The aim of treatment is usually to control the cancer and your symptoms.
Secondary cancer can’t usually be cured. But treatment can control it for some time and help to control symptoms. This is called palliative treatment.
Deciding about treatment
Deciding about treatment can be difficult. You need to understand:
- what treatment can do for you
- any side effects of the treatment
- how many visits to hospital treatment involves
You can stop whenever you want to if you are finding it too much to cope with.
Talk through your options with your doctor or specialist nurse. You may find it helpful to talk things over with a close relative or friend, or a counsellor if one is available.
Your treatment will depend on a number of factors including:
- your type of primary cancer
- the treatment you have already had
- the number of tumours and how much of your lung is affected by the cancer
- whether your cancer has spread to other parts of the body
- your general health
Types of treatment
You may have one or more of the following treatments.
Chemotherapy uses cell killing drugs to kill cancer cells. The type of chemotherapy you'll have depends on your type of primary cancer.
For some types of primary cancer, such as testicular cancer and Hodgkin lymphoma, the aim of chemotherapy may be to cure the cancer. For other cancer types the treatment aims to help control the growth of your cancer and reduce symptoms.
If the first type of chemotherapy you have (called 1st line treatment) does not control your cancer, you can usually have a different type of chemotherapy (2nd line treatment).
Some cancers including breast and prostate cancer depend on hormones to survive and grow. So lowering hormone levels in the body can help to control them.
Hormone treatment may be tablets or injections.
Targeted cancer drugs
Targeted cancer drugs are treatments that change the way cells work and help the body to control the growth of cancer.
Your doctor may suggest a targeted cancer drug if it is suitable for your particular type of primary cancer. There are many different types of drug, including monoclonal antibodies and cancer growth blockers.
Radiotherapy treatment uses high energy waves similar to x-rays to kill cancer cells. Radiotherapy can help to control cancer growth and control symptoms. You usually have this as external radiotherapy. The photo shows an external radiotherapy machine.
Some people have internal radiotherapy (brachytherapy or endobronchial therapy). This is when your doctor puts the radiotherapy near the tumour inside your airway. You might have this if the cancer is blocking, or partly blocking, your airway.
Internal radiotherapy can shrink the blockage to help make your breathing easier. It can also help to control any infection or bleeding caused by the tumour.
Surgery to remove the tumour is a treatment for secondary lung cancer that started in the bone, or for soft tissue sarcomas. It is not usually suitable for other types of cancer.
The aim of this type of surgery is to cure the cancer. Researchers are looking into it for bowel cancer that has spread to the lungs.
Surgery is not usually an option if your cancer has spread anywhere else in your body.
Before you can have surgery for secondary lung tumours your doctor considers:
- where the secondary tumours are in your lungs
- the size of the secondary tumours
- how many secondaries you have
- how well they expect your lungs to work after surgery
- whether you have any other health conditions
You might have chemotherapy or targeted cancer drugs before or after the operation.
Surgery to remove lung tumours is a major operation so you need to be generally fit and well enough to have it. Your doctor will talk to you about exactly what the operation involves in your particular case.
Radiofrequency ablation (RFA)
Radiofrequency ablation (RFA) kills cancer cells by heating them up. RFA is quite a specialised treatment and you may have to travel to a specialist centre to have it.
The treatments above can help to control your symptoms by shrinking or removing the lung tumours. But if symptoms are still a problem, there are other ways of controlling them. The symptoms listed here are the most common ones that people have with secondary lung cancer.
Shortness of breath
Shortness of breath can be frightening.
The treatment you need will depend on the cause of your shortness of breath. You may have:
- oxygen therapy
- medicines to open your airways (nebulisers)
- laser treatment
- a small tube (stent) put in if your cancer is blocking your airway
You can help yourself by practicing breathing control exercises. These can help you to cope when you become short of breath and can make it less frightening.
Fluid on the lung (pleural effusion)
Your doctor may be able to drain the fluid and give you treatment to stop it building up again. They call this pleurodesis.
Radiotherapy can help to reduce a cough. Your doctor or nurse can also prescribe medicines to help.
You may also have general symptoms, such as:
- difficulty swallowing
- loss of appetite
Research into secondary lung cancer
Research is going on all the time into improving treatments for secondary lung cancer and helping people to cope with symptoms. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.