How Is Lung Cancer Treated?

Lung cancer is an aggressive condition that occurs when cancer cells begin to grow in the lungs. Without treatment, the cancer can spread to other organs. 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.

There are two types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Most people with lung cancer have NSCLC (about 80–85%). Though fewer people have SCLC, this type spreads faster than NSCLC. Therefore, treatment options for either type of lung cancer are different.

If you or a loved one has lung cancer, your treatment(s) will depend on several factors, including what type of lung cancer you have, if and how much the cancer has spread, and your overall health and treatment preferences. Your care team of healthcare providers will help you create a treatment plan that is best for you.

Treatments for Non-Small Cell Lung Cancer by Stage 

If your healthcare provider diagnoses you with NSCLC, they will likely order several imaging 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.

Treatments for Stage 1 

Generally, the first recommendation of treatment for those in stage 1 is surgery—which is used to remove cancer cells or a tumor. A thoracic surgeon (a surgeon who specializes in the chest) will perform the surgery. Options for lung surgery depend on the size of your tumor but can include:

• Wedge resection: Removal of tumor and surrounding lung tissue 
• Lobectomy: Removal of a lobe (portion) of the lung
• Pneumonectomy: Removal of the whole right or left lung 

During the surgery, your surgeon may also remove lymph nodes in the mediastinum (the area in between your lungs.) This procedure may be necessary because cells can move to the lymph nodes if the cancer has metastasized (spread).

After surgery, your 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 may include:

• Targeted therapies: Medications called epidermal growth factor receptor (EGFR) inhibitors can help reduce the growth of NSCLC cells. 
• External radiation: External radiation therapy can help kill cancer cells or shrink a tumor. Sometimes, your care team can use this treatment approach if surgery might be dangerous for your health. 
• Chemotherapy: Chemotherapy medications kill fast-growing cancer cells.

Treatments for Stage 2 

Treatments for stage 1 and stage 2 NSCLC are generally similar. The main difference is that the five-year survival rate for stage 2 cancer is typically lower than it is for stage 1 cancer.

Stage 2 treatments may include:

• Surgery 
• Targeted therapies 
• Radiation therapy 
• Chemotherapy

Treatments for Stage 3 

A stage 3 lung cancer diagnosis can mean that cancer cells have spread and the tumor(s) can be any size. Surgeons can’t always remove stage 3 tumors, so you may need other forms of treatment.  

If a surgeon can remove a stage 3 tumor and the tumor hasn’t spread to a significant number of lymph nodes, they will usually perform surgery. You will typically undergo chemotherapy after the surgery to target and kill any remaining cancer cells.

If surgery isn’t an option, treatments can help keep the cancer from spreading. Your care team can recommend chemotherapy, radiation therapy, or immunotherapy—which is a type of biologic therapy that helps enhance your immune defenses to fight cancer cells.

As a way to reduce symptoms like airway obstruction, your healthcare provider may recommend brachytherapy. This is a type of internal radiation therapy in which small seed-like implants are inserted in specific areas of the body to target local cancer cells.

Treatments for Stage 4 

Stage 4 lung cancer can’t be cured. This stage of cancer doesn’t usually respond well to treatments. Though surgery generally isn’t a possibility for those in stage 4, your care can recommend various treatments: chemotherapy, immunotherapy, and targeted therapy.

Even so, treatment might not improve the condition. Research suggests that 10–30% of all stage 4 lung cancer tumors will shrink with chemotherapy.

At this stage, your care team will likely suggest palliative care—sometimes 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:

Treatments for Small Cell Lung Cancer by Stage

SCLC grows faster and is more aggressive than NSCLC. For this reason, healthcare providers don’t stage this type of lung cancer the same way as NSCLC. Instead, they divide SCLC into categories: limited stage and extensive stage.

Treatments for Limited Stage 

If you are in the limited stage, your cancer is only present in one lung. Your care team can recommend treatment options such as: 

• Lobectomy surgery:  Removes the part of the lung where the cancer cells or tumor(s) are located
• Chemotherapy: Used after surgery to kill off any remaining cancer cells 
• Radiation: Prevents the cancer from spreading to major organs (e.g., heart or brain) by shrinking the size of the cancer cells or tumor(s)

It is also common to alternate chemotherapy and radiation treatment after surgery to further prevent the spread of the disease. 

Treatments for Extensive Stage 

If you receive an extensive stage SCLC diagnosis, the cancer has spread to both lungs, nearby lymph nodes, and other organs. This stage of SCLC is even more aggressive than limited stage—therefore, treatment options may be limited. In most cases, your care team may recommend chemotherapy, radiation therapy, and palliative care.

A newer form of treatment for extensive-stage SCLC is called immune checkpoint inhibitor (ICI) combination therapy. ICI is a drug therapy that attacks tumor cells in your immune system, which is done to improve the immune system’s ability to kill cancer cells. 

There are several ICI treatments available and your care team is in the best position to recommend which drug therapy is best for your condition.

Living With and Managing Lung Cancer 

If you receive a lung cancer diagnosis early, you often have the best chance of curing your condition. But a later diagnosis doesn’t mean treatment is not available—it just means you may need to use other forms of treatment. Research on additional cancer treatments is still in progress. If treatment is not working for you, you may want to ask your care team about clinical trials for new treatment approaches. 

In addition to medical treatment, you may also want to incorporate lifestyle changes that support your condition and overall well-being. Some options include:

• Getting good sleep and resting throughout the day
• Light exercise
• Eating a nutritious diet that is right for you
• Staying hydrated with water
• Trying relaxation techniques (e.g., deep breathing, yoga, art) to reduce stress
• Spending time with loved ones
• Engaging in hobbies and activities that you enjoy
• Speaking to a mental health professional or a cancer support group to talk about your condition and ways to cope 
• Keeping in contact with your care team to ask them questions or update them on your health 

Receiving a lung cancer diagnosis is often scary and life-changing. It’s normal to feel overwhelmed or stressed. But keep in mind: you don’t have to deal with it all on your own. 

A Quick Review 

Lung cancer is an aggressive condition, so it’s important to get started on treatment as soon as you can. Your treatment options for lung cancer will depend on where cancer cells and tumor(s) are located, how far cancer cells have spread, the severity of your condition, and your overall health.

There are a variety of treatment options for lung cancer. Your 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. 

Scientists are still studying other treatment options to help improve treatment outcomes for those with lung cancer. If you suspect your treatment isn’t working as well as it should, be sure to talk to your care team about your concerns. In some cases, they may help you get into certain clinical trials for newer treatments or readjust your treatment plan with options that are best for you.