Chemotherapy for lung cancer
What chemotherapy is
Chemotherapy means using anti cancer (cytotoxic) drugs to
destroy cancer cells. These work by disrupting the growth of cancer
cells.
Chemotherapy is the main treatment for small cell lung cancer. Doctors use it because
Often chemotherapy is used on its own. Or you may have chemotherapy before or after radiotherapy (or at the same time). If you are to have surgery for very early small cell lung cancer, your doctor may suggest that you have chemotherapy before or after surgery.
Doctors usually give a combination of chemotherapy drugs, including either cisplatin or carboplatin (Paraplatin). The combinations include
Small cell lung cancer usually responds well to these treatments, but researchers are continuing to test other combinations to see if they can either improve the results, lessen the side effects, or both.
For cancer that has come back after treatment, doctors may use one of the treatments above or one of the following chemotherapy combinations
There is information about current chemotherapy research in the lung cancer research page in this section. And you can find out about clinical trials on our clinical trials database. Choose 'lung' from the dropdown menu of cancer types.
- This type of cancer responds very well to chemotherapy
- Small cell lung cancer tends to have spread beyond the lung when it is diagnosed
Often chemotherapy is used on its own. Or you may have chemotherapy before or after radiotherapy (or at the same time). If you are to have surgery for very early small cell lung cancer, your doctor may suggest that you have chemotherapy before or after surgery.
Doctors usually give a combination of chemotherapy drugs, including either cisplatin or carboplatin (Paraplatin). The combinations include
Small cell lung cancer usually responds well to these treatments, but researchers are continuing to test other combinations to see if they can either improve the results, lessen the side effects, or both.
For cancer that has come back after treatment, doctors may use one of the treatments above or one of the following chemotherapy combinations
- CAV (cyclophosphamide, doxorubicin and vincristine)
- CAVE (CAV plus etoposide)
- ACE (doxorubicin, cyclophosphamide and etoposide)
There is information about current chemotherapy research in the lung cancer research page in this section. And you can find out about clinical trials on our clinical trials database. Choose 'lung' from the dropdown menu of cancer types.
Doctors use chemotherapy to treat non small cell lung cancer in the following situations
Combinations of chemotherapy tend to work better than single drugs. Usually doctors combine cisplatin or carboplatin (Paraplatin) with at least one other drug such as
These treatments can also help some people with advanced non small cell lung cancer to live longer even if they are not likely to be cured of their cancer. If you are fairly fit, your doctor may suggest combined treatment with radiotherapy and chemotherapy (chemoradiation) as the best way of trying to control it.
Your doctor will usually offer you treatment with either cisplatin or carboplatin combined with one of the following drugs
If your cancer continues to grow during chemotherapy, your doctor may recommend docetaxel (Taxotere) chemotherapy if you have not had that before. Or your doctor may recommend changing to another chemotherapy treatment.
If your cancer cells have particular proteins that make them respond to biological therapy drugs such as erlotinib (Tarceva), gefitinib (Iressa) or crizotinib (Xalkori) your doctor may suggest that you have one of these. We have a page about biological therapy treatments for lung cancer.
Your doctor will talk to you in detail about the possible risks and benefits of further treatment. These treatments will not help everybody. It will depend on how fit you are, and how able you are to cope with any side effects.
- After surgery for early stage cancer
- Before, after, or alongside radiotherapy treatment
- For locally advanced lung cancer or cancer that has spread
Chemotherapy after surgery
Chemotherapy after surgery for early stage NSCLC can help to lower the risk of the cancer coming back. It is important that your doctor talks to you beforehand about the benefits and possible risks of chemotherapy because the drugs can cause side effects. Chemotherapy tends to work best in patients who are fit. If you are fit enough to have chemotherapy you usually start it within about 8 weeks of having surgery.Combinations of chemotherapy tend to work better than single drugs. Usually doctors combine cisplatin or carboplatin (Paraplatin) with at least one other drug such as
Chemotherapy and radiotherapy
Giving chemotherapy before or after radiotherapy can sometimes help to get rid of early stage NSCLC in people who can't have surgery. The chemotherapy drugs will usually be the same as mentioned above.These treatments can also help some people with advanced non small cell lung cancer to live longer even if they are not likely to be cured of their cancer. If you are fairly fit, your doctor may suggest combined treatment with radiotherapy and chemotherapy (chemoradiation) as the best way of trying to control it.
Chemotherapy for locally advanced NSCLC or cancer that has spread
Locally advanced lung cancer means that the cancer has spread beyond the lung into surrounding tissues or nearby lymph nodes. Metastatic lung cancer means the cancer has spread into other organs or lymph nodes far away in the body. Chemotherapy can help to shrink or slow the growth of locally advanced or metastatic NSCLC. It can also help to control symptoms for some people.Your doctor will usually offer you treatment with either cisplatin or carboplatin combined with one of the following drugs
- Gemcitabine (Gemzar)
- Paclitaxel (Taxol)
- Vinorelbine (Navelbine)
- Docetaxel (Taxotere)
- Pemetrexed (Alimta)
If your cancer continues to grow during chemotherapy, your doctor may recommend docetaxel (Taxotere) chemotherapy if you have not had that before. Or your doctor may recommend changing to another chemotherapy treatment.
