The aim of treatment for secondary cancer is usually to control the cancer and your symptoms.
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 the 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 anti cancer drugs to kill cancer cells. The type of chemotherapy you have depends on the 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. You might have the hormone treatment as a tablet or injection.
Targeted cancer drugs
Targeted cancer drugs are treatments that target the differences that help a cancer cell to survive and grow.
Your doctor may suggest a targeted cancer treatment if it is suitable for your primary cancer. There are different types of targeted cancer drugs including:
- monoclonal antibodies (MABs)
- cancer growth blockers
- PARP inhibitors
- drugs that block blood vessel growth (anti angiogenics)
Immunotherapy uses your immune system to fight cancer. It works by helping the immune system recognise and attack cancer cells. Some types of immunotherapies are also called targeted treatments or biological therapies.
You might have this on its own or with other cancer drugs.
Radiotherapy treatment uses high energy x-rays to kill cancer cells. Radiotherapy can help to control cancer growth and symptoms. You usually have this as external radiotherapy. This is where the therapy radiographer uses a machine outside the body to direct radiation beams at the cancer to destroy it.
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 bowel, 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
- how well you could cope with surgery
- how well your primary cancer is being controlled
You might have chemotherapy, immunotherapy 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.
Treatment using heat and cold to kill cancer cells (ablation)
Ablation means to destroy and kill cancer cells using heat or the freezing cold.
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.
Cryotherapy kills cancer cells by freezing them. You might have this type of treatment to shrink a tumour that is blocking an airway. This can help relieve symptoms such as:
- a cough
- coughing up blood
- a chest infection in the blocked part of the airway
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 practising breathing control exercises. These can help you to cope when you become short of breath and can make it less frightening.
Fluid around the lungs (pleural effusion)
This is when fluid collects between the sheets of tissue that cover the outside of the lung and the lining of the chest cavity. These sheets of tissue are called the pleura. Doctors call this fluid collection a pleural effusion.
Your doctor may be able to drain the fluid with a temporary or permanent drain and give you treatment to stop it from building up again. They call this
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 and weight loss
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.