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are being used. This treatment is used in all stages of lung cancer and can prolong life even in elderly persons as long as they are in good general health. Some chemotherapy drugs increase damage done to tumors by the radiation treatment of cancer cells. Others keep the tumor cells at a stage where they are most susceptible to radiation treatment, or impair the ability of cancer cells to repair themselves after a course of radiation therapy. Evidence is mounting that a combination of these drugs integrated with radiotherapy is more effective than radiotherapy alone, but there is a substantial risk of serious side effects. Chemotherapy may cause significant side effects, such as nausea with vomiting and damage to the white blood cells that are needed to combat infection, but there now are ways to counter and treat most of these effects. Lung Cancer Treatment Page 3 of 8 Copyright© 2019, RadiologyInfo.org Reviewed: Jul-17-2019 How does the treatment method depend on the type of lung cancer? There are two main types of lung cancer that have different microscopic appearances: Small-cell lung cancer (SCLC)—also referred to as oat-cell cancer—usually is found in active or former cigarette smokers. Although SCLC is less common than the other type of lung cancer, it is a more aggressive tumor that is more likely to spread to other body sites. Chemotherapy is the mainstay of the treatment for SCLC. Radiation therapy is often used along with chemotherapy to treat lung tumors that have not spread beyond the chest or other organs. Surgery is not commonly used in SCLC due to its tendency to spread quickly. While surgery is seldom used to treat patients with SCLC, occasionally it is used to obtain tissue samples for microscopic study to determine the type of lung cancer present. For small cell lung cancer, after treatment directed to the disease in the chest, the radiation oncologist may suggest radiation therapy directed at the brain even though no cancer has been found there. This is called prophylactic cranial irradiation and is given to prevent lung cancer metastases from forming at this vital site. Non-small-cell lung cancer (NSCLC) tends to grow more slowly and takes longer to spread beyond the lung. Local treatments such as surgery and/or radiation therapy are the main-stay of treatment for NSCLC. If chemotherapy is used, it is often to increase the effectiveness of surgery or chemotherapy, and is generally different in NSCLC than in SCLC. Different types of chemotherapy may be used for different types of non-small cell lung cancer. How does the stage of disease guide lung cancer treatment? Small-cell lung cancer: For limited stage disease (confined to the chest), chemotherapy and radiation therapy are used as curative treatments. Radiation typically starts concurrently with the first or second dose of chemotherapy. Six weeks of once daily radiation or three weeks of twice-daily radiation are common radiation regimens. For limited stage, the radiation oncologist may suggest radiation therapy directed at the brain even though no cancer has been found there. For extensive stage SCLC, chemotherapy alone is the mainstay of therapy. For extensive stage, the radiation oncologist may consider radiation therapy directed at the brain even though no cancer has been found there. There is less strong evidence for prophylactic brain radiation than in limited stage disease. Consolidation radiation to the bulky areas of original tumor in the chest may also be considered. For disease recurrence or disease that persists after initial treatment, radiotherapy or chemotherapy may help to reduce pain or other symptoms. Radiotherapy or laser treatment can keep the airways open, allowing the patient to breathe more freely. Non-small-cell lung cancer: Early Stage: The earliest NSCLCs are very small tumors. Special tests may be needed to locate the main tumor. Early stage tumors are treated with surgery stereotactic or radiation therapy. Lung Cancer Treatment Page 4 of 8 Copyright© 2019, RadiologyInfo.org Reviewed: Jul-17-2019 main tumor. Early stage tumors are treated with surgery stereotactic or radiation therapy. Advanced Stage: Combined treatment is indicated when cancer has spread to structures near the lung, such as the