Chemotherapy is a common term for the use of medications to cure cancer. Patients with various forms of Lung Cancer are likely to get various Chemotherapy drug combinations. Upon reviewing treatment choices with patients, physicians will determine which medications are most appropriate for the Chemotherapy.

Chemotherapy can be used to treat Lung Cancer in several ways:

Cure early or locally advanced inoperative Lung Cancer combined with Radiotherapy (chemoradiotherapy) Check for tumor shrinkage before Surgery or Radiotherapy (neoadjuvant chemotherapy) Extend life if treatment (palliative chemotherapy) is not possible; Kill any undetectable cancer cells that may still remain after successful Lung Cancer Surgery or to help prevent recurrence (adjuvant chemotherapy); Reduce symptoms such as breathlessness (palliative chemotherapy)

Chemotherapy for small cell lung cancer

If you are suffering from small cell Lung Cancer (SCLC), Chemotherapy is typically the first form of treatment you receive. This is because SCLC can grow and spread rapidly, and when the Lung Cancer is detected, it has often spread outside the lung, and responds well to Chemotherapy.

Systemically treating it with Chemotherapy typically leads to symptom relief and longer survival. After chemotherapy, Radiotherapy can be performed to try to stop the cancer from returning.

Small cell Lung Cancer has a number of different types of Chemotherapy medications. A combination of etoposide and one which contains platinum (cisplatin or carboplatin) is the most common first-line treatment.

Many medications that can be used after initial Chemotherapy as a further treatment (second or third line) include:

• Topotecan
• Cyclophosphamide
• Doxorubicin
• Vincristine.

The first drug, topotecan, is used on its own, and the other three are used together in what is known as the “CAV regime”.

Chemotherapy for non-small cell lung cancer

Non-small cell Lung Cancer (NSCLC) may also be treated with Chemotherapy. It may be used as the only therapy, as a pre- or post-operative treatment, or for treating symptoms of advanced Lung Cancer.

If Lung Cancer Surgery is not suitable for you, and your type of Lung Cancer means that a Targeted therapy or Immunotherapy drug is likely to be less effective, either Chemotherapy on its own or in combination with Radiotherapy (if you are fit enough) may be offered.

When you have had Lung Cancer Surgery and all cancer cells have been removed, then Chemotherapy (adjuvant chemotherapy) can still be given afterwards. If you have had Surgery and cancer cells stay, however, your cancer doctor will talk to you about whether you should have Radiotherapy and/or Chemotherapy (chemoradiotherapy).

For people with NSCLC the most widely used Chemotherapy includes platinum (cisplatin or carboplatin) with one of the following drugs:

• Pemetrexed
• Vinorelbine
• Gemcitabine
• Paclitaxel.

The cancer doctor may use a variety of Chemotherapy medicines to treat the Lung Cancer either as a first after diagnosis treatment, or if it returns (called a relapse). Second- or third-line treatments can include different Chemotherapy drugs, targeted therapies or immunotherapies.

Side Effects:

Everyone responds to Chemotherapy differently:

• Fatigue
• Nausea and vomiting
• Mouth sores
• Taste changes
• Loss of appetite
• Anemia
• Hair loss
• Skin changes
• Fingernail changes
• Depression
• Peripheral neuropathy
• Fertility problems
• Kidney problems
• Thrombocytopenia