Can Lung Cancer Be Cured?

Whether or not lung cancer is curable is a difficult question to answer in a straightforward way. Successful remission depends on how early the disease is caught and what other health issues you might be dealing with. And there is always a chance (sometimes a very small one) that lung cancer can recur even after it has been in remission for years or decades.

Because of this, many doctors will say that lung cancer is never truly cured. However, the longer someone lives with no evidence of cancer (NED), the less likely it is that they’ll see their cancer return.

Improvements in lung cancer treatment have helped many people survive. Even so, a high mortality rate continues to be a serious concern in the medical community.

"Lung Cancer-Free" Doesn't Mean "Cured"

Lung cancer is similar to other solid tumors such as breast cancer and colon cancer in which long-term remission is possible, but physicians are hesitant to say cases are ever cured.

Actually, few cancers can be declared "cured" in the purest sense of the word. Those that are truly curable are usually blood-related cancers such as leukemia in children.

When lung cancer treatment is successful and you are cancer-free, the risk of death from lung cancer still persists for up to 15 years after you show no evidence of cancer.

Recurrence is more likely in those with lung adenocarcinoma than squamous cell lung cancer. It’s also more likely if cancer has spread to lymph nodes or if surgery wasn’t performed (such as with inoperable tumors). 

It's not known exactly how cancer can hide for years or even decades and then reappear. One theory is that there is a hierarchy of cancer cells, with some of the cells (cancer stem cells) being more resistant to treatment and having the ability to lie dormant.

A "Never-Cured" Exception

There is one exception to the above: Those who recover from stage 1A lung cancer with no vascular invasion, which means the tumor was very small and had not extended into any blood vessels or lymph nodes before going into remission.

In this type of early-stage non-small cell lung cancer (NSCLC), surgery offers the best chance for long-term survival. And following surgery, if there's no evidence of cancer after five years, doctors may indeed use the word "cured" to describe your health status.

Impact of Treatment

Even if lung cancer is not curable, it is almost always treatable. And thankfully, newer options often have fewer side effects than conventional chemotherapy, so you can enjoy a higher quality of life than previous generations who fought the disease.

To have the clearest sense of what your cancer treatment plan can offer you, it's worth learning more about the potential effects of each option in terms of remission, survival, and more.

With Surgery

Surgery may be performed for those with stage 1, stage 2, or stage 3A NSCLC. In these instances, five-year survival rates range from 77% for those with stage 1a NSCLC (the least invasive type with tumors measuring no more than 3 centimeters) to 23% for those with stage 3A tumors.

In stage 2B and stage 3, tumors spread to the lymph nodes. Surgery may completely or partially remove lymph nodes.

In cases where lymph nodes must be removed, studies showed that the five-year survival rate was approximately 74% for people who had lymph node dissections versus 63% for those who had samples taken of individual nodes for testing, but who did not have entire nodes removed.

With Chemotherapy

Chemotherapy uses a combination of drugs to kill cancer cells. For lung cancer, the medication is usually administered intravenously.

These drugs are not generally used with the intent of curing lung cancer. Instead, there are three reasons chemotherapy is usually recommended:

  • Neoadjuvant therapy: In cases where tumors are large or the cancer has spread beyond the lungs, doctors may administer medication before surgery to shrink the cancer. This neoadjuvant chemotherapy can have disadvantages, though, especially if the drugs cause side effects that delay surgery.
  • Adjuvant therapy: With adjuvant chemotherapy, medication is administered after surgery to kill any undetected cancer cells, known as micrometastases, that may have spread to other parts of the body.
  • Palliative therapy: The other primary goal of chemotherapy with lung cancer is palliative. This is a treatment that is given to extend life or reduce the pain and discomfort of symptoms, but it's not meant to cure a disease.

Treatment recommendations vary from person to person. Chemotherapy before or after surgery, for instance, may not be recommended for people who have other health problems.

When possible, though, adjuvant therapy may offer the best hope for long-term remission. A study of those who had one lung removed (pneumonectomy) due to stage 3 NSCLC found that post-operative adjuvant therapy resulted in a significantly higher five-year survival rate when compared to those who had neoadjuvant therapy or who had undergone surgery with no chemo treatments.

