Radiation therapy is a common treatment for lung cancer, but can it cure the disease?
There’s not a simple yes or no answer.
While the term “cure” is rarely used, many people will remain cancer free.
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When reviewing these, however, it’s important to note that no two lung cancers are alike.
In addition, there are limitations to using statistics, including that people aren’t statistics.
There is no “average” person who has an “average” journey with lung cancer.
For example, for decades there was relatively little progress in lung cancer treatment.
This began to change quickly, starting around the year 2010, first with targeted therapies and then immunotherapy.
There was a new drug available every few months.
If you receive one of these treatments, statistics from 2010 to 2016 may mean little.
The overall five-year survival rate of all stages combined is 7%.
Small cell cancers tend to grow near the large airways and cause symptoms soon after they are present.
They tend to be aggressive and spread early (often to the brain).
The treatments vary significantly based on each stage and substage of the cancer.
It works by damaging the DNA within cancer cells.
While there are variations, a typical example would be daily sessions five days per week for five weeks.
The radiation is directed from outside of the body toward that region.
It is used in similar situations as external beam radiation is and most often provides similar results.
Traditional radiation travels through a tumor and reaches some tissue beyond the tumor before dying off.
It can be done during surgery or during abronchoscopy.
In some cases, the pellets may be left in place permanently, with the radiation decreasing over time.
Unfortunately, what patients expect isn’t always what doctors hope to achieve.
With limited stage, there are different degrees of tumor involvement.
Extensive tumors are those that have spread to distant regions.
It is considered the standard of care for those who can tolerate the combination of radiation and chemotherapy.
Chemotherapy should be given in addition to SBRT.
External beam therapy is usually given once or twice a day for three to seven weeks.
The overall five-year survival rate ranges from 30%35% when the guidelines are followed.
It also appears to control local growth of tumor about 25% better than chemotherapy alone.
Success Rates
Survival rates are estimates and may not account for recent treatment advances.
People are not statistics.
Immunotherapy teaches the immune system to attack some types of lung cancer cells.
Fortunately, studies are in progress to better define the role.
In some cases, these are divided by the four stages of the disease.
Other studies look at other differences, such as studying only people who had stage 1A NSCLC.
For both groups, the overall survival was 91% at one year.
Another study found that SBRT was excellent for controlling the growth of early lung cancers.
Some people (and some tumors) are better candidates for SBRT as a treatment for early lung cancer.
Compared with standard radiation, survival with SBRT is almost twice as high.
With this combination, long-term survival is possible for some people.
When this is the case, radiation therapy or chemotherapy have traditionally been used one treatment at a time.
This approach may be changing as studies now show a survival advantage to using the treatments together.
However, there are not yet large studies comparing the outcomes of the approaches.
This study looked at people with both stage 3 and stage 4 NSLC.
Most Lung Cancers are Treatable
A very concerning finding was noted in this study.
A full 27% of people received no treatment.
This may include a few “spots” on the brain or other regions.
When used in the appropriate setting, SBRT for oligometastatic disease may prolong both progression-free and overall survival.
Bone metastases are common with lung cancer and can be extremely painful.
Local therapies treat a tumor where it began and include surgery and radiation.
In local stages, radiation may be used alone.
In distant stages, the goals change to extending life and reducing symptoms.
The important thing is to talk to your radiation oncologist about how your age might affect your treatment.
These are enough so that radiation oncologists are now talking about “gender-dependent radiation therapy.”
Overall, females appear to be more sensitive to the effects of radiation.
Radiation therapy is more likely to be curative for females than males, but that comes with a drawback.
Females are also more likely to have side effects.
It can be thought of in much the same way as how a vaccine works to prevent an infection.
The effect has also been seen with SBRT.
Checkpoint inhibitors can be very effective.
They sometimes lead to a durable response, but only a minority of people respond to these drugs.
Smoking
Does current smoking affect lung cancer survival or the effects of radiation therapy?
Smoking, in general, is associated with poorer survival with lung cancer.
Continued smoking also appears to reduce the effectiveness of radiation therapy.
Radiation therapy works by creating molecules calledfree radicalsfrom oxygen.
These free radicals, in turn, cause damage to DNA in cancer cells that makes the cells die.
Smoking results in less oxygen in the tissues (due to narrowing of blood vessels).
Every person is unique, and every lung cancer is different in some way.
If you are considering radiation therapy for lung cancer, talk to your healthcare provider.
Some people like to chart out a list of the pros and cons of treatment.
It’s as important to discuss potential side effects as the potential effectiveness of therapy.
Your quality of life while going through cancer treatment is important.
There’s no correct answer when it comes to making a decision.
Some side effects may be very bothersome to one person but not another.
In early-stage lung cancer, radiation may be used in an attempt to cure the cancer.
But even when lung cancers are advanced, there are options.
Unfortunately, lung cancer was viewed with a sometimes fatalistic approach, without hope, until recently.
With early-stage lung cancers, treatment can often result in long-term survival.
With advanced lung cancers, long-term survival almost never occurred in the past.
Newer treatments are changing that.
With targeted therapies, some people can live with their cancer controlled for several years.
In this case, the cancer is not cured and will almost always recur if the treatment is stopped.
Yes, you’re free to live with one lung, and many people do.
Some have even climbed mountains with one lung.
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