How Lung Cancer Is Treated

Treatments for lung cancer—surgery, chemotherapy, radiation, targeted therapies, and immunotherapy—have improved dramatically in recent years, as have the survival rates associated with them. Lung cancer treatment can have different goals, depending on the type of cancer, the stage, and other factors. The goal may be to cure the cancer, control it to keep it from growing or spreading, or to reduce your symptoms and allow you to have a better quality of life.

Recent advances that allow physicians to personalize lung cancer treatments, as well as a better understanding of how the immune system works to fight cancer, have significantly increased the options for treating this disease.

Types of Treatments

Given the range of options, it can first be helpful to understand the two main buckets they fall into. The type of cancer you have, its stage, and other important factors will determine which are appropriate for you.

Local Treatments
  • Treat cancer at its source

  • Remove the tumor but are unable to reach cells that have traveled beyond the original site

  • May be enough to attempt to cure early-stage lung cancer

  • E.g., surgery, radiation therapy

Systemic Treatments
  • Kill cancer cells wherever they happen to be in the body

  • Often best when cancer has spread to lymph nodes or other regions of the body

  • May be used as adjuvant therapy or neoadjuvant therapy*

  • E.g., chemotherapy, targeted therapies, immunotherapy

*Neoadjuvant treatments are those given to reduce the size of the tumor before surgery. Adjuvant treatments are those that are done to treat any cells that have spread beyond the initial site of the cancer, though they may not yet be detectable with currently available imaging tests. For example, chemotherapy, radiation, or a targeted therapy drug may be given even though surgery is the primary treatment.

Surgery

When lung cancer is caught in the early stages—before it has spread beyond the lungs—surgery may be curative. It is often considered for early-stage, non-small cell lung cancers (specifically stages I to IIIA), and it may also be considered for early (limited-stage) small cell lung cancer on rare occasions.

There are five primary surgical procedures that may be done to treat lung cancer:

  • Pneumonectomy: A pneumonectomy refers to the removal of a whole lung.
  • Lobectomy: In a lobectomy, one of the lobes of a lung is removed.
  • Wedge resection: In a wedge resection, the tumor is removed along with a wedge-shaped area of lung tissue surrounding the tumor.
  • Sleeve resection: In a sleeve resection, a lobe of the lung, along with part of the bronchus (the airways leading to the lung), is removed.
  • Segmentectomy: In a segmentectomy, a segment of a lobe is removed. The amount of tissue removed by this procedure is more than with a wedge resection, but less than with a lobectomy.

Common side effects of surgery include infections, bleeding, and shortness of breath, depending on lung function prior to surgery and the amount of lung tissue removed.

Radiation Therapy

Radiation therapy for lung cancer uses high-energy X-rays applied from outside the body to kill cancer cells. There are a few ways in which radiation is used for lung cancer:

  • As an adjuvant treatment to treat any cancer cells that remain after surgery
  • As a neoadjuvant therapy to help decrease the size of a tumor so surgery is possible
  • As a palliative treatment to decrease pain or airway obstruction in people who have cancers that cannot be cured
  • As a curative treatment: A specific type of radiation therapy known as stereotactic body radiotherapy (SBRT) uses high-dose radiation given to a small area in the lungs. This may be used as an alternative to surgery when surgery is not possible.

Common side effects of radiation therapy can include redness and irritation of the skin, fatigue, and inflammation of the lungs (radiation pneumonitis).

Chemotherapy

Chemotherapy for lung cancer uses medications designed to kill rapidly dividing cells such as cancer cells. Chemotherapy drugs may be used as a primary treatment for advanced lung cancer, as adjuvant therapy, or as neoadjuvant therapy.

Combination chemotherapy—using more than one chemotherapy drug at the same time—is most commonly used. Different medications interfere with cell division at different points in the cell cycle, and targeting this process in more than one way increases the likelihood of treating as many lung cancer cells as possible simultaneously.