Chemotherapy 5-Year Survival Rate
Adjuvant therapy
+ surgery
60%
Neoadjuvant therapy + surgery 33%
Surgery alone 30%

When reviewing chemotherapy options with your doctor, it's important to understand the role chemo can play in supporting surgery or easing pain and symptoms caused by cancer, which can be beneficial even if the treatments don't cure you.

Be sure to discuss your goals with your doctor, too. For instance, if you have aggressive lung cancer but are still hoping for a cure versus the comfort of palliative care, you may want to consider a clinical trial or an option such as immunotherapy instead of chemo.

With Radiation

Stereotactic body radiotherapy (SBRT), known popularly as "cyber knife" procedures, may be as effective as surgery for some people with early-stage lung cancer that can't be treated with surgery. In a small study of patients who survived five years following SBRT, 25% remained cancer-free longer than the typical rate of recurrence.

Like chemo, traditional radiation therapy is often used as an adjunct therapy to support surgery. It may also be recommended to reduce the chance of recurrence, to extend life, or to decrease the symptoms of lung cancer such as bone pain or airway obstruction.

With Use of Targeted Therapies

Newer targeted therapies for NSCLC use drugs to fight specific types of cancer cells. The treatments are most often used to ease symptoms and stop tumors from spreading in advanced lung cancers. They're used either along with chemo or by themselves.

Among the approved targeted therapies are:

  • Angiogenesis inhibitors: These drugs target new blood vessel growth around the tumors so the cancer can't grow or spread.
  • Drugs that target gene changes: Using gene mutation testing, your doctor can determine whether the tumors will respond to medications that target cells with EGFR, ALK, ROS1, BRAF, MET, or NTRK gene changes. These drugs will halt growth, shrink tumors, or inhibit the cancer in other ways.

Clinical trials are underway for other possible targeted therapies.

Resistance to targeted therapies almost always develops in time, although newer options appear to work for durations. When resistance occurs, there are now alternative treatments available for some gene mutations.

With Immunotherapy

Immunotherapy breathes the promise of long-term disease-free survival for at least some people with advanced lung cancer. These medications help your immune system fight cancer. They have become an effective way to treat NSCLC that isn't responding to chemo or other treatments.

Opdivo (nivolumab) and Keytruda (pembrolizumab) were approved for the treatment of lung cancer, and two other medications in this category have now been improved as well. In addition, combinations of immunotherapy drugs are being evaluated in clinical trials, and early results are very encouraging.

Keep in mind: Targeted therapy is usually only effective when the person is receiving treatment or for a short while thereafter.

Positive outcomes with immunotherapy drugs have led to hopes that there may be the possibility of long-term survival and even true cures for some cancers.

Treatment of Metastases​

Though rare, long-term survival is sometimes possible even when lung cancer has spread to other parts of the body. There are reports of more than a dozen people who have lived 10 years or more after brain metastases from lung cancer have been treated.

Research also suggests that treating metastases at multiple sites with stereotactic body radiotherapy may be a way of improving long-term survival for some people with stage 4 lung cancer in the future.

Currently, treatments for bone metastases, adrenal gland metastases, brain metastases, and liver metastases focus on systemic therapy, including chemotherapy, immunotherapy, and targeted therapies.

With Natural Treatments

The internet is flush with ads for so-called "natural cures" for cancer. Unfortunately, studies to date fail to show a survival benefit for any of these approaches.

Some alternative treatments could actually interfere with chemotherapy or other medications. Choosing alternative treatments may also cause a delay in starting proven treatments, which could shorten life expectancy.

However, some of these treatments—such as acupuncture or ginger for chemotherapy-induced nausea—may help people cope with the symptoms of conventional medical treatment for cancer, and in doing so, improve the quality (though not length) of life.

If you want to use any natural treatments in conjunction with your conventional therapies, be sure to do so under the advisement of a licensed professional who specializes in integrative medicine.

A Word From Verywell

Coping with the uncertainty of cancer is one of the most difficult aspects of survivorship. And knowing that your lung cancer may never be considered fully cured can hit hard, especially when working so hard to reach remission.

You may not be able to stop cancer from progressing or coming back, but you can take control of how you live and how you proceed with treatment to ensure that you continue to feel as strong and healthy as possible.

Becoming involved in the lung cancer community has helped many people cope with "scanxiety" and the fear of cancer recurrence.

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