Can targeted therapy help in my brother’s lung cancer at 55?

Question

Hello doctor,

My brother is 55, was recently told he has stage 4 lung cancer, and doctors recommended targeted therapy. We do not fully understand how it works. Please let us know:

How is targeted therapy different from regular chemotherapy?
Is it effective only for certain types of tumors, or can anyone with stage 4 lung cancer benefit?
Also, what are the main side effects we should monitor?
How long does it typically take to see any improvement in symptoms or tumor response?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query.

I understand how confusing and worrying this diagnosis can be for a family.

Targeted therapy is different from traditional chemotherapy in the way it works on cancer cells. Chemotherapy generally attacks all rapidly dividing cells in the body, which includes cancer cells but also some normal cells, and this is why patients often experience more generalized side effects. Targeted therapy works in a more specific way. These medicines are designed to block particular genetic changes inside cancer cells that allow them to grow and spread.

Because of this reason, targeted therapy is useful only when the lung cancer carries certain mutations. Before starting this treatment, doctors usually perform molecular testing on the tumor tissue or sometimes on blood to identify these mutations.

If a mutation such as EGFR (estimated glomerular filtration rate), ALK (anaplastic lymphoma kinase), ROS1 (c-ros oncogene 1), or some others is present, targeted therapy can work very well in many patients with stage 4 lung cancer. If these mutations are not present, then other treatments such as chemotherapy or immunotherapy (a cancer treatment that boosts the body's natural defenses to fight cancer) are usually considered instead.

The side effects of targeted therapy are usually milder compared with conventional chemotherapy, but some things should still be watched for. Patients may develop skin rash, dryness or itching of the skin, diarrhea, mouth soreness, fatigue, or reduced appetite. Occasionally, liver enzyme changes can occur on blood tests.

If any persistent diarrhea, severe rash, worsening cough, or breathing difficulty appears, it is important to inform the treating doctor early so adjustments can be made.

In terms of improvement, some patients start noticing relief in symptoms such as cough, breathlessness, or appetite within a few weeks if the treatment is responding. However, doctors usually assess the response more reliably after about six to eight weeks by repeating imaging scans to see whether the tumor has shrunk or the disease has stabilized.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.