What are the main treatment options for lung cancer?
Treatment options for lung cancer include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. The choice depends on the type and stage of cancer, as well as the person’s overall health.
What if I’m not based in London?
I’ll arrange to review all of the investigations you’ve had already and arrange a video consultation if you’d prefer not to travel for your initial appointment. If we decide to proceed with treatment, depending on the treatment plan, hotel accommodation is provided by the hospital free of charge to you or discounted rates can be accessed at hotels that I partner with close to the treating hospital.
If I have surgery, can I avoid chemotherapy and radiotherapy?
This very much depends on the stage of your lung cancer and the results of the surgery. Increasingly, we are offering chemo/immunotherapy before operations to shrink the tumours and increase the likelihood of surgical success. Or we may offer you chemotherapy or targeted therapies after surgery depending upon the stage of your lung cancer and its genetic drivers. Radiotherapy is sometimes offered after surgery – usually if there is a risk of microscopic cancer cells being left behind.
If I have chemotherapy or radiotherapy, can I avoid surgery?
We’ll talk about the overall aim of your treatment before starting out. If you receive SABR for early-stage lung cancer, your treatment is complete as soon as it finishes. Chemoradiotherapy is given with the aim of cure of Stage III lung cancer and while I don’t routinely refer all patients for surgery after chemoradiotherapy. If I feel there is an advantage of surgery, I’ll discuss this with you. Sometimes, I recommend chemotherapy and immunotherapy before surgery or chemotherapy or targeted therapies (e.g. Osimertinib) after surgery or radiotherapy.
If I need further treatment after surgery, how long do I have to wait?
In principle, we’d want to start any further treatment as soon as possible. That being said, you need to have sufficiently recovered from surgery before starting. With modern surgical techniques, post-operative hospital stays and recuperation periods are shortening.
How does radiotherapy work for lung cancer?
Radiotherapy uses high-energy radiation to kill cancer cells or shrink tumours. It can be used alone or in combination with other treatments, and advanced techniques like SABR provide precise targeting to minimise damage to healthy tissue.
What is SABR and how is it different from traditional radiotherapy?
Stereotactic Ablative Radiotherapy (SABR) is a highly precise form of radiation therapy that delivers high doses of radiation to a small, targeted area. It’s different from traditional radiotherapy in its accuracy and ability to minimise exposure to surrounding healthy tissues.
What are the side effects of lung cancer radiotherapy?
Common side effects of radiotherapy for lung cancer include fatigue, skin reactions, coughing, and shortness of breath. Side effects vary depending on the specific area being treated.
I know someone who had lung cancer and had chemoradiotherapy and had terrible side effects (painful swallowing, infections) will I get that too?
When I started training in oncology, it was not unusual for patients receiving chemoradiotherapy for lung cancer to be admitted to hospital during their treatment as they were unable to eat and needed strong painkillers because of painful swallowing. Using the modern radiotherapy techniques I use for my patients, I can’t remember the last time I had to do this. One of the side effects of chemotherapy is an increased risk of potentially serious infection. What’s important here is that if you have a high temperature while receiving chemotherapy, or if you are just not feeing quite right, it’s important to seek advice and treatment immediately. I work at private hospitals that can see you any time to start treatment for side effects as soon as they appear – any time of the day or night.
Can radiotherapy be used for metastatic lung cancer?
Yes, radiotherapy can be used to treat metastatic lung cancer, particularly in cases of oligometastatic disease where the cancer has spread to a limited number of sites. It can help control the disease and relieve symptoms.
What is the success rate of lung cancer radiotherapy?
The success rate of radiotherapy for lung cancer varies based on the stage and type of cancer, as well as the patient’s overall health. SABR has a high cure rate for early-stage lung cancer.
Will I die from lung cancer?
Survival rates after treatment for lung cancer vary widely. From my personal figures, 90% of the patients I have treated with SABR for early-stage lung cancer were cured by the treatment. For patients with Stage III lung cancer (large tumours, or those that have spread within the chest), with chemoradiotherapy followed by immunotherapy, the chance of being alive 5 years after treatment is currently about 40%. However, treatments for lung cancer are always improving, so I expect this figure to continue to improve. For patients with metastatic lung cancer, I see patients who have had an excellent response to treatment who remain well, with controlled cancer, many months to years after diagnosis. A proportion of patients with oligometastatic lung cancer who receive SABR to the metastatic disease can expect to remain cancer-free with good quality of life for longer than ever before.
How long will I live/what are my chances?
Before starting any treatment, I’ll tell you if the treatment is likely to offer you a cure or if it is being given with the aim of shrinking, controlling, containing the cancer for a period of time. If your lung cancer can’t be cured, there are still a number of treatment options that can keep you feeling well with a maintained quality of life for longer than ever before. I’ll talk about all of the options and the likelihood of success before embarking on any treatment plan.
How long does a typical radiotherapy session last?
A typical radiotherapy session for lung cancer usually lasts between 10 to 45 minutes, depending on the complexity of the treatment.
How many radiotherapy sessions are needed for lung cancer?
