Chemotheraphy For Lung Cancer
Chemotherapy for lung cancer is one of the primary treatment methods.
Chemotherapy can help you survive lung cancer. Chemotherapy is a treatment using anti-cancer or “cytotoxic” drugs to destroy cancer cells. These drugs circulate in your bloodstream and reach the cancer cells wherever they are.
Chemotherapy Administration
Chemotherapy can be administered in many different ways
Clinical trials take place before the drug becomes readily available. They determine the dose and method of administration. Stomach acids can destroy certain drugs, and others work best if directly into the bloodstream, which is called intravenous dosing or IV.
These drugs circulate in your bloodstream and reach the cancer cells wherever they are.
Some of the administration methods are:
1.Oral chemotherapy
- Can be swallowed in pill form with a protective coating
- Can be absorbed under the tongue
2. Subcutaneous injection
- With a short needle between the skin and the muscle tissue
- Commonly used for some types of biologic response modifiers
3. Intra-muscular injection
- With a larger needle with deeper penetration through the skin into the muscle
- Usually used for anti-nausea medications because it bypasses the stomach
- Avoided when possible in patients with low platelets
4. Intravenous dosing
- Allow for rapid entry into the body’s circulatory system.
- Most common form of administration
- Portable pumps, housed in a container the size of a video cassette, allow medication to be given in small doses over a longer period of time (24/7)
- a) An angiocatheter can be placed in a vein in the arm or hand and then removed after the meds are given. It is a temporary device.
- b) PICC line can be inserted and used for six weeks. It involves the placement of a long plastic catheter into one of the larger veins of the arm
- c) Non-tunneled catheters are inserted directly through the skin into the jugular or subclavian vein, which is a vein that is located on either side of your body. They are most commonly used for short-term situations but require careful maintenance.
- d) Tunneled catheters are placed through the skin in the middle of the chest. They are inserted into the superior vena cava vessel at the entrance of the right atrium of the heart. These catheters can be left in place for months or years; maintenance is required. Tunneled catheters are frequently called by their brand names: Broviac, Groshong and Hickman.
- e) Port-a-cath is a more permanent option and is placed under the skin on the chest and inserted into the superior vena cava vessel at the entrance to the right atrium of the heart. The lifetime of a port-a-cath is between three and five years. Medications are given and blood can be drawn. The use of a portable pump allows the meds to be dispensed over several days in the home.
Chemotherapy makes use of different drugs depending on the type of cancer you have.
There are two kinds of lung cancer:
Small cell lung cancer (SCLC),
Non-small cell lung cancer (NSCLC).
There are three sub-categories of non-small cell lung cancer.
- Squamous: The most common type of NSCLC in men, found in the lining of the bronchial tubes.
- Adenocarcinoma: The most common type in women, found in the glands that produce mucus.
- Large-cell carcinoma: Rapid growth of cancer cells, found in the outer edges of the lungs.
Chemotherapy Drugs for Small Cell Lung Cancer
Chemotherapy uses five drugs to treat SCLC. They include the following.
Chemotherapy Drugs for Non Small Cell Lung Cancer
There are 11 drugs used as treatments for lung cancer (NSCLC). They include the following.
- Ifosfamide is a drug that works by sticking the cancer cell's DNA (the cell's genetic code) together so that it cannot dissolve again; in other words, the cell cannot reproduce. The most common side effects are:
- Fatigue - which may continue after the treatment is finished.
- Increased risk of infection because of a temporary drop in white blood cell count produced by the bone marrow.
- Lack of energy and breathlessness due to a drop in red blood cell count.
- Bruising easily because of the drop in the number of platelets
- Generally feeling sick for up to three days.
- Hair loss (which is temporary)
- Irritation of the bladder and kidneys, so drink lots of water (You will receive a drug called mesna to protect your bladder and kidneys)
- Nails may become ridged
- Loss of fertility
- Mytocin C also works by regrouping the cancer's cell's DNA together, preventing the cancer cell from continuing to divide and grow. It is a purple liquid. The most common side effects are:
- Fatigue which may be the most troublesome
- Increased risk of infection because of a temporary drop in white blood cells
- Loss of energy and breathlessness because of a drop in red blood cell count.
- Bruising easily because of a drop in the number of platelets.
- Severe depletion of the bone marrow.
- Loss of appetite
- Generally feeling sick for about three days
- Loss of fertility.
- Vinorelbine is a drug that belongs to a group called plant alkaloids, which can be used for chemotherapy for lung cancer. They were first developed from the periwinkle plant or "vinca". They are also called microtubule inhibitors. The drug works by blocking the cancer's growth. The most common side effects are:
- Fatigue
- Constipation is a problem in about 30% of patients.
- Feeling generally sick.
- Depletion of the bone marrow, which causes:
- A) Increased risk of infection
- B) Tiredness and breathlessness
- C) Bruising more easily
- Diarrhea
- Loss of fertility
- Amenorrhea (loss of periods in women)
- Cisplatin is the first drug outlined above.
