Lung cancer: current treatment options

What it is

There are two main types. The most common is non-small cell lung cancer, which accounts for most cases and usually grows more slowly. The other is small cell lung cancer, less common but faster growing. Knowing which of the two a person has is essential, because the treatment is different for each one.

It is important to say this clearly and without alarm: many people with lung cancer feel nothing at first. That is why, when there are risk factors or discomfort that will not go away, the most valuable step is a timely medical evaluation. Finding it early opens up more treatment options.

Risk factors

• Smoking tobacco (cigarettes, cigars, pipes) is the most important risk factor. The risk grows with the years and the amount smoked. Quitting reduces the risk at any age, and it is never too late to do it.
• Having smoked in the past, even after quitting.
• Breathing other people's tobacco smoke (secondhand smoke).
• Wood smoke in poorly ventilated kitchens, a common exposure in rural areas of Mexico.
• Workplace exposure to substances such as asbestos, arsenic, silica, or diesel fumes.
• Radon gas and air pollution.
• Family history of lung cancer.
• Having received radiation to the chest for another illness.

A note on tone for this page: there are also people who develop lung cancer without ever having smoked. Smoking, or having smoked, is no reason for guilt or shame: it is information that helps your doctor take better care of you. What matters today is getting evaluated on time.

Warning signs / common symptoms

• A cough that will not go away or gets worse over the weeks.
• Coughing up blood or phlegm streaked with blood.
• Chest pain that gets worse with deep breathing, coughing, or laughing.
• Shortness of breath or wheezing.
• Hoarseness or changes in your voice.
• Constant tiredness without explanation.
• Loss of weight or appetite with no apparent cause.
• Respiratory infections (bronchitis, pneumonia) that keep coming back or do not improve.

These problems can come from many other causes that are not cancer, such as infections or common respiratory illnesses. Only a doctor can evaluate them. If any of them has lasted several weeks, come in for an evaluation.

How it is detected and diagnosed

Everything starts with a consultation: the oncologist reviews your medical history and background (including smoking, without judgment) and performs a physical exam. From there, imaging tests are ordered, such as a chest X-ray and CT scan, to see whether there is a lesion in the lungs.

If the tests show something suspicious, the diagnosis is confirmed with a biopsy: a small tissue sample is taken and analyzed to know exactly what kind of cells they are. The Unidad de Oncología Menonita performs evaluation appointments, biopsies, and the tests needed to reach a precise diagnosis, and in certain cases molecular tests of the tumor are ordered to help choose the most appropriate treatment for each person.

Treatment options

Treatment depends on the type of cancer (small cell or non-small cell), how far it has spread, and the person's overall health. The unit offers several of the main options:

• Chemotherapy: medicines that destroy cancer cells or slow their growth.
• Targeted therapy: medicines that attack specific alterations in the tumor; this is why molecular tests are so useful.
• Immunotherapy: medicines that help the body's own defenses recognize and attack the tumor.
• Cancer surgery: in selected cases, the affected part of the lung can be removed.
• Palliative care: it accompanies any stage of treatment to control pain, shortness of breath, and other symptoms, and to improve quality of life for the patient and their family.

Being honest about radiation therapy: some cases of lung cancer require radiation therapy, alone or combined with other treatments. The unit does not have this service; when it is needed, the patient is referred to a center with radiation therapy in Chihuahua City, and the unit's team coordinates the referral and continues the follow-up of the rest of the treatment.

Early detection / prevention

• Not smoking, and quitting smoking, is the most effective prevention measure; the risk starts dropping the moment you quit.
• Avoid other people's tobacco smoke and improve ventilation where wood is used for cooking.
• Screening with low-dose CT: the reference guidelines (USPSTF and the American Cancer Society) recommend a low-dose CT scan every year for adults ages 50 to 80 who smoke or used to smoke, with a history of heavy smoking (around 20 "pack-years" — for example, a pack a day for 20 years). This test can find cancer before it causes symptoms.
• If this profile fits you, come in for an evaluation: the oncologist can tell you whether yearly screening is right for you.

Frequently asked questions

If I have never smoked, can I still get lung cancer? Yes, although it is less common. Wood smoke, secondhand smoke, and some workplace exposures also play a role. If you have persistent symptoms, come in for an evaluation.

Is coughing up blood always cancer? No. It can be caused by infections and other conditions. However, it should always be checked by a doctor as soon as possible.

What happens if my treatment requires radiation therapy? We refer you to a center with radiation therapy in Chihuahua City, and our team coordinates and follows up on your entire treatment, including any chemotherapy, immunotherapy, or targeted therapy given at the unit.

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