Tag: inoperable lung cancer

Inoperable Lung Cancer: Current Advances, News, and Trends
By Foster Lasley, MD, as told to Kara Mayer Robinson

If your lung cancer can’t be treated with surgery, it doesn’t mean there’s nothing you can do.

You may still have treatment options like radiation therapy and chemotherapy. Nonsurgical treatments can lead to good outcomes and they’re commonly used around the world today.

What’s Inoperable Lung Cancer?

Inoperable lung cancer is simply a tumor that surgery can’t treat, which could be because your cancer is in a difficult spot to reach, it’s spread outside your lungs, or you have other serious health conditions.

For example, if your lungs aren’t healthy enough in general, or you have a prior condition like heart disease, it can make surgery too risky.

How Do You Treat Inoperable Lung Cancer?

It’s up to you and your doctor to decide which options are best for you. Every person is different, so your best treatment plan is based on your specific needs.

Radiation, chemotherapy, targeted therapy, and immunotherapy can each be used to treat inoperable lung cancer. Your doctor may recommend one treatment or a combination of treatments.

What Are the Latest Advances in Inoperable Lung Cancer?

Lung cancer treatment continues to improve thanks to ongoing improvements in detection and treatment.

CT scans and other screening methods are becoming more and more capable of detecting tumors early on, when they’re more treatable.

Different combinations of radiation therapy, chemotherapy, targeted therapy, and immunotherapy are being tested in clinical trials to figure out the best order and period of time for each treatment.

Doctors are constantly reviewing the latest research to find tweaks to improve care.
What’s Coming in the Near Future?

There’s a lot of research in the works.

Current and upcoming clinical trials are looking at:

How to tailor treatment to individual cancer types

How to treat higher numbers of metastatic sites

Improving detection of small sites of distant metastases so that they can be treated

Experts are also discussing how to handle metastases to the brain. Doctors have different opinions on the best approach.
Exciting research is being done to look at the use of stereotactic body radiation therapy (SBRT) in combination with checkpoint inhibitors. SBRT is a type of radiotherapy that uses 3D imaging to target tumors all over your body. Checkpoint inhibitors are a type of drug that blocks proteins found in some cancer cells.

Using checkpoint inhibitors combined with other treatment methods may allow doctors to better treat lung cancer without surgery. This is especially exciting for people with inoperable lung cancer. Clinical trials are still in the early phase I stage, but this could be a big development.

Another exciting new development is the increasing use of SBRT to decrease the amount of oligometastatic sites in your body, often in combination with other therapies.

How Do Disparities in Health and Health Care Impact Inoperable Lung Cancer?

Unfortunately, recent research shows racial disparities for minorities in how long they have to wait for cancer care.

Many wealthy communities in the U.S. have an abundance of medical resources at their disposal. They’re also more concentrated around major cities.

But this means lower income areas, which have more people of color, are comparatively underserved. When access is difficult, and a larger area with more people only has a few cancer care locations, this can create a bottleneck and longer wait times for care.

To combat this, public and private practices must make an effort to establish sites in these lower income and rural areas so that they’re closer to underserved communities.

We work hard in my practice to make sure patients get the same care regardless of race, ethnicity, and background, in a way that’s personalized to their specific needs and health conditions.

What Can You Do to Manage the Stigma of Lung Cancer and Other Mental Health Concerns?

People may assume your cancer is self-inflicted due to smoking. But it can happen even if you’ve never smoked a cigarette. There are plenty of other factors that play a role, including your family history of lung cancer.

This stigma, along with the emotional challenges of having lung cancer, can take a toll on your mental health, which plays a big role in holistic care.

If you lose hope or feel like your quality of life is getting worse, it can have a negative effect on your emotional and physical health. This can lead to a lack of exercise and high levels of stress, which can harm your treatment process and outcomes.

To help with this, I recommend finding a support group in your area. There are more and more popping up across the nation. If you can’t find one locally, there are many online communities willing to help and provide resources during your treatment process.

It’s also a good idea to exercise, eat right, and try to live your life as normal. Doing so helps with positivity and overall happiness, which can stave off stress and depression. A positive outlook and can-do attitude go a long way in helping to achieve a better outcome.

What’s the Outlook for Inoperable Lung Cancer?

There’s still hope if your lung cancer is inoperable. Modern medicine has found ways to treat patients with inoperable lung cancer effectively, so it’s absolutely vital you keep hope, stay positive, and fight.

Every day, doctors around the world are conducting clinical trials to find new, better ways to treat inoperable lung cancer. The solution to your specific case could be right around the corner, so we all have to keep going to get there.

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January 3, 2023
A Day in My Life With Inoperable Lung Cancer

By Amy McMillin, as told to Kendall Morgan

When I found out I had lung cancer, I was working full time. That hasn’t changed. I am still working full time, and my family tries to stick with the same routine we had prior to my diagnosis, with some exceptions and adjustments, of course.

