Lung Cancer Treatment Options

Fighting lung cancer with pinpoint accuracy.

At MRO, we use radiation, or radiotherapy, to destroy cancer cells with high doses of radiation. Using state-of-the-art imaging technologies, such as MRI, CT, and PET, your MRO care team can pinpoint radiation doses down to the millimeter. The role of radiation therapy in cancer treatment has been changing rapidly since the introduction of new and advanced technology, especially in tumor tracking, image guidance, and radiation delivery. When radiation therapy is a treatment option for you, your MRO care team will work closely with your oncology care team to provide the information you and your family need to be fully informed about lung cancer and treatment options.

Because there are so many different types of lung cancer, radiation oncology strategies differ from person to person; your own treatment plan is designed specifically for you by your MRO care team: doctors, dosimetrists, and physicists. At MRO, your treatment schedule will be specifically tailored to you, at the clinic that is most convenient for you. Your own treatment will depend on the type of tumor you have, where it’s located, and what type of technology we’ll be using.

Like an x-ray, radiation therapy is painless. There’s no fear of becoming radioactive during or after treatment.

The four most common reasons for radiation treatment:

1. After surgery, to kill any remaining tumor cells in the margins.
2. As the primary treatment, if surgery is not a good option.
3. Along with chemotherapy, to maximize efficacy of treatment.
4. To help prevent or relieve symptoms from the tumor.

For small cell lung cancer (SCLC), radiation therapy is considered in several situations:

• In limited stage SCLC, radiation therapy can be given along with chemotherapy – called concurrent chemoradiation – to treat the tumor and lymph nodes in the chest.
• Radiation can also be given after the chemotherapy is finished. This is sometimes done for patients with extensive stage disease, or it can be used for people with limited stage disease who have trouble getting chemotherapy and radiation at the same time.
• SCLC often spreads to the brain. Radiation can be given to the brain to help lower the chances of spreading. This is called prophylactic cranial irradiation.
• Radiation can be used to shrink tumors to relieve symptoms of lung cancer such as pain, bleeding, trouble swallowing, cough, and shortness of breath.

In cases of non-small cell lung cancer (NSCLC), radiation therapy might be used:

• As the primary treatment – sometimes along with chemotherapy – especially if the lung tumor can’t be removed, if a person isn’t healthy enough for surgery, or if a person doesn’t want surgery.
• After surgery (alone or along with chemotherapy) to try to kill any small areas of cancer that surgery might have missed.
• Before surgery (usually along with chemotherapy) to try to shrink a lung tumor to make it easier to operate on.
• To treat a single area of cancer spread, such as a tumor in the lung or an adrenal gland. (This might be done along with surgery to treat the main lung tumor.)
• To relieve symptoms of advanced NSCLC such as pain, bleeding, trouble swallowing, cough, or problems caused by spreading to other organs such as the brain.

Types of radiation therapy for lung tumors

There are 3 main radiation therapy techniques used to treat lung cancer. They all fall into the category of external beam radiation therapy (EBRT), which delivers high doses of radiation to cancer cells from outside the body, using a variety of machine-based technologies. In recent years, newer EBRT techniques have been shown to help treat lung cancers more accurately while lowering the radiation exposure to nearby healthy tissues.

1. Three-dimensional conformal radiation therapy (3D-CRT): 3D-CRT uses imaging to map the location of the tumor precisely, then shapes and aims multiple radiation beams from different directions. Each beam itself is fairly weak, to prevent damage to normal tissues, but the beams converge at the tumor to give a higher cumulative dose at one precise spot.
2. Intensity modulated radiation therapy (IMRT): IMRT is an advanced form of 3D therapy. First, a treatment plan is optimized in the computer planning system, and then during treatment the machine moves around you as it delivers radiation. It shapes the beams and adjusts the intensity of the beams from all angles to limit the dose reaching nearby healthy tissues. This technique is used most often if tumors are near important structures such as the spinal cord.
3. Stereotactic body radiation therapy (SBRT): SBRT, also known as stereotactic ablative radiotherapy (SABR), is sometimes used to treat very early-stage lung cancers when surgery isn’t an option due to a person’s health or in people who don’t want surgery. Instead of giving a small dose of radiation each day for several weeks, SBRT uses very focused beams of high-dose radiation given in fewer treatments. Several beams are aimed at the treatment area from different angles. To target the radiation precisely and reduce the movement of the lung tumor while breathing, you’re put in a specially designed body frame for each treatment.

Since radiation therapy for lung cancer requires utmost precision, you’ll also go through a simulation at your nearby MRO Therapy Center. Using image mapping as a guide, your care team will position you as you would be for treatment and take measurements to build a targeted treatment plan and pinpoint the radiation for the best possible outcome.
Radiation therapy for lung cancer is often given daily, Monday through Friday, for about six weeks. You’ll also meet with your MRO care team each week to monitor progress and answer any questions you may have.

“I’ve spent over 30 years helping my patients understand their unique situations and treatment options. I’m proud that I’ve been able to take part in research efforts that have helped expand diagnoses and treatment options and helped expand patient access to new treatment options.”
Richard F. Diaz M.D
MRO | Fairview Southdale