Lung Cancer Patients Benefit from Combined Surgical, Chemotherapy and Radiation Regimens

March 1, 2008

Lung cancer is the second most common form of cancer in the United States and ranks as the number one cause of cancer deaths, but the prognosis does not have to be dreary. Many patients are unaware of their full range of options, both for curative and palliative care. Floyd Memorial and the Cancer Center of Indiana offer patients the option of combined treatment using surgery, chemotherapy and radiation therapy, with personalized treatment plans for each individual patient. Physicians Naveed Chowhan, MD, medical oncologist, and B. Oliapuram Jose, MD, radiation oncologist, both with The Cancer Center of Indiana, share their insights.

Quitting Smoking is Essential

“The vast majority of lung cancers, 80-90 percent, are smoking related, but there are two important points here to consider,” said Dr. Chowhan. “First off, continuing to smoke after diagnosis has been proven to make the cancerous cells multiply and spread much faster than in non-smokers, so it’s always advisable to immediately stop smoking after diagnosis. Second, many people believe that they can stop smoking at any time and immediately offset their risk for developing lung cancer down the road, which is a myth. While risk does drop immediately after quitting, studies have shown that it takes the lungs 10 or more years to fully recover to non-smoker levels, and the longer the person smoked, the longer it takes to achieve full recovery.” He added, “The most important thing any smoker can do for their health is to immediately cease smoking.”

Adjuvant Treatment Plans Have Proven Promising

“Adjuvant or, combined, chemotherapy and radiation therapy have become standard practice for both surgery-eligible and nonsurgical candidates only in the last few years. However, the results we’re seeing with patients are proving that combined therapies are definitely our best options for both curative and palliative treatment,” said Dr. Jose.

Nearly every lung cancer patient is eligible for radiation and/or chemotherapy treatment, depending on the stage and location of the cancer within their lung. However, not all patients are eligible for surgical removal of cancerous tissue, which can be due to a variety of reasons, including the patient’s overall state of health or the degree to which the cancer has spread. “Adjuvant treatment options display teamwork at its best,” said Dr. Chowhan. “The surgeon, radiation and medical oncologists all work together as a team to determine the best course of treatment for each individual patient.”

“For example, many stage two and three lung cancers are treated with chemotherapy after a surgeon has removed the cancer to prevent recurrence,” stated Dr. Chowhan. “This is because chemotherapy drugs actually kill the cells that may have escaped surgical resection.” Dr. Jose added, “In addition to this, radiation can be used to specifically target, destroy and prevent the recurrence of cancerous tissue unable to be removed by surgery. It can also be utilitized for palliative care as well to reduce the pain and difficulty breathing that often accompany lung cancer. While both options are excellent, we tend to see the best results when patients are willing to combine their treatment plans. It’s a win-win situation.”

What Does Chemotherapy and Radiation Treatment Involve?

“Patients always want to know what the chemotherapy and radiation process involves and what kind of side effects they can expect,” said Dr. Chowhan. While each treatment plan is tailored to the individual patient, one round of chemotherapy will generally involve four infusions administered three weeks apart. Each infusion lasts a couple of hours and is administered at the Cancer Center of Indiana in a comfortable and soothing setting. Side effects vary from person to person, but commonly involve nausea, fatigue and hair loss or thinning. However, excellent treatments are available today to prevent these side effects.

Dr. Jose explained, “Radiation patients can usually expect to receive 3-D conforming or IMRT radiation treatment, which involves a cat scan to mark exactly where the cancer is located, followed by high energy radiation directed precisely at the tumor to destroy it while preserving healthy surrounding tissues. This is done daily, Monday thru Friday, for six to seven weeks and takes approximately 15-20 minutes each time while the patient is lying on a table under a beam of radiation. Patients also receive weekly X-rays to track progress and adjust treatment plans accordingly. A significant benefit of radiation therapy is that the patient cannot feel, taste, smell, or hear the treatment while it is being given and it often has palliative effects in that it reduces difficulty breathing and pain in many patients. Common side effects include sore throat, cough and skin changes, all of which are treatable with medication.“

For more information on treatment options at the Cancer Center of Indiana, call 812-945-4000.