Your treatment options also depend on your health, lung function, and personal preferences.
This article will provide a general description of each type of lung cancer treatment. It will also explain lung cancer diagnosis, staging, and what this means for your treatment.
The five basic ways to treat lung cancer are:
- surgery
- chemotherapy
- radiation therapy
- targeted therapy
- immunotherapy
People with lung cancer may receive more than one type of treatment.
Surgery aims to resolve the cancer by removing the cancerous tumor, the tissue surrounding it, and nearby lymph nodes. This may involve removing all or part of a lung.
Surgery may be an option for some lung cancers that have not spread beyond the lung. These include early stage non-small cell lung cancer (NSCLC) and lung carcinoid tumors.
Surgery may be an option for small cell lung cancer (SCLC) that is only present in one lung.
Chemotherapy is a type of medication that eliminates cancer cells. You can take these drugs orally, or a professional may administer them through an IV. Doctors often use chemotherapy along with other treatments.
Chemotherapy can shrink a tumor before surgery or eliminate cancer cells that might remain after surgery.
Chemotherapy kills some healthy cells in your body, along with cancer cells. That can cause side effects such as fatigue and nausea.
Radiation therapy uses X-rays to eliminate cancer cells in the lung. Radiation may also get rid of cancer cells that have spread outside the lung.
Doctors will focus radiation on areas of your body that have cancer cells. There are different types of radiation therapy for cancer. Some types involve delivering radiation from outside the body. Another type involves implanting sealed radioactive materials inside the body near the tumor.
The goal of radiation therapy also varies and could include:
- shrinking a tumor before surgery
- treating lung cancer in place of surgery
- reducing the chance of metastasis to the brain, for example, by irradiating the head
- relieving symptoms of lung cancer
Radiation can also damage and eliminate some healthy cells. This damage can cause side effects, such as mouth sores, a sore throat, and skin reactions.
Targeted therapies are drugs that block cancer growth and the spread of cancer cells. They can be oral pills or IV treatments. Depending on the specific drug, targeted therapy may:
- reduce blood supply to a tumor, slowing its growth
- shrink the tumor
- inhibit the growth and spread of cancer cells
Targeted therapies may have fewer side effects than other treatment options, such as radiation therapy.
Targeted therapy is
Immunotherapy medications stimulate your immune system to recognize and eliminate cancer cells more effectively. Your care team administers these by IV. Immunotherapy is more likely to be part of the treatment for advanced lung cancer than earlier stages.
Immunotherapy effectiveness varies, and there is a wide range of side effects. Common ones include flu-like symptoms, rash, and shortness of breath.
Palliative care is an option, regardless of age or lung cancer stage. The goal of palliative care is to relieve the symptoms and side effects of cancer and its treatment. Examples include acupuncture, physical therapy, and counseling.
Your doctor will evaluate your general health and the characteristics of your tumor when considering treatment options.
Tumor characteristics include the type and stage, which describes how far it has spread from its original site. Your doctor also needs to know about specific anomalies in the cancer cells themselves.
Lung cancer tests you may have include:
NSCLC has 5 stages, ranging from 0–4. Lower numbers indicate less advanced disease. Stage 4 is metastatic lung cancer. Per the American Cancer Society (ACS), the following is a summary of
- Stage 0: At this stage, surgery alone is usually sufficient to remove the cancer.
- Stage 1: At this stage, optimal treatment includes surgery with or without chemotherapy or radiation therapy. For larger stage 1 tumors, you may have immunotherapy alongside chemotherapy before surgery.
- Stage 2: The treatment for this stage is surgery with or without chemotherapy or radiation therapy. Treatment may include immunotherapy and targeted therapy, which may occur before surgery.
- Stage 3: The primary treatment for this stage is chemotherapy and radiation, with or without surgery afterward. Further treatment may include immunotherapy and targeted therapy.
- Stage 4: Targeted therapy and immunotherapy may occur first if cancer is widespread at this stage. Surgery and radiation can help relieve symptoms caused by tumors in other parts of the body.
To plan SCLC treatment, doctors use a simplified staging system. Treatment may consist of:
- Limited stage: If the tumor is small and in one lung, surgery is the primary treatment. The usual treatment is a combination of chemotherapy and radiation.
- Extensive stage: Treatment is usually chemotherapy, immunotherapy, and radiation to relieve symptoms. It usually focuses on the chest but can treat other areas.
Most doctors who treat lung cancer consider only
- Resectable: Resectable means a surgeon can cut the tumor out. Surgery alone may resolve many of these cancers. However, your doctor may also recommend chemotherapy and radiation therapy.
- Unresectable: This is a tumor that doctors cannot completely remove with surgery. Chemotherapy, targeted therapy, and radiation are the usual treatments.
Adithya Cattamanchi, M.D., reviewed the following questions.
Where does lung cancer spread first?
Lung cancer spreading through the bloodstream
What are the final stages of lung cancer?
Stage 4 is the final stage of lung cancer. At this stage, the tumor
- the other lung
- the fluid around the lungs
- distant sites, such as the liver or bones
How long does it take for lung cancer to spread?
Lung cancer tends to spread early. On average, most lung tumors begin to metastasize approximately 2.74 years before clinical detection. Lymph node involvement occurs an average of 4.26 years before detection and diagnosis.
Ask your oncologist and surgeon about different treatments for lung cancer. They can provide details on how effective certain treatments may be for your type and stage of lung cancer. Your age and overall health make a difference, too.
It is important to clearly understand what the treatment means for you, both medically and personally. The facts will help you decide and hopefully feel more prepared for the journey ahead.