What is my cancer staging?1
Stage III lung cancer is divided into three stages: stage IIIA, stage IIIB, and stage IIIC.
(Click visuals below to expand and illustrate)
Select Primary Tumour (T), Regional Lymph Nodes (N), and Distant Metastasis (M):
How is Stage III Lung Cancer Treated?
Treatment selection depends on characteristics of the lung cancer including the tumour size, location and whether it has spread. Treatment selection can also be influenced by patient factors such as your health status and medical history, age, past treatments and other health conditions that you may have.
Surgery involves the removal of a tumour and some healthy tissue around the tumour. Surgery is only an option if the cancer is found early, if the tumour has not spread within the chest or to other organs and if the tumour can be removed completely.
Radiation is given over 10-15 minutes every day of the week except holidays and weekends. You will get your radiation while lying down under a radiation machine, as pictured above. Radiation works by directing a high energy x-ray beam at the tumour and nearby lymph nodes to interfere with dividing tumour cells by either killing them or stopping the cells from growing and reproducing.
Chemotherapy does not target specific molecules on or inside cancer cells but uses drugs to destroy cancer cells or slow their growth. This treatment is given through an infusion into the bloodstream in order to reach cancer cells all over the body.
Immunotherapy is a new type of treatment that works by helping your immune system fight the cancer. Immunotherapy can help slow or prevent the cancer from growing and can also shrink the tumour. Immunotherapy works differently from chemotherapy and radiation therapy. Instead of killing cancer cells directly, immunotherapy helps the body’s own natural defense system (the immune system) become better at detecting and destroying cancer cells.
Can I have surgery to remove the tumour?
Your healthcare team has determined that due to the location of the tumour or lymph nodes involved, surgery is not a good option for treating your cancer.
Commitment to the lung cancer treatment journey
Treatment with chemoradiation and immunotherapy with durvalumab offers the best chance for a cure, and committing to the full 2-part treatment program will increase the chance of achieving that goal.
What does my treatment journey look like?
The most effective treatment option for stage III lung cancer is chemotherapy + radiation which is given together (chemoradiation) followed by immunotherapy. This treatment is given in 2 parts:
Drug therapy for stage III lung cancer include chemotherapy and immunotherapy.
How do chemotherapy and immunotherapy work?
Chemotherapy is very different from immunotherapy. Both given by infusion through the vein. However they work in their own way.
Chemotherapy uses drugs to kill cancer cells or slow their growth.
Immunotherapy is designed to help your body’s own immune system recognize and kill the cancer cells or stop their growth
This is the same immune system that helps you to fight infections such as the flu. Your immune system has immune cells that patrol your body looking for things that may cause you to get sick. In the same way, these immunes cells patrol for cancer cells.
However some cancer cells can outsmart the immune cells into thinking that they are healthy cells so they continue to grow undetected. Immunotherapy helps your body to recognize the cancer cells as foreign and harmful.
Immunotherapy works with your body to help to destroy the cancer cells.
Part 1: Chemoradiation
Chemoradiation is given over 6-7 weeks. This involves radiation given 5 days a week for 5 to 7 weeks. Chemotherapy will be given at the same time with the schedule to be determined by your oncologist.
What are the side effects of chemoradiation?
Side-effects of chemotherapy will depend on the type of drug(s) you are given, the dose of each drug, how the treatment is given and your overall health.
Chemotherapy drugs affect healthy body tissues in which the cells are constantly growing and dividing, such as your hair follicles (your hair is always growing); your bone marrow (your bone marrow is constantly producing blood cells); your skin and the lining of your digestive system, which are constantly renewing themselves.
Different drugs cause different side effects. Your healthcare team will tell you about specific side effects of your own treatment.
Common side-effects include:
Part 2: Immunotherapy with Durvalumab
Many patients who complete chemoradiation will receive immunotherapy. You will have a CT scan and be assessed by your healthcare team to make the final decision. In general, patients will still feel some chemoradiation side-effects as immunotherapy treatment begins.
The chemoradiation that you received in Part 1 of treatment makes the tumour cells even more susceptible to the immunotherapy. Durvalumab is an immunotherapy that is approved for stage III lung cancer and is given as an IV treatment over 30 minutes every 2 weeks, for 1 year.
For an Interactive Survey considering the benefits and risks of chemoradiation, please click on the icon below.