How Is Lung Cancer Treated?
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Medically reviewed by Gagandeep Brar, MD
Treatment for lung cancer will depend on several factors, like the type of lung cancer and your overall health and treatment preferences. Some treatment options include chemotherapy, radiation therapy, or surgery. A care team of healthcare providers will help you create a treatment plan that is best for you.
This team will include a primary healthcare provider, a pulmonologist (who specializes in the lungs), and an oncologist (who specializes in cancer). You might also work with other specialists, such as a surgeon, nutritionist, physical therapist, and psychologist.
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Treatments for Non-Small Cell Lung Cancer by Stage
A diagnosis of NSCLC can require several imaging tests. A healthcare provider will likely order tests to determine where the cancer started, how big the tumor is, and if cancer cells have spread to nearby lymph nodes or organs. This can help your care team determine the stage of your cancer.
The stages for NSCLC range from 1 to 4. Stage 1 is the earliest and most treatable stage, while stage 4 is the most severe stage. There is no cure for people in stage 4, but the condition can still be treated to prolong life expectancy in some cases.
A diagnosis of NSCLC can require several imaging tests. A healthcare provider will likely order tests to determine where the cancer started, how big the tumor is, and if cancer cells have spread to nearby lymph nodes or organs. This can help a care team determine the stage of your cancer.
The stages for NSCLC range from 1 to 4. Stage 1 is the earliest and most treatable stage, while stage 4 is the most severe stage. There's no cure for people in stage 4. The condition can still be treated to prolong life expectancy in some cases.
Stage 1
The first treatment recommendation for those in stage 1 is generally surgery. Surgery is used to remove cancer cells or a tumor. A thoracic surgeon (who specializes in the chest) will perform the surgery.
Options for lung surgery depend on the size of your tumor but can include:
Lobectomy: Removal of a lobe (portion) of the lung
Pneumonectomy: Removal of the whole right or left lung
Wedge resection: Removal of tumor and surrounding lung tissue
A surgeon may also remove lymph nodes in the mediastinum, which is the area between your lungs. This procedure may be necessary because cells can move to the lymph nodes if the cancer has metastasized (spread).
A care team may also recommend treatments to ensure the cancer cells are gone and to reduce the chance of the cancer coming back. These treatments include:
Chemotherapy: Chemotherapy medications kill fast-growing cancer cells.
External radiation: External radiation therapy can help kill cancer cells or shrink tumors. A care team can sometimes use this treatment approach if surgery might be dangerous for your health.
Targeted therapies: Medications called epidermal growth factor receptor (EGFR) inhibitors can help reduce the growth of NSCLC cells.
Stage 2
Treatments for stage 1 and stage 2 NSCLC are generally similar. The main difference is in the five-year survival rate. This survival rate refers to the percentage of people living with a condition who are alive five years after receiving a diagnosis. The five-year survival rate for stage 2 cancer is typically lower than it is for stage 1 cancer.
Stage 2 treatments may include:
Chemotherapy
Surgery
Targeted therapies
Stage 3
A stage 3 lung cancer diagnosis can mean that cancer cells have spread, and the tumors can be any size. Surgeons can't always remove stage 3 tumors, so you may need other forms of treatment.
A surgeon will usually perform surgery if they can remove a stage 3 tumor and the tumor hasn't spread to a significant number of lymph nodes. You will typically undergo chemotherapy after the surgery to target and kill any remaining cancer cells.
Other treatments can help keep the cancer from spreading if surgery isn't an option. A care team can recommend chemotherapy, radiation therapy, or immunotherapy. Immunotherapy is a type of biologic therapy that helps enhance your immune defenses to fight cancer cells.
A healthcare provider may recommend brachytherapy to reduce symptoms like airway obstruction. This type of internal radiation therapy involves inserting small seed-like implants in specific areas of the body to target local cancer cells.
