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About chemotherapy for lung cancer

Chemotherapy means using anti cancer (cytotoxic) drugs to destroy cancer cells.

Chemotherapy for small cell lung cancer

This is the main treatment for most people with small cell lung cancer. This type of cancer responds very well to chemotherapy. And because chemotherapy circulates in the bloodstream around the body, it can treat any cells that have already broken away from the lung tumour. Some people have chemotherapy combined with radiotherapy.

Chemotherapy for non small cell lung cancer

Doctors may use chemotherapy after surgery for early stage non small cell lung cancer (NSCLC). They may also suggest it before or after radiotherapy. These treatments aim to get rid of the cancer. 

If you have advanced non small cell lung cancer, your doctor may suggest that you have radiotherapy and chemotherapy together. The treatment won't cure the cancer but it can keep it under control for some time. 

Chemotherapy to control symptoms

You can have chemotherapy to help control symptoms of lung cancer that has spread into surrounding tissues or to other parts of your body.

How you have chemotherapy

You have most chemotherapy drugs by injection into a vein or through a drip. But some are tablets or capsules that you swallow. Usually, you have treatment with a combination of 2 or 3 different drugs. Most often, you have chemotherapy every 3 or 4 weeks. You usually have 4 to 6 treatments. So a full course can take 3 to 4 months.

 

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What chemotherapy is

Chemotherapy means using anti cancer (cytotoxic) drugs to destroy cancer cells. These work by disrupting the growth of cancer cells. 

 

Chemotherapy for small cell lung cancer

This is the main treatment for small cell lung cancer. Doctors use it because

  • This type of cancer responds very well to chemotherapy
  • Small cell lung cancer tends to have spread beyond the lung when it is diagnosed

Chemotherapy drugs circulate in the bloodstream around the body. So they can treat cells that have broken away from the lung tumour and spread to other parts of the body even if they are too small to see on scans. This microscopic spread often happens even in the early stages of small cell lung cancer.

You may have chemotherapy on its own. Or you may have it before or after radiotherapy (or at the same time). If you are going to have surgery for very early small cell lung cancer, your doctor may suggest that you have chemotherapy before or after your operation.

Doctors usually give a combination of chemotherapy drugs, including either cisplatin or carboplatin (Paraplatin). The combinations include

Small cell lung cancer usually responds well to these treatments. But researchers are continuing to test other combinations to see if they can either improve the results, lessen the side effects, or both.

For cancer that has come back after treatment, doctors may use one of the treatments above or one of the following chemotherapy combinations

People who have medical conditions that mean they cannot have CAV or ACE chemotherapy may have topotecan chemotherapy capsules.

 

Chemotherapy for non small cell lung cancer

Doctors use chemotherapy to treat non small cell lung cancer in the following situations

Chemotherapy after surgery

For early stage NSCLC, chemotherapy after surgery can help to lower the risk of the cancer coming back. It is important that your doctor talks to you beforehand about the benefits and possible risks of chemotherapy. The drugs can cause side effects. Chemotherapy tends to work best in patients who are fit. If you are fit enough to have chemotherapy, you usually start it within about 8 weeks of having surgery.

Combinations of chemotherapy tend to work better than single drugs. Usually doctors combine cisplatin or carboplatin (Paraplatin) with at least one other drug such as

Chemotherapy and radiotherapy

Giving chemotherapy before or after radiotherapy can sometimes help to get rid of early stage NSCLC in people who can't have surgery. The chemotherapy drugs will usually be the same as mentioned above.

These treatments can also help some people with advanced non small cell lung cancer to live longer even if they are not likely to be cured of their cancer. If you are fairly fit, your doctor may suggest combined treatment with radiotherapy and chemotherapy (chemoradiation) as the best way of trying to control it.

Chemotherapy for locally advanced NSCLC or cancer that has spread

Locally advanced lung cancer means that the cancer has spread beyond the lung into surrounding tissues or nearby lymph nodes. Metastatic lung cancer means the cancer has spread into other organs or lymph nodes far away in the body. Chemotherapy can help to shrink or slow the growth of locally advanced or metastatic NSCLC. It can also help to control symptoms for some people. 

Your doctor will usually offer you treatment with either cisplatin or carboplatin combined with one of the following drugs

If you have cisplatin and pemetrexed treatment and your cancer shrinks or stops growing, your specialist may recommend that you continue with pemetrexed treatment on its own. Doctors call this pemetrexed maintenance treatment.

If your cancer continues to grow during chemotherapy, your doctor may recommend docetaxel (Taxotere) chemotherapy if you have not had that before. Or your doctor may recommend changing to another chemotherapy treatment. 

If your cancer cells have particular proteins, they may respond to biological therapy drugs such as erlotinib (Tarceva), gefitinib (Iressa) or crizotinib (Xalkori). Your doctor may suggest that you have one of these drugs. We have a page about biological therapy treatments for lung cancer.

Your doctor will talk to you in detail about the possible risks and benefits of further treatment. These treatments will not help everybody. It will depend on how fit you are, and how able you are to cope with any side effects.

 

How you have chemotherapy

You have most chemotherapy drugs by injection into a vein or through a drip. But some are tablets or capsules that you swallow.

How you have the drugs, and how often, depends on which drugs you are having. Usually, you have treatment with a combination of drugs. You will need to ask your chemotherapy nurse or doctor to explain the details of your treatment to you.

Most often, you have treatment every 3 to 4 weeks. Then you have a rest period to allow your body to get over any side effects. The number of treatments you have depends on

  • Which drugs you are having
  • The type of lung cancer you have
  • How well the treatment is working
  • How your body is coping with the side effects

You can have most chemotherapy drugs as an outpatient. So you go into the hospital or clinic for the day to have treatment and go home afterwards. Your chemotherapy nurse will give you medicines to take home in case you need them to control side effects.

There are some chemotherapy drugs that you have to have in hospital. Usually this is because you have them through a drip over a number of hours. So depending on your treatment, you may have to stay overnight, or for a few days.

 

How many treatments you may have

Your doctor is most likely to suggest 4 to 6 treatments of chemotherapy. So a full course can take 3 to 6 months.

The aim of treatment to control symptoms is to help you feel better. Your doctor will keep an eye on how well the treatment is working by monitoring your symptoms. They might also check the size of your cancer on scans and X-rays. 

If the treatment is working well you will continue with it. If the treatment is not working well your doctor will suggest changing to a different treatment or stopping it. 

It may be very upsetting if your doctor tells you that they are stopping after only a few treatments. But you can talk to your doctor or specialist nurse about other treatment options open to you.

 

Dietary or herbal supplements and chemotherapy

We don't yet know much scientifically about how some vitamin tablets or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take anything like this. Or if you are prescribed therapies by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having cancer treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.

Some studies seem to suggest that fish oil preparations may stop chemotherapy drugs from working so well. If you are taking, or thinking of taking, these supplements talk to your doctor to find out whether they could affect your treatment.

 

Getting more information about chemotherapy

You can look at the main chemotherapy section. It has detailed information about

You can ask your doctor or chemotherapy nurse to write down the names of the drugs you will have. Then you can look them up in our cancer drugs section. We have information on all the most commonly used chemotherapy drugs. 

You can phone the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. Our lung cancer organisations page gives details of people who can give information about lung cancer chemotherapy. Some organisations can put you in touch with a cancer support group. Our lung cancer reading list has information about books and leaflets on lung cancer treatments.

There is information about current chemotherapy research in the lung cancer research page in this section. And you can find lung cancer trials on our clinical trials database.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 28 March 2014