External radiation is the main form of treatment for people with lung cancer who are unable to tolerate surgery and for those whose cancer has spread beyond the reach of surgical removal. The standard course of radiation treatment is five days a week for four to eight weeks.
Radiation may be directed to areas of cancer in the lung that cannot be removed with surgery, or it may be used to treat cancer that has spread to the brain or bones or that compresses the spinal cord. Side effects of external radiation include nausea and vomiting, local skin irritation, and fatigue.
Photodynamic Therapy to Treat Lung Cancer
Photodynamic therapy (PDT) may be used to treat inoperable lung cancer. Photodynamic therapy involves the injection of a light-activated drug (e.g., photofrin/polyhaematoporphyrin, lumin). Then, during bronchoscopy (examination of the airways using a flexible scope), the lung tumor is illuminated by a laser fiber that transmits light of a specific wavelength. At that time, the laser light is used to destroy the sensitized tumor tissue. Skin photosensitivity (light sensitivity) is a side effect of PDT.
The curative potential of PDT is the most exciting aspect of this therapy in lung cancer patients whose tumors are occult (hidden, unseen) on chest x-ray. The tissue-sparing effects of PDT may be particularly important for patients who have limited lung function.
Electrosurgery is surgery performed using a needle, bulb, or disk electrode. Nd-YAG laser therapy (neodymium-yttrium/argon laser that concentrates high-energy electromagnetic radiation to destroy tissue), cryotherapy (destruction of tissue using extreme cold), and brachytherapy (treatment with ionizing radiation) are additional tumor debulking, or size-reducing, techniques that may be performed during bronchoscopy. These methods are especially useful for obstructive, inner cavity (intraluminal) lung tumors.