I have two kids. My oldest is away at college and my youngest can drive now, so I don’t have to do the morning school routine. This is a huge help since fatigue is one of the biggest side effects of my treatment. Thankfully, also, my mother-in-law lives close by. She is such a huge help to our family. She comes and deep cleans our home once a month and helps in any other way we may need.

It’s important to have a support system, both at home and at work. I am so fortunate to work from home and have a great work support system. When I was diagnosed, I went to my supervisor, and we discussed options that allow me some flexibility in my work schedule. I can rest at times when I am in pain or not feeling well. I find that a quick power nap at lunch can help me to get through the day.

I have set up my home office so that I can stay on top of deadlines and priorities. My memory is a bit of a struggle at times, and things take me longer than they used to. To stay on track, I use a large desktop calendar, to-do lists, and other organizational tools. These help me know where I left off the day before and what I need to do next. I’ve adapted.

One of the things that was brand new to me with the cancer diagnosis was medication management. The targeted medicine I take for my lung cancer type is very specific about when I need to take it. I have to take two pills twice a day. They also must be taken 12 hours apart. On top of that, you can’t eat for 2 hours before and 1 hour after taking the pills. It took some trial and error to land on a schedule that would work with our family’s schedule.

I find that taking it at 5 a.m. and 5 p.m. allows me to have dinner with my family in the evenings at a time that works for everyone. Along with the targeted medication, I take another medicine now to help with digestive issues from radiation, and that has to be taken at specific times also.

Prior to my diagnosis, I went to see my primary care doctor once a year or on the rare occasion I had a bad cold. These days, it feels as though I am at a doctor all the time. I see my local doctor once a month at least for checkups related to the medications I take. They help me to manage my side effects and any other issues I might be having.

I also travel to [a specialty hospital] once every 3 months for scans. I get checkups with my oncology team and my cardiology team. I’ve had to learn to live with a long list of side effects, including fatigue, stomach issues, skin issues, sun sensitivity, bloating, and weight gain. Each of these side effects requires a different doctor to manage them. Managing all the medicines and all the doctor appointments on top of my usual work schedule and home life is probably one of the biggest challenges in terms of day-to-day life.

But even with all the side effects, medications, and doctor visits, I think it’s important for me mentally to maintain as much of a normal lifestyle as I possibly can. It’s good for me as well as my family. I’m still young and have so much to contribute to my family and friends. I want to keep moving and grooving as long as I can.

Some days it’s wonderful and some days it’s very hard, but I find that having a solid support system in all aspects is what’s most important. Trust your team of doctors. Lean on your friends and family to help you because they want to and you need it. Beyond that, just keep putting one foot in front of another. Keep fighting.

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November 22, 2022
Inoperable Lung Cancer: The Emotional Side of Treatment I Wasn’t Prepared For

By Natalie Brown, as told to Kendall Morgan

When I was diagnosed with stage IV lung cancer at age 33, I had to make a lot of tough decisions quickly, including whether to freeze my eggs before treatment started or not be able to have kids. We decided to go ahead with treatment immediately. In the beginning of treatment, I felt awful. I was exhausted, and there was little I could do. It took time to come to terms with the diagnosis. How I feel mentally still changes day to day.

Overall, the emotional impact and experience hasn’t been what I expected in the beginning. I didn’t expect treatment to go the way that it is going. It’s going surprisingly well for stage IV, so let’s start there. But I say emotionally, every treatment is completely different. Sometimes, I can go through treatment and it’s like, “Hey, I have chemo.” Sometimes, it’s like, “Oh my gosh, I can’t believe I have lung cancer. I can’t believe I’m having to put poison in my body.”

I have to alter my life around treatment. I’ll do as much as I can before the medicine kicks in. I still work and it is very difficult to try and work and be on treatment at the same time. If I have treatment on a Monday, I’ll do all I can because by Wednesday or Thursday, I might not feel like walking up the steps.

Emotionally, it’s all over the place. It’s like a rollercoaster. Sometimes you are up and sometimes you are down. It’s a complex combination of emotions with treatment every 3 weeks. I know I’ll be down for a week, so I’ll hurry and stress. I’ll make sure all the clothes are washed. My husband helps, of course, but I want a clean house when I’m in treatment. I rush around, cooking, cleaning, or ordering food because I won’t feel like cooking. It’s a lot of anxiety to make sure things are perfect before treatment. If I don’t get it all done, then I’ll try and do it in the week of treatment and it makes me more fatigued. That’s when it gets frustrating.

Sometimes I just shut down. Two treatments ago, I cried and cried because I was so fatigued to the point where I couldn’t believe I was having to deal with this. I cried the whole week. I didn’t want to talk to anyone or get on social media. I went into a funk. It happens periodically. You’re just so tired. The fatigue weighs on you the most, no matter how much you sleep.