Stage 4
Stage 4 lung cancer can't be cured since this stage doesn't usually respond well to treatments. Surgery generally isn't a possibility for those in stage 4. A care team can recommend other treatments: chemotherapy, immunotherapy, and targeted therapy.
Treatment might not improve the condition. Research has found that 10% to 30% of all stage 4 lung cancer tumors will shrink with chemotherapy.
A care team will likely suggest palliative care, also referred to as "comfort care." Palliative care is an interdisciplinary type of treatment (i.e., an approach that uses services from many different healthcare specialists).
Treatment options during palliative care can include:
Type of Care | Description |
Emotional | Stress management, counseling, or light physical activities that help you manage anxiety or depression associated with cancer |
Financial | Help you understand the cost of treatment, applying for disability or medical leave, or explaining insurance options |
Medical | Medication and physical checkups with a care team |
Nutritional | Diet options that support your condition |
Physical | Support with pain, fatigue, and nausea |
Social | Learn how to talk to your loved ones about your condition or ask for support |
Spiritual/communal | Work with a faith community or support group to help you find meaning |
Treatments for Small Cell Lung Cancer by Stage
SCLC grows faster and is more aggressive than NSCLC. Healthcare providers don't stage this type of lung cancer the same way as NSCLC. They instead divide SCLC into categories: limited stage and extensive stage.
Limited Stage
Cancer is only present in one lung if you are in the limited stage. A care team can recommend treatment options, such as:
Chemotherapy: Used after surgery to kill off any remaining cancer cells
Lobectomy surgery: Removes the part of the lung where the cancer cells or tumors are located
Radiation: Prevents the cancer from spreading to major organs (e.g., heart or brain) by shrinking the size of the cancer cells or tumors
It's also common to alternate chemotherapy and radiation treatment after surgery. This further prevents the spread of the disease.
Extensive Stage
The cancer has spread to both lungs, nearby lymph nodes, and other organs if you receive an extensive stage SCLC diagnosis. This stage of SCLC is even more aggressive than the limited stage, so treatment options may be limited. A care team may recommend chemotherapy, radiation therapy, and palliative care.
Another option is immune checkpoint inhibitor (ICI) combination therapy. ICI is a drug therapy that attacks tumor cells in the immune system to improve the immune system's ability to kill cancer cells.
There are several ICI treatments available. A care team is in the best position to recommend which drug therapy is best for your condition.
Living With and Managing Lung Cancer
The cancer can spread to other organs without treatment. More than 225,000 people receive a diagnosis of lung cancer in the United States each year. The disease also accounts for 25% of all cancer deaths, which is why treatment is so important.
You often have the best chance of curing your condition if and when you receive a lung cancer diagnosis early. A later diagnosis doesn't mean treatment is unavailable. It just means you may need to use other forms of treatment.
Research on additional cancer treatments is ongoing. You may want to ask a care team about clinical trials for new treatment approaches if treatment is not working for you.
You might also want to incorporate lifestyle changes that support your condition and overall well-being. Some options include:
Eating a nutritious diet that is right for you
Engaging in hobbies and activities that you enjoy
Getting good sleep and resting throughout the day
Keeping in contact with a care team to ask them questions or update them on your health
Speaking to a mental health specialist or a cancer support group to talk about your condition and ways to cope
Spending time with loved ones
Trying relaxation techniques (e.g., deep breathing, yoga, art) to reduce stress
Receiving a lung cancer diagnosis is often scary and life-changing. It's normal to feel overwhelmed or stressed. Remember that you don't have to deal with it all on your own.
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A Quick Review
Lung cancer is an aggressive condition, so it's important to get started on treatment as soon as you can. Treatment options will depend on where cancer cells are located, how far cancer cells have spread, the severity of your condition, and your overall health.
A care team can recommend surgery, radiation, chemotherapy, immunotherapy, drug treatment, and lifestyle changes to help you manage your condition. Early treatment can prevent the cancer from spreading to other organs and improve your overall quality of life.
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