What Is Chemotherapy?When it comes to lung cancer, chemotherapy essentially means the use of cytotoxic (cell-killing) medications to kill cancer cells or make them less active.
How Does Chemotherapy Work?Chemotherapy medications work by killing rapidly dividing cells. Since cancer cells divide more frequently than most cells, they are particularly susceptible to these drugs. Some normal cells also divide continuously, such as hair follicles, the stomach lining, and the bone marrow that makes red and white blood cells. This accounts for many of the side effects experienced during chemotherapy, such as hair loss, nausea, and low blood cell counts. Different chemotherapy medications work at different stages of cell division. For this reason, often two or more medications are given at the same time to kill as many cancer cells as possible.
When Is Chemotherapy Used?Unlike surgery and radiation therapy, which are considered “local” treatments, chemotherapy is a “systemic treatment,” meaning that it works to kill cancer cells anywhere in the body. This can be particularly helpful if cancer cells may have spread beyond the regions treated by surgery and radiation. Chemotherapy may be considered for several reasons:
- As an adjunct (in addition) to surgery – In this case, chemotherapy is given to kill any cancer cells that may have spread beyond the cancer but are undetectable by scans.
- To shrink a tumor before surgery – In some cases, chemotherapy is used before surgery to shrink a tumor and improve the chances that surgery will be effective.
- To cure cancer – Rarely, lung cancer may be cured by chemotherapy but this is more common with cancers such as leukemia.
- To prolong life in those with advanced cancer – Often chemotherapy can extend life when a cure is not possible.
- To help with symptoms of cancer – When a tumor is causing symptoms such as pain or shortness of breath, sometimes chemotherapy can reduce the size of the tumor to decrease symptoms.
How Is It Given?Some chemotherapy medications are given as an oral pill, but most are given intravenously. Initial treatment for lung cancer usually involves the use of 2 or more drugs (combination chemotherapy). These drugs are often given in cycles of 3 to 4 weeks at least 4 to 6 times.
MedicationsMany different medications are used to treat lung cancer. Most commonly, treatment begins with either cisplatin or carboplatin combined with another medication. In some cases, targeted therapy may also be used. Common medications used in lung cancer include:
- Paraplatin (carboplatin)
- Platinol (cisplatin)
- Taxotere (docetaxel)
- Adriamycin (doxorubicin)
- VePesid (etoposide)
- Gemzar (gemcitabine)
- Ifex (ifosfamide)
- Camptosar (irinotecan)
- Taxol (paclitaxel)
- Alimta (pemetrexed)
- Hycamtin (topotecan)
- Oncovir (vinblastine)
- Oncovin (vincristine)
- Navelbine (vinorelbine)
- Tarceva (erlotinib)
Side EffectsSide effects of chemotherapy vary depending on the medications you are given, and other factors such as your age, sex, and general medical condition. Thankfully, management of these side effects has made tremendous strides over the past few decades. Everyone responds to chemotherapy differently. You may have few side effects or find the symptoms quite troubling. These side effects can improve over time or worsen over time. Sometimes a medication may need to be changed, but often there are medications and treatments that can control your symptoms and make you more comfortable. Make sure to share any symptoms you are experiencing with your health care team.
The most common side effects are related to the effect of chemotherapy on rapidly dividing cells. Therefore, symptoms such as hair loss, digestive tract symptoms such as mouth sores and nausea, and a lowering of your white and red blood cell counts from suppression of your bone marrow may occur.
Supplements and ChemotherapyMany people with cancer decide to use complementary treatments such as nutritional supplements. When going through chemotherapy it is very important to discuss any supplements you are using with your oncologist. Some supplements can decrease the effectiveness of chemotherapy, while others may make the medication toxic.
- Nausea and Vomiting
- Mouth Sores
- Taste Changes
- Loss of Appetite
- Anemia(low red blood cell count)
- Neutropenia(low white blood cell count)
- Thrombocytopenia(low platelet count)
- Hair Loss
- Skin Changes
- Fingernail changes
- Chemobrain(cognitive changes after chemotherapy)
- Peripheral Neuropathy
American Cancer Society. Detailed Guide: Lung Cancer – Non-small Cell. Chemotherapy. Updated 12/16/10. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-treating-chemotherapy
National Cancer Institute. Chemotherapy and You: Support for People with Cancer. Updated 06/29/07. http://www.cancer.gov/cancertopics/chemotherapy-and-you
National Cancer Institute. Non-small cell lung cancer treatment. Updated 01/20/12. http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/HealthProfessional