7 Questions to Ask Your Oncologist About Lung Cancer Treatment

If you or a loved one received a lung cancer diagnosis, you likely have many concerns about what comes next, but may not be sure what questions to ask your doctor. The more you understand about lung cancer and the specifics of your diagnosis, the better you can prepare for what is next in your cancer journey.

Here are some important questions to consider when meeting with your lung cancer oncologist. 

1. What specific type of lung cancer do I have?

Lung cancer isn't just one disease, but rather a group of several subtypes. Generally, lung cancers can be classified into two main types: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Of these, non-small cell lung cancer is the most common. Within these two categories, there are three primary subtypes based on the type of cells found in the tumor:  

• Adenocarcinoma
• Squamous cell carcinoma
• Large cell carcinoma 

Another type of lung cancer, called carcinoid, is less common. Your specific type of lung cancer will influence your recommended treatment plan.

2. What is the stage of my lung cancer? 

The extent of your cancer refers to the size of the tumor and its spread. This can be spread within the lung, to lymph nodes, or to other organs. Your oncologist will refer to this as the cancer's stage. The lung cancer staging process involves several tests, such as imaging and biopsy. Your oncologist uses the type and stage of your lung cancer to determine the most effective treatments.  

Non-small cell lung cancer is staged differently from small cell lung cancer. 

Staging Non-Small Cell Lung Cancer  

Non-small cell lung cancer is staged using the TNM system, which is based on three key pieces of information:

• The size and extent of the primary tumor (T)
• The spread to nearby lymph nodes (N)
• The spread (metastasis) to other organs (M)

Your cancer care team will collect data to determine the T, N, and M classifications and assign an overall stage ranging from Stage 0 to Stage IV (4), with Stage IV being the most severe.  

Staging Small Cell Lung Cancer

Small-cell lung cancer is described as limited or extensive.

• Limited stage means cancer is found in one lung, the tissues between the lungs, and nearby lymph nodes only.
• Extensive stage describes cancer that has spread beyond the lung where it originated or to other parts of the body.

Early-stage lung cancers generally have better outcomes than those diagnosed at a later stage. 

3. What treatments are available for lung cancer? 

While several factors influence a patient's treatment plan, oncologists typically begin by determining the type and stage of lung cancer.

Your oncologist will work with other lung cancer specialists, including a surgeon and a radiation oncologist, to determine the most effective treatments and the appropriate timing for them. More complex treatments are generally required for lung cancer diagnosed at later stages. Depending on your specific diagnosis, you may receive one or more of the following lung cancer treatments:

• Surgery: Early-stage non-small cell lung cancer is often treated with surgery, along with other therapies. This is not the case for small cell lung cancer (SCLC), as it has typically already spread by the time it is detected, making surgery difficult. Learn more about lung cancer surgery. 
• Radiation therapy: Both NSCLC and SCLC are frequently treated with radiation therapy, sometimes in combination with chemotherapy (called chemoradiation). The most common technique for treating lung cancer is external beam radiation therapy (EBRT), which directs high-energy beams at the cancerous tumor from outside the body. Read our blog to learn more about radiation for lung cancer. 
• Chemotherapy: Although chemotherapy is not the initial treatment for non-small cell lung cancer, it may be recommended before surgery to shrink a tumor, after surgery to eliminate any remaining cancer cells, or to alleviate symptoms. Most often, chemotherapy is used to treat patients diagnosed with small cell lung cancer and may be given alone or alongside radiation.
• Targeted therapy: These drugs specifically target cancer cells, sparing healthy cells and resulting in fewer side effects than traditional chemotherapy. Targeted therapy is available for patients with non-small cell lung cancer that is an advanced stage or recurrent disease. Before starting targeted therapy, patients must undergo biomarker testing to identify specific genetic mutations. If mutations are found, your oncologist will choose the targeted therapy drugs designed to specifically counteract the mutation.
• Immunotherapy: Patients with both small and non-small cell lung cancer may receive immunotherapy drugs, which boost the body's immune system to attack cancer cells. The immunotherapy drugs used for lung cancer belong to a class known as checkpoint inhibitors.

Your lung cancer specialist can inform you of the potential risks and benefits associated with each treatment option, including how they may affect your overall health and quality of life.

Learn more about lung cancer treatment options at Compass Oncology. 

4. How do doctors determine the best lung cancer treatment plan for me? 

The treatment plan for lung cancer primarily depends on the type and stage of the disease. Non-small cell lung cancer (NSCLC) is treated differently from small cell lung cancer (SCLC).

Patients diagnosed with metastatic (Stage IV) or recurrent NSCLC typically undergo biomarker testing to identify genetic mutations fueling cancer cell growth. The results of these tests help oncologists determine if newer treatment options, such as targeted therapy, will be effective for your specific subtype of lung cancer. 

5. What treatment side effects can I expect?

Lung cancer and its treatments may cause several side effects that can impact your quality of life and your ability to stick with the treatment. Common side effects include fatigue, weakness, depression, and anxiety. However, specific reactions related to particular treatments might also occur:

• Radiation therapy may cause skin reactions, dry mouth, sore throat, shortness of breath, and pain at the treatment site.
• Immunotherapy can lead to skin rashes and flu-like symptoms.
• Targeted therapies might result in diarrhea, skin changes, and high blood pressure.
• Chemotherapy can cause nausea, hair loss, and neurological problems like neuropathy and “chemo brain.”

Your oncologist and care team will provide information and support to help you manage these side effects, allowing you to continue treatment and maintain your daily life. 

6. Am I a suitable candidate for a lung cancer clinical trial? 

Clinical trials offer lung cancer patients access to promising new therapies that are not yet available to the public. Depending on your specific diagnosis, your oncologist may suggest participating in a clinical trial as part of your treatment plan.

If offered this option, talk to your care team about the risks and potential benefits of clinical trial participation. You will never be enrolled in a clinical trial without your consent. Compass Oncology currently has several clinical trials open for lung cancer patients diagnosed at various stages of the disease. 

Learn more about Lung Cancer Research and Clinical Trials at Compass Oncology.

7. What happens when I complete my treatment? 

After completing lung cancer treatment, you will still be in the process of recovering from the treatments and surgery. Your body will need time to regain strength. And, for many patients, this involves adjusting to a new normal.

It’s essential to show up for each follow-up appointment so your lung cancer doctor can closely monitor your recovery. This may include additional exams, imaging tests, or lab tests to check for any signs of cancer recurrence or side effects from the treatment.

Related reading: How Do You Know If Lung Cancer Has Come Back?

Lung Cancer Specialists in Portland, Oregon, and Vancouver, Washington

We hope this information helps you better understand lung cancer so you can discuss it with an oncologist. The lung cancer specialists at Compass Oncology are ready to support you throughout your treatment and recovery journey.

If you or a loved one has recently been diagnosed with lung cancer, request an appointment for a consultation or second opinion. Our lung cancer specialists offer the latest lung cancer treatment options to patients in the Portland, OR, and Vancouver, WA, area.