Some chemotherapy medications used for people with lung cancer include:

  • Platinol (cisplatin)
  • Paraplatin (carboplatin)
  • Gemzar (gemcitabine)
  • Taxotere (docetaxel)
  • Taxol (paclitaxel) and Abraxane (nab-paclitaxel)
  • Alimta (pemetrexed)
  • Navelbine (vinorelbine)
  • Imfinzi (durvalumab)
  • Tecentriq (atezolizumab)
  • Yervoy (ipilimumab)

Common side effects of chemotherapy include bone marrow suppression (a reduction in red blood cells, white blood cells, and platelets), hair loss, and fatigue. Nausea and vomiting are dreaded side effects of chemotherapy, but thankfully the management of these adverse effects has improved dramatically in recent years.

Clinical Trials

Every lung cancer treatment used today was once studied as part of a clinical trial before being approved. Thanks to evolving research, more new treatments were approved for lung cancer between 2011 and 2015 than during the prior four-decade period.

The National Cancer Institute (NCI) recommends that everyone with lung cancer consider enrolling in such a study. Talk to your doctor if this is something you'd like to explore. The NCI provides a searchable database of supported trials, and your doctor can help identifying options that match the particular characteristics of your cancer.

Targeted Therapies

Targeted therapies for lung cancer are drugs that are tailored to attack certain characteristics of cancer cells and, hence, may have fewer side effects than traditional chemotherapy.

It is extremely important that everyone who is diagnosed with non-small cell lung cancer, particularly lung adenocarcinoma, have gene profiling (molecular profiling) of their tumor performed. You may hear your doctor talk about "targetable" gene mutations and genetic changes. What this means is that some lung cancer cells have genetic changes that can be targeted (and treated) with medications that address them specifically.

Treatments have been approved for those with EGR mutations, ALK rearrangements, ROS1 rearrangements, and there are also clinical trials studying medications for other mutations and genetic changes in cancer cells. This area of science is changing very rapidly, and it's likely that new targets and new medications will continue to be discovered.

While targeted therapies can be very effective, resistance to these treatments usually develops over time. However, second- and third-generation drugs are now available and being studied for when this occurs.

Some targeted medications approved for lung cancer include:

  • ALK inhibitors: Xalkori (crizotinib), Zykadia (ceritinib), and Alecensa (alectinib)
  • Angiogenesis inhibitors: Avastin (bevacizumab) and Cyramza (ramucirumab)
  • EFGR inhibitors: Tarceva (erlotinib), Gilotrif (afatinib), Iressa (gefitinib), Tagrisso (osimertinib), and Portrazza (necitumumab)

Immunotherapy

A new type of treatment for lung cancer became available in 2015. Immunotherapy drugs work by essentially harnessing your immune system to help rid your body of cancer cells. Though medical news is often overhyped, immunotherapy is truly a reason to get excited about the future of lung cancer. In fact, the treatment was named the 2016 Clinical Cancer Advancement of the Year by the American Society for Clinical Oncology. Immunotherapy 2.0 was cited for the same award in 2017.

While targeted therapies tend to be more effective in people who have not smoked, immunotherapies may be more effective in people who smoked and who have cancers such as squamous cell lung cancer.

Immunotherapy drugs currently approved for lung cancer include:

  • Opdivo (nivolumab)
  • Keytruda (pembrolizumab)

Your doctor may also prescribe a variety of other medications (Rx or over-the-counter) to address pain and side effects of surgery or other therapies. Always discuss anything you are taking with your doctor, including supplements, as some products may interact with the treatments or produce side effects such as bleeding with surgery.

Lifestyle

If you are a current smoker, quitting smoking can improve your chances of surviving early-stage lung cancer and can lower your risk of recurrence of cancer after treatment. Smoking can also worsen some symptoms of lung cancer, such as shortness of breath.

