testing or genomic testing. Biomarker testing looks for changes in the tumor's DNA, such as mutations, additions, deletions, or rearrangements. The first line of recommended treatment will be based on the type of genetic mutation found. 
If no biomarkers are found, your oncologist will recommend a different approach. 

There are currently FDA-approved targeted therapies for NSCLC tumors showing the following genetic mutations:

  • EGFR
  • KRAS
  • ALK
  • ROS-1
  • NTRK
  • MET
  • RET
  • BRAF V600E

Patients who do not test positive for a biomarker with an approved targeted therapy are going to receive a different recommended treatment plan. They may be eligible for a clinical trial that identifies treatments based on other biomarkers found outside of those with an established targeted therapy. 

Related Read: Novel Treatments in Lung Cancer See Expanded Use

Clinical Trials for Lung Cancer 

Some treatments are standard (currently used treatments), and some are being tested in clinical trials (potential new treatments). 

A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show a new treatment is better than the standard treatment, the new treatment may become the standard. Patients may want to consider taking part in a clinical trial but note some are open only to patients who have not started treatment. 

Virginia Oncology Associates is committed to lung cancer research and plays a key role in advancing lung cancer treatment through participation in the MYLUNG clinical research trial. 

Laser Therapy for Treating Lung Cancer

Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells. It is sometimes used to open up the airways of patients if the tumor begins to block the airway making it hard to breathe. 

While you are under general anesthesia, the oncologist inserts the laser with a bronchoscope and then aims the beam at the tumor to burn it away. If needed, the treatment may be repeated. 

Find a Lung Cancer Specialist at Virginia Oncology Associates

If you have been newly diagnosed with lung cancer, the first step is to schedule a consultation with an oncologist. If you are in the Hampton Roads area, we offer personalized treatment plans and second opinions on treatment in Chesapeake, Elizabeth City, Newport News, Norfolk, Suffolk, Virginia Beach, and Williamsburg. Learn more about why you should choose VOA for your lung cancer care.

Listen to our podcast episode about the progression and treatment of non-small cell lung cancer.

In this episode, learn about the groundbreaking strides made in the fight against non-small cell lung cancer. Dr. Christopher Paschold, oncologist at VOA, shares his expertise on the latest in lung cancer treatment and screening. This conversation sheds light on the silent progression of non-small cell lung cancer and the important role early detection plays in improving outcomes. Dr. Paschold talks about the importance of proactive screening, especially for those at high-risk of developing the disease. We also explore the impact of breakthrough therapies, like immunotherapy and targeted therapy treatments, offering new hope to patients.