Lung cancer is usually treated with combination therapy, which means a combination of surgery and chemotherapy or radiation therapy or surgery with chemotherapy and radiation therapy. The T and N stages of the tumor are used to determine if combination therapy is needed. Surgery may be the first step in your cancer treatment. Post-operative chemotherapy The need for post-operative chemotherapy depends on the post-operative pathological stage. Chemotherapy refers to the use of drugs to kill cancer cells. The drugs are usually given through a vein or by mouth. Once the drugs enter the bloodstream, they will reach every part of the body. Several drugs are usually given at the same time, which has been shown to be more effective than using a single drug. Doctors administer chemotherapy in cycles, with each treatment period followed by a recovery period. Chemotherapy cycles usually last 21 to 28 days, and the beginning of treatment usually consists of four to six cycles. Chemotherapy is not recommended for patients in poor general condition (performance status 3-4). Older age is not a barrier as long as the patient is not in poor condition. The most common drug combinations used for initial chemotherapy in non-small cell lung cancer are oxaliplatin, cisplatin or carboplatin colleagues in combination with one of the following drugs: paclitaxel (trade name: Tysol), doxorubicin, trade name: Tysodi, gemcitabine (trade name: Kenzyme), vincristine (trade name: Novibrium), irinotecan (trade name: Kepitol), etoposide (also known as gibberellins, trade names include: vanbies (also known as rastatide capsules), and vincristine. Patients who can tolerate combination chemotherapy can be treated with single-drug chemotherapy. Second-line therapeutic agents used for chemotherapy or targeted therapy for non-small cell lung cancer (drugs used for continued cancer growth or after starting chemotherapy): paclitaxel, gefitinib (trade names: Enoxaparin) alone. The drugs most commonly used in combination chemotherapy at the start for small cell lung cancer are: limited stage: cisplatin and etoposide, carboplatin and etoposide; extended stage: cisplatin and etoposide, carboplatin and etoposide, cisplatin and irinotecan The following chemotherapy drugs are used if the small cell lung cancer recurs: isocyclophosphamide, paclitaxel or gemcitabine if the recurrence occurs within 2 to 3 months. Topotecan, irinotecan, cyclophosphamide/adriamycin/vincristine (CAV), gemcitabine, paclitaxel, paclitaxel, oral etoposide, methotrexate, or vincristine if recurrence occurs between 2 and 3 months and 6 months. Six months of relapse allows for repeat of the original chemotherapy. All chemotherapy has side effects that can occur. Short-term side effects include loss of appetite, nausea, vomiting, mouth pain, and hair loss. Because chemotherapy may damage blood-forming cells in the bone marrow, a drop in white blood cells may increase the patient’s risk of infection; a lack of platelets can cause bleeding after a small cut or bruising after a small bruise; and a decrease in red blood cells (low hemoglobin levels) can cause fatigue. However, treatment can prevent or reduce these side effects. For example, some drugs can prevent or reduce nausea and vomiting (see the Handbook for the Treatment of Nausea and Vomiting in Cancer Patients). A new class of drugs called growth factors can help the bone marrow recover after chemotherapy and reduce periods of low blood counts. Early onset menopause, infertility, or heart and lung damage may occur in patients who use anti-cancer drugs for a long time. Before chemotherapy, your doctor and nurse will discuss with you and your family the possible side effects and what measures can be used to reduce them. Once treatment has begun, your doctor and nurse will expect you to keep them informed of any adverse reactions you experience. Targeted therapies: In the past few years, cancer treatment researchers have studied drugs that interfere with the growth of cancer cells. A drug of this type called gefitinib has recently been used to treat non-small cell lung cancer that no longer responds to chemotherapy (usually after 2 different regimens) with satisfactory results. This drug is administered orally. The usual side effects of Enoxaparin reported in clinical trials are nausea, vomiting, diarrhea, rash, acne, and dry skin. (Currently this drug has been shown to be effective in only some Asians, especially non-smoking women.)