Diagnosis and treatment

Treatments for early NSCLC

#

There are many different types of treatment available for people with lung cancer. This page will take you through some of the treatments you may currently be receiving, or may receive in the future.

Remember, your healthcare team are always the best source of information about your cancer and its treatment, and can give you personalised information. So don’t hesitate to get in touch with them with any questions you may have.

If your cancer is already advanced, you may still receive some of these treatments, but instead of only treating your lungs, they may also be used to treat any areas where the cancer may have spread. You can read a bit more about advanced cancer treatments here.

What are side effects?

As much as possible, cancer treatments are designed to only affect cancer cells, however some healthy cells inevitably get damaged. The damage to these healthy cells is what causes side effects.1

What should I do if I have a side effect?

Your healthcare team can tell you more about any side effects, you may experience while you’re receiving a treatment. You should always tell them if you are experiencing any side effects, either at appointments of after you have gone home. They can help you manage side effects by adjusting the dose of any chemotherapy you are taking, and/or by prescribing supportive medications to help alleviate them.

You should never take a medicine (or a herbal, or complementary therapy) to treat a side effect unless your healthcare team has already told you it is safe to do so.

If a side effect is very bad, your healthcare team may stop a treatment you are receiving. Some people worry about this, and avoid talking about their side effects, however it is important that you are always honest with your healthcare team. This is because:

  • Leaving a bad side effect untreated can cause more harm to you than the good the cancer treatment is doing. By talking to your healthcare team, and allowing them to support you, you can make sure you are getting the best possible care
  • Side effects for some medicines are still actively being monitored. By reporting what side effects you experience, you can help other people who are going through the same treatment, and a similar cancer experience, as you

Chemotherapy
What is it?

There are many different types of chemotherapy available, but all of them treat cancer in a similar way. They attack cells which are dividing and growing quickly in your body (like cancer cells) to help control the cancer.2

How do I receive it?

This will depend on the type of chemotherapy you have.

Intravenous (IV) chemotherapies:

Some chemotherapies are given with an IV drip in hospital or at a clinic. Every clinic is different, but as a general guide:

  • You may have an appointment with your oncologist before each chemotherapy session. During these appointments, your oncologist will check your general health to make sure you are well enough to receive chemotherapy
  • On the day of your chemotherapy session, when you arrive at the clinic you may need to fill in some paper work, and confirm your name, date of birth, and address
  • Your nurse will explain what kind of chemotherapy you will be receiving and make sure that you are seated comfortably. Most chemotherapy suites have big comfy chairs that you can relax in
  • You may be given some medicine that will help manage any side effects that you get while receive the chemotherapy. For example, anti-emetic medication, in case you start to feel a bit nauseated
  • When your treatment is ready, a nurse will bring it over in a plastic bag with a tube coming out of it. On the end of the tube is a needle, which the nurse will carefully insert into a vein – usually either on the back of your hand or in your arm
  • You can then sit back and wait while the treatment flows out of the bag and into your vein
  • If at any point you feel worried, or unwell, call a nurse over and they will help you
  • Once your treatment is over, the nurse will remove the needle and give you some instructions. When they think you are ready to leave the clinic, you can head home

Oral chemotherapies

Other chemotherapies are available as pills or tablets that you can take at home, although you will need to come in and see your oncologist for some health checks before beginning to take them, and at regular intervals afterwards. The number of pills you take, how often you take them, and for how long will depend on the specific medicine you have been prescribed.

Top tips
  • If you are receiving IV chemotherapy, you may be at the clinic for quite a while. Bring some home comforts and things to keep you comfy and distracted. For example, a blanket, pillows, a book, a craft project, or a tablet with your favourite movie or TV series loaded onto it
  • Some people receiving IV chemotherapy sometimes get a side effect where they might notice a funny, metallic taste in their mouth. Sucking on some sweets, or chewing gum might help with this
  • If you are taking pills or tablets at home, you might occasionally forget to take your treatment. In these cases, make sure you know what to do. Don’t assume you can take a double dose next time – many treatments strongly advise against this
What side effects might I get?

Side effects will vary depending on exactly what chemotherapy you are receiving. Your healthcare team will be able to tell you what are the most common side effects that occur in people who are receiving the same therapy as you.

We have put together a list of common side effects that can affect people who are receiving chemotherapy.2 Looking at this may feel a bit overwhelming, or cause you some worries, however it is important to remember that everyone is different, and you may only experience some of the below side effects. You may also have different side effects, or experience none of these at all.

  • Feeling tired most of the time
  • Feeling sick, and/or vomiting
  • Hair loss
  • An increased risk of picking up infections
  • A sore mouth
  • Dry, sore, or itchy skin
  • Diarrhoea or constipation

Radiotherapy
What is it?

Radiotherapy is a type of treatment where radioactivity is applied to a cancer to try and damage the cells in tumours. There are a few different ways to receive radiotherapy.3

External radiotherapy3,4

External radiotherapy uses very narrow beams of high-intensity radiation to reach and damage tumours inside of your body.

Internal radiotherapy3,4

An implant containing radioactive material is put into your body, near the cancer, or radioactive material is injected into your blood, or given to you as a drink.

How do I receive it?

External radiotherapy

External radiotherapy is given with a special machine,4 so you need to attend an appointment at a hospital or clinic.

Once there, you will lie on a bed, and have marks made on your skin in a long-lasting ink, so that the technician can always line up the radiation in the same place. If you are having radiotherapy on your head or neck, you will have a mask that holds your head in place, and the ink marks will be made on this.4

The radiotherapy technician will adjust the machine and the position you are lying in so that the radiation can reach where the cancer it. Once ready, the machine sends a beam of radiation at your cancer.4

After you have had your radiotherapy, the technician may give you some instructions to follow, and then you can head home.