The number of radiotherapy sessions required varies based on the treatment plan. SABR may require fewer sessions (typically 3-5) compared to conventional radiotherapy, which may involve several weeks of daily treatment.
Can I continue my normal activities during radiotherapy?
Many patients are able to continue their normal activities during radiotherapy, although some may experience fatigue and other side effects that could require rest and adjustments to their routine. I’ll talk to you about the impact side effects will have on your day-to-day life and how likely the side effects are to occur
Can I drive during radiotherapy?
There’s no reason that you can’t drive during or after radiotherapy to the chest. If you are feeling more tired than usual, I’d recommend that you don’t drive in the same way that you wouldn’t drive if you were tired for any reason. If your lung cancer has spread to your brain, you must stop driving and inform the DVLA.
What happens during my radiotherapy appointment?
When you attend for radiotherapy, radiographers will accompany you into the radiotherapy room. They will get you into the right position on the treatment couch and then leave the room. Before the treatment starts, they will take some scans to make sure you are positioned perfectly. They will then deliver the treatment before coming back in to the room.
What do I see/feel during radiotherapy?
I’ll talk about the specifics of the machine we are using before we start treatment. The machine will move around you, but it will never touch you. You won’t see or feel anything during treatment – the radiation is invisible and painless. It is just the same has having an X-ray.
Will I be radioactive/can I be around my children/grandchildren during radiotherapy?
The only radiation you will be exposed to is when the machine delivers the treatment. This radiation doesn’t stay in the body and you will not carry it around with you when you leave the room. You are not a risk to anybody else and there are no additional precautions that you need to take.
Does radiotherapy hurt?
You don’t see or feel anything during your radiotherapy treatment. It shouldn’t cause you any pain while the treatment is being delivered. The side effects of radiotherapy build up during and just after treatment has finished. The side effects you can expect are individual to you and should be discussed with you before and during treatment. Some patients can experience (usually mild) chest wall pain many months after SABR treatment. This is usually in patients whose tumours lie next to the chest wall.
Will all my hair fall out?
Only hair that is in the radiotherapy field is at risk of coming out. For men with lung cancer, they may lose some chest hair. If you are receiving radiotherapy to the brain, your hair will come out – how much depends on the type of radiotherapy to the brain you are receiving. Not all drug treatments for lung cancer cause hair loss and you’ll be advised of this before starting treatment. For the more traditional types of chemotherapy that are associated with hair loss, we can talk to you about strategies that can reduce the risk of this happening.
Will I need a tattoos for radiotherapy?
This very much depends on the type of radiotherapy and the machine we are using to deliver the treatment. Not everybody needs to have radiotherapy tattoos. I’ll tell you if we need to use them, but in recent years, we are using them less frequently. If you require tattoos, they are small dots (about the size of a penpoint) on either side of your chest and one in the middle of your chest.
Why do people have tattoos for radiotherapy?
To maximise your chance of cure, radiotherapy needs to be as accurate as possible. Traditionally, small dots will be tattooed on to the body so that the patient can be lined up to lasers that are present in the radiotherapy room. This is the first step in positioning you for treatment. Some departments use different ways to check your position and the use of tattoos is becoming less common.
What about my diabetes and other health problems?
People’s blood sugars are not often altered by radiotherapy – unless side effects change the amount and type of things that you are eating. Some chemotherapy drugs require the use of steroids to prevent side effects and these can affect your blood sugars. Before starting treatment, I’ll take a detailed medical history and I’ll explain how the treatment I am recommending can impact on your other health problems. One of the advantages of private medicine, is that, if needed, I can access other experts to optimise your other health problems quickly to make sure we can can deliver the best quality cancer treatment.
I have heart trouble, does that matter?
Absolutely. The role of heart disease and the impact of radiotherapy for lung cancer on the heart is a current hot-topic and one of my current research interests. We know that people with heart disease who receive high radiation doses to the heart during treatment for lung cancer have poorer outcomes. If you have heart disease and a tumour that is close to your heart, I will talk to you about using proton beam therapy to reduce the chance of you running into problems.
Do I have to fast or come in starved before radiotherapy?
When you are receiving radiotherapy to the chest, there is no reason to avoid food or drink before radiotherapy. In certain situations, such as if you are having SABR for a cancer deposit in the upper abdomen, I’ll talk to you about fasting for a few hours before treatment. Each situation is unique.
What is the advantage of proton beam therapy (PBT) for lung cancer?
PBT allows accurate placement of the radiation dose which can reduce the radiation dose to the heart, spinal cord and normal lung tissue. This can reduce side effects. The accuracy of the treatment can also mean we can retreat areas that have already received radiotherapy.
What is the advantage of the MR-Linac for lung cancer?
During treatment on the MRI-guided radiotherapy machine, it is possible to see your tumour in real time during treatment. This allows us to only deliver the radiotherapy when the tumour is in one position, thereby improving the accuracy of the treatment and reducing the amount of normal tissues, such as the wind pipe (trachea) receiving a high radiation dose. We can also adapt the treatment day-to-day to improve the quality of the SABR treatment.
For more personalised information and to discuss the best treatment options for your specific lung cancer, please contact me or schedule a consultation.