After a lung cancer diagnosis

Consider Your Options

A lung cancer diagnosis is life altering and brings a mix of difficult emotions. It also brings up questions, including some that no one can answer, like “Why me?” and others your doctors and care team can address, including “What’s next?” Understanding your lung cancer diagnosis and learning about your options may help you move through the emotional challenges and allow you to step more confidently into care.

Illustration of patients and physician

Lung cancer basics1,2

Cancers develop when changes in a cell cause it to misbehave and stop responding to your body's control signals. These outlaw cells start dividing out of control. At first, they stick together in a cluster, such as a lung nodule or mass (also called a tumor). If lung cancer is diagnosed at this early (localized) stage, it's associated with a nearly 8x higher five-year survival rate than if diagnosed at a late stage.3 That's why doctors recommend lung cancer screening for current and former smokers.

As the cluster of cells grows, the tumor can invade and damage nearby tissue, lymph nodes, and organs. Doctors refer to this as regionalized cancer. Eventually, lung cancer cells can spread away from the original tumor to different parts of the body, a process called metastasis. When this happens, tumors can form where the cancer cells spread. This more advanced cancer is referred to as metastasized or distant lung cancer.

Understanding your lung cancer

All cancers that start in the lungs are called lung cancers, and there are several different types. Non-small cell lung cancer (NSCLC) is the most common. It makes up about 80 percent of lung cancer cases.4 The most common type of NSCLC is adenocarcinoma, which makes up about 40% of all lung cancers. NSCLC squamous cell carcinoma makes up about 25% of all lung cancers. And NSCLC large cell carcinoma makes up about 10% of all lung cancers.5 Small-cell lung cancer (SCLC) makes up about 15% of lung cancers6 and is almost always associated with cigarette smoking.4

After determining the lung cancer type, doctors often assign a stage number (0 through 4) based on the tumor’s size and location, whether the cancer has spread to nearby lymph nodes, and if it has spread to other places in the body. Stage 0 lung cancer means abnormal cells are present but haven’t turned into cancer or spread, while stage 4 indicates the cancer has spread to distant parts of the body.2

Biomarker testing7

Your doctor may also recommend biomarker testing (also called molecular or genomic testing) of the tumor tissue to learn if specific genetic changes are present. Targeted drug therapies are available for some lung cancer gene mutations. Biomarker testing lets doctors know if you might be a candidate for one of these drug therapies.

Learn about your care options

The approach to care your doctor recommends depends on your overall health; lung cancer type, which could include genetic features revealed through biomarker testing; tumor size and location; and if the cancer has spread beyond the original tumor. Because no two patients or cancer tumors are the same, only your care team can provide the best recommendations for your situation.

Small cell lung cancer

In patients with small cell lung cancer, doctors most often recommend chemotherapy, radiation therapy, or a combination of both. Surgery followed by chemotherapy and/or radiation therapy is sometimes recommended, as well.6

Non-small cell lung cancer

Care options for patients with NSCLC are more varied and are often combined into a treatment plan. The following is not a complete list of all care options, only the most common. You should talk to your doctors about all the therapies available and which they suggest for you.

Surgery:8 Surgery to remove the lung cancer may be an option, especially if the cancer is localized and has not spread. During the procedure, your surgeon will remove the lung cancer tumor and surrounding tissue, along with nearby lymph nodes. The amount of lung tissue removed depends on the size and location of the tumor and how far it has spread.

Lung surgery can be performed through traditional open surgery (thoracotomy) or a minimally invasive method. Minimally invasive lung surgery approaches include video-assisted thoracoscopic surgery (VATS) or robotic-assisted surgery with the da Vinci robotic surgical system.   

Depending on the cancer stage and your overall health, surgery may be combined with other therapies, either before or after your surgical procedure.

Radiation therapy:9 Doctors deliver radiation therapy by aiming high-energy rays at the cancer from outside the body (external radiation) or by placing a small amount of radioactive material directly into or near the cancer (internal radiation or brachytherapy).

Chemotherapy:10 Often given by mouth or intravenously (through IV), chemotherapy is treatment with anti-cancer drugs. It’s often combined with other therapies to achieve different results, such as shrinking a tumor before surgery or killing undetectable cancer cells that remain after surgery or radiation.

Targeted therapies:11 A growing number of drugs have been developed to go after specific cell changes found in cancer tumors. Unlike chemotherapy, which affects healthy and cancer cells alike, targeted therapies go directly to specific targets on cancer cells. Biomarker testing (above) is needed to find out if your cancer cells contain any of the genetic changes targeted therapy drugs address.

Immunotherapy:12 Immunotherapy drugs help boost your immune system’s ability to find and destroy cancer cells.

Unfortunately, there’s no quick and easy approach to lung cancer care. Each therapy and surgical approach comes with risks and potential side effects. You and your doctors should discuss the benefits and risks of your treatment options so that you can decide what’s right for you.

Learn more about lung cancer

You can find more comprehensive information about lung cancer from the American Lung Association, American Cancer Society, and National Cancer Institute.

Your care journey

 

Patients should consult their physician to decide whether robotic-assisted surgery is appropriate in the individual case in order to make an informed decision taking into account benefits and risks.

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