If your cancer cells have particular proteins that make them respond to biological therapy drugs such as erlotinib (Tarceva), gefitinib (Iressa) or crizotinib (Xalkori) your doctor may suggest that you have one of these. We have a page about biological therapy treatments for lung cancer.
Your doctor will talk to you in detail about the possible risks and benefits of further treatment. These treatments will not help everybody. It will depend on how fit you are, and how able you are to cope with any side effects.
You have most chemotherapy drugs by injection into a vein or through a drip. But some are tablets or capsules that you swallow.
How you have the drugs, and how often, depends on which drugs you are having. Usually, you have treatment with a combination of drugs. You will need to ask your chemotherapy nurse or doctor to explain the details of your treatment to you.
Most often, you have the chemotherapy treatment every 3 to 4 weeks. Then you have a rest period to allow your body to get over any side effects. The number of treatments you have depends on
Some chemotherapy drugs have to be given in hospital. Usually this is because you have to have them through a drip over a number of hours. So depending on your treatment, you may have to stay overnight, or for a few days.
How you have the drugs, and how often, depends on which drugs you are having. Usually, you have treatment with a combination of drugs. You will need to ask your chemotherapy nurse or doctor to explain the details of your treatment to you.
Most often, you have the chemotherapy treatment every 3 to 4 weeks. Then you have a rest period to allow your body to get over any side effects. The number of treatments you have depends on
- Which drugs you are having
- The type of lung cancer you have
- How well the treatment is working
- How your body is coping with the side effects
Some chemotherapy drugs have to be given in hospital. Usually this is because you have to have them through a drip over a number of hours. So depending on your treatment, you may have to stay overnight, or for a few days.
Most chemotherapy is given for 4 to 6 treatments. So a full course can take 3 to 6 months.
If you are having treatment to control symptoms, the aim of the treatment is to help you feel better. Your doctor will keep an eye on your progress by monitoring your symptoms and possibly by checking the size of your cancer on scans and X-rays.
If the treatment is working well you will continue with the treatment. If the treatment is not working well your doctor will suggest changing to a different treatment or stopping it.
It may be very upsetting if your doctor tells you that they are stopping your treatment after only a few treatments when you thought you would have more. But you can talk to your doctor or specialist nurse about the other treatment options open to you.
If you are having treatment to control symptoms, the aim of the treatment is to help you feel better. Your doctor will keep an eye on your progress by monitoring your symptoms and possibly by checking the size of your cancer on scans and X-rays.
If the treatment is working well you will continue with the treatment. If the treatment is not working well your doctor will suggest changing to a different treatment or stopping it.
It may be very upsetting if your doctor tells you that they are stopping your treatment after only a few treatments when you thought you would have more. But you can talk to your doctor or specialist nurse about the other treatment options open to you.
We don't yet know much scientifically about how some
nutritional or herbal supplements may interact with chemotherapy. Some
could be harmful. It is very important to let your doctors know if you
take any supplements. Or if you are prescribed therapies by alternative
or complementary therapy practitioners.
Talk to your specialist about any other tablets or medicines you take while you are having cancer treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.
Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.
Talk to your specialist about any other tablets or medicines you take while you are having cancer treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.
Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.
- What chemotherapy involves
- How chemotherapy is planned
- General chemotherapy side effects
- Living with chemotherapy
You can phone the Cancer research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. Our lung cancer organisations page gives details of people who can give information about lung cancer chemotherapy. Some organisations can put you in touch with a cancer support group. Our lung cancer reading list has information about books and leaflets on lung cancer treatments.
If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or you can go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.
Why you get side effects
Chemotherapy drugs kill cells that are dividing. Cancer cells
divide more often than normal cells. But some normal body cells also
divide quickly and so are also affected by chemotherapy. Quickly
dividing cells include those in your skin, hair, nails, the lining of
your digestive system, and your blood cells. Unlike cancer cells, these
normal body tissues can recover. So you usually have a couple of weeks
break between treatments to allow your normal body tissues to get over
the effects of the chemotherapy.
Chemotherapy affects different people in different ways. Your doctor or chemotherapy nurse can tell you what may happen. But they can't tell beforehand exactly what treatment will be like for you. It isn't something you can easily predict. Side effects are worse for some people than others. Many people can go on with their normal lives during their treatment and some can even carry on working. Other people find that they are very tired and have to take things more slowly. Side effects may seem hard to bear at the time. But most disappear when your treatment ends.
Remember that not all chemotherapy drugs cause the same side effects and some people have very few. There is detailed information about the side effects of specific drugs in the cancer treatment section.
This page gives information about the common side effects of lung cancer chemotherapy.
