Lung Cancer Chemotherapy

When lung cancer metastasis occurs, chemotherapy is one of the few treatment options available. Chemotherapy drugs target rapidly growing cells and kill them, slowing tumor growth and metastasis. Unfortunately, as the medication affects the entire body, healthy cells that reproduce quickly are also targeted, producing a variety of chemotherapy side effects, including nausea, fatigue, hair loss, and sometimes peripheral neuropathy.

Small cell lung cancer responds best to drug-based treatment. SCLC metastasis happens quickly, spreading tiny amounts of cancer throughout the body. These amounts are so small that diagnostic scans often miss them. As a result, many doctors prescribe chemotherapy treatment as a precaution for SCLC cases even if metastasis is not evident.

Non small cell lung cancer does not respond to chemotherapy as readily as SCLC. However, drugs may be used alone or in combination with radiation to shrink NSCLC tumors before surgery. Chemotherapy also provides palliative care for both types of lung cancer, providing symptomatic relief.

Live Vaccine Warning

People undergoing chemotherapy treatment should avoid contact with live vaccines, and people who have recently been immunized with a live vaccine should avoid chemotherapy. The body’s immune system is compromised during treatment, increasing the possibility of serious infection.

Chemotherapy Medications: Cisplatin and Taxotere

Initial treatment is likely to include a combination of medications, usually given by injection or through a catheter inserted into a vein. Often gemcitabine or paclitaxel is combined with a platinum-based drug, such as carboplatin or cisplatin. The platinum in cisplatin and carboplatin kills tumor cells. Research indicates that cisplatin combined with radiation therapy can improve survival rates.

Taxotere, a drug based on chemicals found in yew tree needles, prevents tumor cells from reproducing. Taxotere is rarely prescribed unless a previous course of chemotherapy has been tried without success.

Chemotherapy Side Effects: Nausea, Fatigue, Peripheral Neuropathy

Chemotherapeutic agents can have severe side effects. Chemotherapy side effects can include:

  • anemia
  • easy bruising or bleeding
  • fatigue
  • fluid retention
  • hair loss
  • kidney damage
  • lowered bone marrow function
  • nausea
  • rash
  • sore mouth
  • peripheral neuropathy.

Nausea and fatigue are side effects common to most chemotherapy drugs, but they can be especially severe when taking cisplatin. Taxotere causes complete hair loss in eight out of ten people.

Some chemotherapy drugs also cause peripheral neuropathy, or nerve damage. Peripheral neuropathy is most often experienced as a tingling in the fingers or hands. In severe cases people experience severe hand and foot pain, muscle paralysis, or incontinence.

Chemotherapy Side Effects vs. Symptom Relief

Given the severe side effects associated with chemotherapy, one might question whether the treatment does more harm than good, especially if there is little chance of recovery from the cancer. However, medications provide enough symptomatic relief that overall quality of life is improved. By shrinking the tumor, the therapy can relieve pain and open blocked airways.

Angiogenesis and Thalidomide

The body’s ability to grow new blood vessels is called angiogenesis. Tumors grow their own blood vessels as they grow. The medication thalidomide inhibits angiogenesis. Without new blood vessels, tumors cannot grow. Thalidomide is receiving a great deal of attention in lung cancer clinical trials.

Resources

Bergman, B. (2001). Lungcancer. Lkemedelsboken. Apoteket AB, Farmaci/Marknad (ed.). BTJ Tryck AB, Lund, pp. 596-602.

Cancer Research UK. (updated 2002). Cisplatin.

Cancer Research UK. (updated 2002). Docetaxel (Taxotere).

National Cancer Institute. (updated 2002). What you need to know about lung cancer: Treatment for lung cancer [NIH Publication No. 99-1553].

OncologyChannel.com. (updated 2003). Lung cancer: Treatment.

Schaake-Konig, C., van den Bogaert, W., Dalesio, J. Festen, J., Hoogenhout, J., van Houtte, P., Kirkpatrick, A., et al. (1992, February). Effects of concomitant cisplatin and radiotherapy on inoperable non-small-cell lung cancer [electronic version]. New England Journal of Medicine, 326(8), 524-530.