- Gemcitabine is a drug called an anti-metabolite. They are very similar to cellular molecules but the cells are unable to divide. These anti-metabolites are called cell-cycle specific, meaning that they interfere with the normal progression of cell life.The most common side effects are:
- Fatigue
- Temporary effect on the bone marrow causing:
- Increased risk of infection from decreased white blood cell count.
- Feeling tired and breathless from a decreased red blood cell count.
- Bruising easily from a decreased platelet count.
- Generally feeling sick for about 70% of the people
- A skin rash in 25% of the patients
- Swelling in your face, hands and feet occurs in about 30% of the people
- Paclitaxel (Taxol) is a drug that works by blocking the growth of cancer cells. It comes from the bark of a yew tree. You may have heard of taxol in connection with breast cancer. It is also used as a treatment for lung cancer. The most common side effects are:
- Fatigue, possibly the most disruptive side effect.
- Feeling generally sick
- Temporary bone marrow effects causing the risk of infection, tiredness and bruising
- Hair loss
- Numbness and tingling in the hands and feet
- Aching joints and muscles in about 60% of the patients
- Diarrhea
- Mild allergic reaction in 20% of the patients
- Loss of fertility
- Doxetaxel (Taxotere) is a man-made drug that was first made from the needles of the yew tree. It works by preventing the cancer cells from separating into two new cells. The most common side effects are:
- Fatigue which affects up to 80% of the people treated
- Temporary bone marrow effects causing the risk of infection, tiredness and bruising
- Fluid retention in 50% of the patients
- A rash in 50% of the patients
- Your fingernails may become discolored
- Hair loss in 80% of the patients
- Mouth sores in about 40% of the patients
- Diarrhea in about 40% of the patients
- Numbness and tingling in your hands and feet
- Allergic reaction during infusion in about 25% of the people
- Loss of fertility
- Doxorubicin works by sticking to the cancer cells' DNA and blocking the enzyme (topoisomerase 2). This tangles the DNA and prevents cell division and growth. The most common side effects are:
- Increased risk of infection from decreased white blood cells
- Lack of energy and breathlessness from a drop in red blood cell count.
- Bruising more easily from decreased platelets
- Fatigue during and after treatment
- Feeling generally sick may be severe
- Hair loss occurs in almost everyone
- A sore mouth
- Sensitivity to sunlight
- Watery eyes
- Loss of fertility
- Etoposide (Eposin) is another drug that blocks the enzyme topoisomerase 2 which is necessary for cell division. When the enzyme is blocked, the DNA gets tangled and the cell cannot divide. You can take this drug as a capsule to swallow. The most common side effects are:
- Temporary bone marrow effects causing the risk of infection, tiredness and bruising
- Fatigue during and after treatment
- Feeling generally sick in about 40% of the patients
- Hair loss in about 70% of the patients
- Loss of appetite
- Inflammation around the drip site
- Loss of fertility
- Pemetrexed is another drug known as an anti-metabolite. They stop the cells from making and repairing the DNA needed to grow. This drug is used to treat pleural mesothelioma that is caused by inhalation of asbestos. The most common side effects are:
- Fatigue which affects 33%: of the patients
- Temporary bone marrow effects causing the risk of infection, tiredness and bruising
- Feeling generally sick which affects 33% of the patients
- Loss of appetite happens in 20% of patients.
- A skin rash occurs in about 14% of patients.
- Diarrhea affects 11% of the patients.
- Loss of fertility
- Topotecan (Hycamtin) is a drug that was originally made from the wood of a Chinese tree. It is called a topoisomerase 1 inhibitor. It works by blocking the enzyme that separates and repairs cell’s DNA. The cells then die. The most common side effects are:
- Fatigue, possibly the most troublesome effect.
- Temporary bone marrow effects causing the risk of infection, tiredness and bruising
- Feeling generally sick (can be severe; happens to 70% of patients.)
- Hair loss and thinning occurs in 60% of patients.
- Diarrhea is a complaint of 40%
- Constipation is a complaint of another other 40%
- High fever is a possibility.
- Mouth sores
- Loss of appetite
- Loss of fertility
This information doesn't cover all possible uses, precautions, interactions or adverse effects of these lung cancer chemotherapy drugs. If you have questions about the drugs you are to take, check with your health care professional.
It is also important to remember that with lung cancer, chemotherapy is not the only option. You can also opt for surgery or radiation: your doctor can tell you which treatment is best for you.
Chemotherapy for lung cancer can be terrifying. You won't know whether things will turn out right, or know exactly what to do. It is always best to have an open relationship with family and friends, and keep in contact with a doctor that can help you through anything that you may have questions about.
Written by Margaret Stenerson-Reynolds
07-15-09
Reviewed by Susan McCracken
07-23-09
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