Internal radiotherapy

If you are having an implanted therapy, this may require some surgery.4 In these cases, your healthcare team will guide you through exactly what will happen. How long implants are left in varies. Some may only be there for a few minutes, others may be a few days. Some very small implants can be left in permanently, as they only contain a small amount of radiation and this gradually decreases over time. You may need to stay in hospital for a few days while any excess radiation leaves your body, and visitors may be limited during this time to avoid exposing them to any radiation you may be emitting.4.5

If you are receiving a therapy that you inject or swallow, you will receive this in a hospital or clinic. Again, you may need to stay in the hospital for a while until the excess radiation has left your body.4

Top tips
  • If you are going to be in hospital for a while after internal radiotherapy, confirm any rules around visits from friends and family. Immediately after you receive your implant or swallow your radiotherapy, you may not be allowed any visitors. Later, visits might be restricted, and pregnant women and very young children may not be allowed to visit at all5
What side effects might I get?

Side effects with radiotherapy typically appear in the week or two after your appointment, and go away on their own. They might include:3

  • Sore, red skin
  • Fatigue
  • Hair loss around the area where the radiation has been focused
  • Nausea
  • Diarrhoea
  • Sore mouth
  • Loss of appetite

Surgery
What is it?

Surgery is used to try and remove areas of the cancer from within your body. Sometimes this is done to remove all the cancer, and other times it is done to reduce the amount of cancer ahead of you receiving another type of treatment.6

How is surgery carried out?

Your exact surgical procedure will depend on where your cancer is growing, and what type of surgery you are having. If you are having surgery that requires a general anaesthetic, your experience might be something like the below:

  • You will have a consultation with a surgeon (your oncologist may also be there too). They will review your medical file and any x-rays and scans you have had7
  • On the day of your surgery:
    • You will be asked not to eat or drink anything for several hours beforehand7
    • You will be given a hospital gown to wear, and some tight socks, called compression stockings – these help to prevent blood clots from forming in your legs, called deep vein thromboses (DVT)7
    • You may also be asked to have a shower, and shave any body hair over the area that is being operated on (a surgical nurse might help with this)7
    • You will also be asked to review and sign some paperwork7
  • When it is time for your surgery, a specialist doctor called an anaesthetist will come and visit you. They will have calcuated the amount of anaesthesia you need to help you go to sleep, and give this to you with either an injection or a face mask.8 They might ask you to count backwards from ten as the medicine takes effect. Most people fall asleep very quickly, after counting only a few numbers
  • Once you are asleep, you will be wheeled into the surgical theatre where the surgeon and their team will be waiting, and they will perform your surgery. The aneasthetist will join them, and keep an eye on your anaesthesia levels, and vital signs8
  • When the surgery is completed, you will be wheeled back to a recovery ward, where you will be looked after while the anaesthesia wears off. You may find that when you wake up you feel quite groggy and confused8 – this is normal, and will eventually stop on its own
  • The healthcare team will give you and your loved one some advice on anything you need to do in the coming days to help you recover, and your surgeon may visit you to discuss how the surgery went
  • You may need to spend some time in hospital while you recover initially. If you go home on the same day you probably won’t be able to drive, so somebody will need to pick you up, and keep an eye on you for the rest of the day
Top tips
  • If you are likely to be in hospital for a few days, make sure you bring some entertainment from home – a book, craft project, or a tablet loaded with your favourite movies or TV series are good ideas
  • If you are worried about anything after your surgery, get in touch with your healthcare team. They can give you advice, and support you if needs be
Side effects

As with any treatment, any side effects you experience will depend on your situation, and what your surgery has involved. Some common side effects of surgery include:9

  • Pain
  • Fatigue
  • Loss of appetite
  • Swelling, and/or bruising around the surgical site
  • Drainage from the surgical site
  • A bit of bleeding may sometimes happen around the surgical site
  • Feeling groggy, confused, and/or nauseated from anaesthesia (usually immediately after waking up, but this gets better after a while)

Clinical trials

You may be interested in enrolling onto a clinical trial. If so, it is best to discuss this with your healthcare team as the criteria for joining these can be extensive, specific and varied.

Your healthcare team can explain certain aspects of trials to you in detail, such as criteria you need to meet to enrol, benefits and limitations of clinical trials, and any requirements there may be to travel to take part.

ALKAnaplastic lymphoma kinase
NSCLCNon-small cell lung cancer

  1. American Cancer Society. Chemotherapy side effects. 2016. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html. Last accessed August 2019.
  2. NHS. Chemotherapy. 2017. Available from: https://www.nhs.uk/conditions/chemotherapy/. Last accessed August 2019.
  3. NHS. Radiotherapy. 2017. Available from: https://www.nhs.uk/conditions/radiotherapy/. Last accessed August 2019.
  4. NHS. Radiotherapy: What happens? 2017. Available from: https://www.nhs.uk/conditions/radiotherapy/what-happens/. Last accessed August 2019.
  5. American Cancer Society. Internal radiation therapy (brachytherapy). 2017. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/internal-radiation-therapy-brachytherapy.html. Last accessed August 2019.
  6. Cancer.net. What is cancer surgery? 2019. Available from: https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/what-cancer-surgery. Last accessed August 2019.
  7. Macmillan. What happens before surgery? 2016. Available from: https://www.macmillan.org.uk/information-and-support/treating/surgery/surgery-explained/what-happens-before-surgery.html. Last accessed August 2019.
  8. Cancer.net. What to expect when having surgery. Available from: https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/what-expect-when-having-surgery. Last accessed August 2019.
  9. Cancer.net. Side effects of surgery. 2018. Available from: https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/side-effects-surgery. Last accessed August 2019.