Chemotherapy is an outpatient treatment using drugs to kill cancer cells. The decision about chemotherapy is made with your input and heavily relies on your acceptance of aggressive vs non-aggressive management of your disease.
Chemotherapy can be used to increase the chance of cure after the surgery, to increase survival in advanced lung cancer, and to help reduce pain and other problems caused by lung cancer. Side effects depend mainly on the type of drug, how much of it is used, how often it is given and for how long.
Advanced lung cancer
Most often, initial chemotherapy for advanced lung cancer uses a combination of three drugs. The most common combinations include either cisplatin or carboplatin, plus a companion drug and a third drug that interferes with tumor blood vessel production. The drugs most frequently used companion to cisplatin and carboplatin are paclitaxel, docetaxel and gemcitabine. The third drug is bevacizumab (Avastin), which makes chemotherapy more effective. Single-drug chemotherapy is sometimes used for people who might not tolerate combination chemotherapy well, such as those in poor overall health.
Early Stage Lung Cancer
Chemotherapy for early stage lung cancer is sometimes recommended depending on the size of the tumor and its spread to the lymph nodes. If it is done, it generally involves cisplatin and another drug such as navelbine, gemcitabine or docetaxel. The field of chemotherapy for early stage lung cancer is rapidly evolving.
Small Cell Lung Cancer
Chemotherapy for small cell lung cancer also uses a combination of two drugs, with the most commonly prescribed according to stage. If the stage is considered “limited,” initial chemotherapy may include cisplatin and etoposide or carboplatin and etoposide. For “extensive” stage cancer, the combination may be cisplatin and etoposide, carboplatin and etoposide, or cisplatin and Irinotecan. If the cancer progresses during treatment or returns after treatment is finished, different chemotherapy drugs may be tried.