Facts About Lung Cancer

Lung cancer ranks as the second most diagnosed cancer among both men and women and remains the leading cause of cancer-related deaths. The American Cancer Society estimates that approximately 238,000 Americans will receive a lung cancer diagnosis annually. While cigarette smoking is the primary risk factor, other contributors include exposure to asbestos, radon, environmental pollutants, secondhand smoke, and genetic predispositions.

Types of Lung Cancer

Lung cancers are primarily categorized into two types:

Non-Small Cell Lung Cancer (NSCLC): This is the most prevalent form, accounting for about 84% of cases. NSCLC encompasses subtypes such as:

Adenocarcinoma: Originates in the peripheral regions of the lungs.
Squamous Cell Carcinoma: Develops from the cells lining the airways.
Large Cell Carcinoma: A less common subtype with varied cellular origins.

Small Cell Lung Cancer (SCLC): Though less common, SCLC is characterized by rapid growth and a higher propensity to spread. It is strongly associated with smoking.

Treatment Approaches

The management of lung cancer is influenced by factors such as cancer type, genetic mutations, disease stage, and the patient’s overall health. A multidisciplinary team—including radiation oncologists, medical oncologists, thoracic surgeons, and pulmonologists—collaborates to develop a comprehensive treatment plan.

Radiation Therapy

Radiation therapy is a non-invasive modality that targets cancer cells by impairing their ability to multiply. It can be administered alone or in combination with surgery and chemotherapy, depending on individual patient needs. Various forms of radiation, including X-rays and proton beam therapy, are utilized based on the specific clinical scenario.

Early-Stage Lung Cancer: Surgery is often the standard treatment. However, for patients who are not surgical candidates, stereotactic body radiation therapy (SBRT) or stereotactic ablative radiotherapy (SABR) offers a focused and effective alternative.
Locally Advanced Lung Cancer: For larger tumors or those involving lymph nodes, radiation therapy—often combined with chemotherapy—may serve as the primary treatment.
Advanced Lung Cancer: In cases where the disease has progressed, radiation therapy can alleviate symptoms such as cough, shortness of breath, pain, or bleeding.

External Beam Radiation Therapy (EBRT)

EBRT involves delivering high-energy beams, such as X-rays or protons, to the tumor site using a linear accelerator. Treatments are typically scheduled daily, Monday through Friday, over several weeks. In certain cases, such as with small cell lung cancer, multiple treatments per day may be recommended.

Prior to initiating therapy, a planning session called simulation is conducted. This involves imaging studies, such as CT scans, to delineate the treatment area. Small skin markings or tattoos may be applied to ensure precise alignment during each session.

Advanced Radiation Techniques

Several sophisticated techniques enhance the precision and effectiveness of radiation therapy:

Three-Dimensional Conformal Radiotherapy (3D-CRT): Utilizes multiple radiation beams shaped to conform to the tumor, minimizing exposure to surrounding healthy tissue.
Intensity-Modulated Radiation Therapy (IMRT): A refined form of 3D-CRT that adjusts the intensity of each beam, allowing for more precise dose distribution.
Stereotactic Body Radiation Therapy (SBRT): Delivers high doses of radiation to small, well-defined tumors over a shorter treatment course, typically in five sessions or fewer.
Proton Beam Therapy: Employs protons instead of X-rays, potentially reducing radiation exposure to adjacent normal tissues. The advantages of proton therapy over other forms are currently under investigation.

Self-Care During Treatment

Maintaining overall well-being during radiation therapy is crucial. Patients are advised to:

Ensure adequate rest and seek support when needed.
Adhere to medical guidance and promptly report any fevers of 101°F or higher.
Communicate openly with healthcare providers about any concerns.
Discuss all medications, including supplements, with the medical team to prevent potential interactions.
Consume a balanced diet; a dietitian can offer assistance if taste changes or appetite issues arise.
Protect the skin in the treatment area by wearing protective clothing, avoiding extreme temperatures, and using approved lotions or ointments.

Completing treatment and recovery can be challenging. Seek out help from support groups and friends ahead of time. If you have a support network in place before and during treatment, it will be easier to get through side effects since people you can count on will be around to help you. If you need additional support, let your nurse or doctor know.

Potential Side Effects

Side effects vary among individuals. Commonly reported effects include:

Fatigue: A common experience that typically improves within a few weeks post-treatment.
Skin Changes: Irritation resembling sunburn may occur; gentle cleansing with mild soap and warm water is recommended.
Respiratory Symptoms: Shortness of breath or cough may develop, either temporarily or permanently, depending on the treatment and cancer characteristics.
Swallowing Difficulties: Some patients may experience discomfort when swallowing, which usually resolves a few weeks after completing therapy.
Hair Loss: Loss of chest hair may occur in the treated area.

Many side effects can be managed with medications and dietary adjustments. Patients should promptly inform their healthcare team of any discomfort to receive appropriate support.

Our Radiation Oncology Team

Dr. O’Connor and Dr. Montes are experienced radiation oncologists specializing in cancer treatment through radiation therapy. Our multidisciplinary team includes radiation therapists, physicists, dosimetrists, radiation oncology nurses, medical assistants, an oncology nurse navigator, and certified nutrition specialists, all dedicated to providing comprehensive care.