Treatment of lung cancer has developed rapidly in the past 10 years. With earlier detection and improved therapies, patient outcomes have improved significantly.
The therapies used for treatment of lung cancer — chemotherapy, radiation and surgery — certainly cause many acute side effects. But this article will focus on the potential long-term impact of therapy. Many lung-cancer survivors share similar long-term complications or survivorship issues with other cancer patients, but there are some unique aspects to thoracic cancers.
The majority of lung cancers remain tobacco-related cancers. Quitting smoking remains critical for any patient who has been treated for lung cancer. The ongoing effects of tobacco use can further impact normal lung function and remain a strong risk factor for further lung and other cancers. At the Hartford Healthcare Cancer Institute, there are many resources available to help with smoking cessation. The first step is to decide it is time to quit, then ask for help and resources.
The impact of smoking on the lung is considered a “field effect.” This means that the potential cancer causing changes in normal lung tissue may be present throughout the lung, including areas away from the cancer itself. This raises the possibility of developing a second lung cancer.
One of the keys to success in the treatment of lung cancer is periodic surveillance and early detection of a cancer when it is small and easier to treat. To detect any new cancer early, all lung cancer survivors should have ongoing chest CT scans (computerized tomography, using X-ray technology). These should be done at least once a year.
Immunotherapy has been one of the biggest breakthroughs in the treatment of lung cancer. These medications harness the power of the immune system to fight against the cancer. Unfortunately, they do not work for everyone. But some patients have prolonged cancer shrinkage from these medications.
In patients whose tumors are responding, it is not clear when these drugs can be safety discontinued, and some patients may continue them for multiple years. Long-term effects can include changes in the body’s hormone system (for example, low thyroid hormone), skin rash and other skin change, diarrhea and other bowel effects. Any new symptoms or side effects should be reported to your oncologist, as it can be difficult to determine what is related to treatment.
Lung cancers are treated with surgery, chemotherapy and radiation, both individually and in various combinations. Each treatment has the potential to cause unique long-term side effects:
- Surgery can cause pain on the chest wall, limitations related to reduced lung capacity, cough and shortness of breath.
- Radiation can cause inflammation within the lung (pneumonitis), long-term respiratory symptoms and may affect other organs near the lung.
- Chemotherapy has significant short-term side effects that fade within 3-6 months after therapy but can lead to chronic cardiopulmonary changes, nerve changes, bone changes, and nail and skin changes.
One thing that each treatment does have in common is the possibility to cause physical deconditioning as well as decline in respiratory lung functions. It is critical to maintain as much physical fitness as possible during and after therapy. This is especially true around the time of a lung surgery. This can be accomplished through a home exercise routine or more structured physical therapy. The Hartford Healthcare Cancer Institute has a number of resources available for improving and maintaining physical fitness during and after cancer therapies.
Advances in the treatment of lung cancer have led to more and more people living after the diagnosis. This has increased the importance of having resources available to help optimize quality of life and address any long-term complications of therapy. Whether it is tobacco cessation, addressing physical fitness or managing the unique side effects of immunotherapy, the Hartford Healthcare Cancer Institute has built the support to help every patient not only during only active therapy but also in the years that follow.