Chemotherapy affects different people in different ways. Your doctor or chemotherapy nurse can tell you what may happen. But they can't tell beforehand exactly what treatment will be like for you. It isn't something you can easily predict. Side effects are worse for some people than others. Many people can go on with their normal lives during their treatment and some can even carry on working. Other people find that they are very tired and have to take things more slowly. Side effects may seem hard to bear at the time. But most disappear when your treatment ends.
Remember that not all chemotherapy drugs cause the same side effects and some people have very few. There is detailed information about the side effects of specific drugs in the cancer treatment section.
This page gives information about the common side effects of lung cancer chemotherapy.
Chemotherapy can lower the number of healthy white blood cells, red blood cells and platelets you have. This can mean that you
It isn't practical to try to avoid all germs while you are having chemotherapy, but it is important to keep away from anyone you know who has an infection. Avoid crowded, cramped places such as public transport.
There is information about the effect of chemotherapy on your blood cells in the main chemotherapy section.
- Are more likely to get infections
- May be more tired than usual
- Can be prone to nosebleeds and other bleeding problems
It isn't practical to try to avoid all germs while you are having chemotherapy, but it is important to keep away from anyone you know who has an infection. Avoid crowded, cramped places such as public transport.
There is information about the effect of chemotherapy on your blood cells in the main chemotherapy section.
Some people are able to carry on almost as normal when they
are having chemotherapy. But many others become very tired. The further
through your course of chemotherapy treatment you are, the more likely
you are to feel tired and run down. If this is happening to you, try to
take things more slowly. If you feel like having a lie down or putting
your feet up, then you probably need to do just that.
It can help to ask other people to do some things for you so that you can rest if you need to. Other family members or friends can often help with household jobs or shopping. We have information about coping with tiredness. The tiredness may last for some months after your treatment has ended. How quickly you get back to normal will depend on your general health, on the amount of treatment you've had, and on other treatments you have had.
It can help to ask other people to do some things for you so that you can rest if you need to. Other family members or friends can often help with household jobs or shopping. We have information about coping with tiredness. The tiredness may last for some months after your treatment has ended. How quickly you get back to normal will depend on your general health, on the amount of treatment you've had, and on other treatments you have had.
Sickness is a common chemotherapy side effect. Some drugs only
make you feel mildly sick. Others can make some people vomit a lot and
feel very sick. There is a page about coping with sickness
in the cancer drugs side effects section. Nausea and sickness can now
usually be well controlled with anti sickness drugs. Tell your doctor or
chemotherapy nurse if you feel sick, as they can prescribe other anti
sickness drugs, which may suit you better.
Some chemotherapy drugs can affect your sense of taste. Foods
may taste metallic, salty or bitter, or may not taste of anything. These
changes should go away after your treatment ends. We have information
about coping with taste changes.
Some chemotherapy drugs cause mouth ulcers or soreness in the
mouth. To try to prevent infection, it is important to keep your mouth
clean. It is best to use a very soft (or baby) toothbrush to avoid
damaging the lining of your mouth. If you are likely to get a sore
mouth, your nurse will give you mouthwashes to use regularly to help
prevent infection. If the soreness gets very bad, you may need
painkillers until it has healed. We have information about coping with a sore mouth in the chemotherapy side effects section.
Some chemotherapy drugs cause diarrhoea. This can be mild or
more severe. If you have diarrhoea for more than 2 or 3 days, you must
tell your doctor or nurse. You could become dehydrated, and may need to
have anti diarrhoea tablets or medicines.
Your doctor or specialist nurse can also give you advice about what to eat or drink if you have diarrhoea. You may also find our information about coping with diarrhoea helpful.
Your doctor or specialist nurse can also give you advice about what to eat or drink if you have diarrhoea. You may also find our information about coping with diarrhoea helpful.
Not all drugs cause complete hair loss. Some don't cause hair
loss at all. Some nearly always do. With others your hair may just get
thinner during the treatment. Hair usually starts to fall out about 2 to
3 weeks after the chemotherapy begins. It will grow back once the
treatment is over. Ask your doctor or nurse whether you are likely to
lose your hair. Then you can plan how to cope with this.
Many people wear hats, scarves or wigs. It can be less upsetting to cut your hair short, or even have your head shaved, if you know you are going to lose your hair. Find out about getting a free wig on the NHS. Ask your doctor or nurse about it as soon as you know you will have chemotherapy. It can take some time to arrange and you have to be an inpatient when it is ordered and collected.
We have a page about coping with hair loss due to chemotherapy.
Many people wear hats, scarves or wigs. It can be less upsetting to cut your hair short, or even have your head shaved, if you know you are going to lose your hair. Find out about getting a free wig on the NHS. Ask your doctor or nurse about it as soon as you know you will have chemotherapy. It can take some time to arrange and you have to be an inpatient when it is ordered and collected.
We have a page about coping with hair loss due to chemotherapy.
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