Shortness of breath is a common problem when you have lung cancer. Your doctor may give you medications or supplemental oxygen, but you will also need tactics to deal with this problem, including relaxation methods, positions, and focused breathing. You may need to modify your schedule and tasks so you can save your energy or take breaks when tired.

While shortness of breath and side effects from treatment may make it difficult, it is best to stay as physically active as you can tolerate. Try walking or yoga.

Complementary Alternative Medicine (CAM)

While alternative treatments for lung cancer have not been found beneficial in treating lung cancer specifically, there are several integrative cancer treatments that may help people cope with the symptoms of cancer and cancer treatments.

Some of these include acupuncture, massage therapy, hypnosis, and meditation.

A Word From Verywell

The most important thing you can do as you consider lung cancer treatments is to become your own advocate in your cancer care. Find a lung cancer treatment center you trust. Don't be afraid to get a second opinion. You may also wish to ask your oncologist where they would seek treatment if they were to be diagnosed with this disease.

Treatment is your own decision. Certainly, welcome input from loved ones, but stress to them (and yourself) that your ultimate decision must be based on what you are comfortable with and what you feel is best. You may need to remind others who have witnessed someone else be treated for lung cancer years ago that the disease is treated much differently today.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Jones GS, Baldwin DR. Recent advances in the management of lung cancerClin Med (Lond). 2018;18(Suppl 2):s41–s46. doi:10.7861/clinmedicine.18-2-s41


  2. American Lung Association. Your lung cancer, your goals. Updated March 11, 2019.

  3. Lackey A, Donington JS. Surgical management of lung cancerSemin Intervent Radiol. 2013;30(2):133–140. doi:10.1055/s-0033-1342954


  4. Baltayiannis N, Chandrinos M, Anagnostopoulos D, et al. Lung cancer surgery: an up to dateJ Thorac Dis. 2013;5 Suppl 4(Suppl 4):S425–S439. doi:10.3978/j.issn.2072-1439.2013.09.17


  5. Maciejczyk A, Skrzypczyńska I, Janiszewska M. Lung cancer. Radiotherapy in lung cancer: Actual methods and future trendsRep Pract Oncol Radiother. 2014;19(6):353–360. doi:10.1016/j.rpor.2014.04.012


  6. Chatwal MS, Tanvetyanon T. Combination chemotherapy and immunotherapy in metastatic non-small cell lung cancer: a setback for personalized medicineTransl Lung Cancer Res. 2018;7(Suppl 3):S208–S210. doi:10.21037/tlcr.2018.07.15


  7. Huang CY, Ju DT, Chang CF, Muralidhar Reddy P, Velmurugan BK. A review on the effects of current chemotherapy drugs and natural agents in treating non-small cell lung cancerBiomedicine (Taipei). 2017;7(4):23. doi:10.1051/bmdcn/2017070423


  8. National Cancer Institute. What Are Clinical Trials? Updated June 27, 2016.


  9. Hou H, Yang X, Zhang J, et al. Discovery of targetable genetic alterations in advanced non-small cell lung cancer using a next-generation sequencing-based circulating tumor DNA assay. Sci Rep. 2017;7(1):14605. doi:10.1038/s41598-017-14962-0


  10. Devarakonda S, Govindan R. Targeting Resistance to Targeted Therapies: Combating a Resilient Foe. Clin Cancer Res. 2018;24(24):6112-6114. doi:10.1158/1078-0432.CCR-18-3178


  11. American Society of Clinical Oncology. Immunotherapy: The 2016 Clinical Cancer Advance of the Year. 2016.


  12. Cataldo JK, Dubey S, Prochaska JJ. Smoking cessation: an integral part of lung cancer treatmentOncology. 2010;78(5-6):289–301. doi:10.1159/000319937


  13. Frenkel M, Slater R, Sapire K, Sierpina V. Complementary and Integrative Medicine in Lung Cancer: Questions and Challenges. J Altern Complement Med. 2018;24(9-10):862-871. doi:10.1089/acm.2018.0175


Additional Reading