To help with the emotions, I found support through a mentoring program and online. I started seeing a therapist for the first time in my life. I thought at first I could handle this without professional help, but I couldn’t. Seeing a therapist has helped.

A lot of friends got me books. I tried reading them, but I’d read 20 pages and I just couldn’t do it. I started listening to podcasts and that’s better for me. Those seem to help. I listen to a lot of music, especially during treatment weeks. Slow, soft music seems to help a little bit. I take bubble baths, and I never did that before. Relaxing in a tub with candles. That helps a lot.

You have to give it time. I was not immediately able to talk about this the way I am now. I had to take the time to digest the fact of cancer and then I could share my story. Awareness is extremely important, especially in lung cancer.

Through it all, I find reasons to celebrate. I’m turning 35 this year. It’s another birthday, but it’s also another year celebrating that I’m still here. I celebrate everybody’s birthday. I celebrate scans. I had one a couple of weeks ago that was really good. I make sure to celebrate any little thing. Before cancer, I didn’t do that. I celebrated birthdays but not to the extreme. Now, that’s super important to me. It doesn’t have to be anything big. Any small situation, I make it celebratory. This experience has turned me into a more positive human. It sounds crazy. You’d think the opposite. But I’m so much more positive in life than before.

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November 22, 2022
Inoperable Lung Cancer: Innovations That Are Changing the Outlook

By David Tom Cooke, MD, as told to Susan Bernstein

The term is “inoperable lung cancer.” It means that the risk of surgery to remove the lung cancer exceeds the benefits of the surgery for a patient. However, it is hard to tell if someone is “inoperable.”

Age is one factor that can slightly increase your risk, but it’s not necessarily prohibitive. I’ve operated on 90-year-olds. Other health problems you have can be a factor, such as impaired lung function. If we remove a lung tumor in a person who already has minimal lung function due to severe COPD or emphysema, that can make surgery risky, for example. There is a growing population of people who fit that description. To be determined that your lung cancer is “inoperable,” you really need to be seen by a thoracic surgeon.

The gold standard for treatment of early-stage, inoperable lung cancer is something we call SBRT, or stereotactic body radiation therapy. It’s high-dose, focused radiation. SBRT is used to try to destroy the tumor. It’s very targeted, and we use special imaging to be very precise with this treatment, typically CT scans. It’s different from traditional, high-dose radiation therapy to shrink or kill tumors. SBRT has potential to cure lung cancer, but it’s not known if it has the same cure rate for patients as surgery. We usually perform one or two SBRT treatments, and then you have routine follow-up for 5 years.

There are some newer experiments going on in this area. It’s thought that radiation can cause the release of antigens, small proteins that activate your immune system. There are studies to see if the combination of SBRT with immunotherapy drugs called checkpoint inhibitors can increase the likelihood of killing and eliminating lung tumors. Checkpoint inhibitors activate one’s own immune system — to remove the “checkpoints” that slow down the immune system — to fight cancer.

Researchers are studying not only the effects of this combination therapy, but how long patients would have to take these drugs. Right now, there have been phase I studies to look at the safety of this SBRT/checkpoint inhibitor combination, as well as clinical trials underway to look at the results of the combination therapy.

Another treatment used in early stages is the use of [local scopes to treat the tumor], such as navigational bronchoscopy. For this treatment, we take a camera attached to the end of a catheter and insert it into the patient’s trachea, or windpipe. Then, either using high-tech guidance tools or combined with a CT scan, we aim the catheter toward the tumor. This is also being done with robotic technology combined with a CT scan to guide the catheter to the tumor, followed by microwaves to kill the tumor, or to locally inject chemotherapy directly into the tumor. There are animal studies being done now to test this type of technique.

There have been recent advances in surgery, so people whose lung cancer was once considered inoperable may become operable. One key factor here is robotic surgery. We can make smaller incisions for less stress on the body. Robotic surgery also allows us to take less lung tissue out to remove your tumor.

There are other new technologies on the horizon for lung cancer treatment. One may be a combination of robotic surgical technology with 3D imaging and heads-up displays in the operating room to carefully guide the surgery. I always use this comparison: If your child is going to the prom, do you want them going in a 1992 Ford Taurus or a 2022 Toyota Camry with all the latest safety innovations, such as blind spot assist, airbags on all sides, and a backup camera? We can use these technologies to greatly increase safety during surgery.

There is another point that is important for the big picture of lung cancer treatment. According to the American Lung Association’s 2021 “State of Lung Cancer” report, over 20% of patients diagnosed with lung cancer did not receive any treatment whatsoever. In addition, Black patients with lung cancer are 23% less likely to receive surgical treatment and 9% less likely to receive any treatment compared with white patients.

Before you have any treatment for lung cancer, it is best to discuss it with a team of doctors, including a thoracic surgeon, because we have so many different options to fight your disease.

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November 22, 2022