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Lung Cancer Treatment: A Complete Guide

Lung Cancer Treatment: A Complete Guide
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Updated on March 21, 2025
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If you've been diagnosed with lung cancer, your doctor or oncologist will discuss suitable treatments with you. The two main types of lung cancer — small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) — may be treated differently. Limited stage SCLC is treated with chemotherapy and radiation. Extensive stage SCLC is usually treated with chemotherapy and immunotherapy. NSCLC can involve surgery, chemotherapy, targeted therapy, and immunotherapy, depending on the subtype and stage of cancer.

Lung cancer survival rates have improved in recent years thanks to more lung cancer screening and better treatments. The five-year survival rate for lung cancer has increased by 26 percent in the past five years.

Chemotherapy

Chemotherapy is a lung cancer treatment that involves delivering anti-cancer medicines through pills or injections. This treatment is used before or after surgery to kill cancer cells and shrink tumors.

 Chemotherapy can be used along with radiation, immunotherapy, or targeted therapy.

The use of chemotherapy in lung cancer is complicated. It's used after surgery to decrease the risk of recurrence. It can also be used prior to surgery in some cases in combination with radiation or immunotherapy to increase the odds of successful treatment. It is used in late-stage lung cancer when the cancer can't be surgically removed.

The following chemo drugs are commonly given to people with either SCLC or NSCLC. These medicines are usually combined, but depending on the situation, you may take just one at a time.

  • carboplatin
  • cisplatin
  • docetaxel (Taxotere)
  • etoposide (VP-16)
  • gemcitabine (Gemzar)
  • irinotecan (Camptosar)
  • lurbinectedin (Zepzelca)
  • paclitaxel (Taxol)
  • pemetrexed (Alimta)
  • albumin-bound paclitaxel or nab-paclitaxel (Abraxane)
  • topotecan (Hycamtin)
  • vinorelbine (Navelbine)
Side effects of chemo include hair loss, nausea, vomiting, fatigue, bruising, loss of appetite, mouth sores, diarrhea, constipation, and an increased risk of infection. There are many medications that you are given with chemotherapy to help minimize these side effects, and there are many additional medications that you can take as needed to help with side effects such as nausea.

Targeted Therapy

Newer lung cancer treatments that exploit certain abnormalities in cancer cells are known as targeted therapies. These drugs are different from chemotherapy in the way they work. Unlike chemo, targeted therapy recognizes cancer cells based on mutations, or changes, in their DNA that are not seen elsewhere in the body. It specifically attacks the cancer cells, not healthy cells.

 Targeted therapy is used most often in people with advanced lung cancer. These medicines work for a period of time but then stop being effective.

Typically, targeted medicines don't cause as many side effects as chemo, but you could experience a rash, diarrhea, fatigue, nausea, high blood pressure, liver function issues, and heart, vision, or lung problems.

Most targeted drugs work only if you have certain gene mutations, which your doctor can test you for. Here are ones that may be treated with targeted therapies for lung cancer.

EGFR Mutations

Epidermal growth factor receptor (EGFR) is a protein found on the surface of cells, and a mutation can affect how well it functions. Changes in the epidermal growth factor receptor (EGFR) gene can be treated with drugs, such as:

  • afatinib (Gilotrif)
  • dacomitinib (Vizimpro)
  • erlotinib (Tarceva)
  • gefitinib (Iressa)
  • osimertinib (Tagrisso)

ALK Fusion

About 5 percent of NSCLCs have an alteration in the anaplastic lymphoma kinase (ALK) gene. When mutated, it can cause abnormal cell growth and spread. Drugs that target ALK changes include:

  • alectinib (Alecensa)
  • brigatinib (Alunbrig)
  • ceritinib (Zykadia)
  • crizotinib (Xalkori)
  • lorlatinib (Lorbrena)

ROS1 Fusions

The ROS1 gene arrangement is similar to the ALK gene, and some drugs that work for one also work for the other:

  • ceritinib (Zykadia)
  • crizotinib (Xalkori)
  • entrectinib (Rozlytrek)
  • lorlatinib (Lorbrena)
  • repotrectinib (Augtyro)

BRAF Mutations

The BRAF gene helps manage important cell functions related to growth. When mutated, it signals cells to divide uncontrollably.

 Two drug combinations are approved by the U.S. Food and Drug Administration (FDA) to target changes in the BRAF gene:

  • dabrafenib (Tafinlar) and trametinib (Mekinist)
  • encorafenib (Braftovi) and binimetinib (Mektovi)

MET Alterations

Only around 5 percent of patients who have lung cancer have this gene mutation. For those who do, targeted therapy MET inhibitor drugs, such as capmatinib (Tabrecta) or tepotinib (Tepmetko) may be recommended treatments.

RET Mutations

An error in the RET gene can be a biomarker for lung cancer, although it only appears in 1 to 2 percent of patients. Patients who have this mutation are often younger and have never smoked. The two FDA-approved RET inhibitors are selpercatinib (Retevmo) and pralsetinib (Gavreto).

Immunotherapy

Immunotherapy uses medicines to stimulate the body's immune system to target and kill cancer cells more effectively. These drugs are given as an intravenous (IV) infusion.

Available immunotherapy medicines include PD-1 inhibitors and PD-L1 inhibitors.

PD-1 Inhibitors

These drugs block the PD-1 protein to help boost the body's immune system response to fighting cancer cells. Examples are:

  • cemiplimab (Libtayo)
  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)

For those with metastatic lung cancer, these may be used in conjunction with the medication ipilimumab, a CTLA-4 inhibitor, which is another type of immunotherapy drug.

PD-L1 Inhibitors

Meds that block the PD-L1 protein can help the immune system attack cancer cells. Atezolizumab (Tecentriq) and durvalumab (Imfinzi) are PD-L1 inhibitors.

Immunotherapies can be used alone or with other treatments. Side effects of immunotherapy medicines may include autoimmune issues, cough, itching, fatigue, rash, constipation, loss of appetite, diarrhea, and joint pain.

Surgery and Other Procedures

Surgery to remove your lung tumor may be an option if your cancer is found in its early stages. Several types of surgeries are performed, including:

  • Pneumonectomy Your surgeon removes your entire lung with this procedure. You might need a pneumonectomy if your tumor is close to the center of your chest.
  • Lobectomy The lobe that contains the tumor is removed if you have a lobectomy. Your right lung is made up of three lobes, and your left lung is made up of two lobes.
  • Segmental Resection With this surgery, a large portion of your lung is removed — but not the entire lobe.
  • Wedge Resection This procedure involves removing only a small part of the lobe that contains the tumor.

Minimally invasive surgical techniques, which require a smaller incision and from which the recovery is usually easier, may also be available.

Your doctor will choose the type of procedure according to the size and location of your tumor, as well as your lung function.

Risks of surgery may include bleeding, infection, blood clots, and, rarely, death. You may have certain side effects such as shortness of breath after surgery.

Radiofrequency Ablation

Radiofrequency ablation (RFA) uses high-energy radio waves to heat up the tumor and destroy cancer cells. Most of the time, RFA is performed as an outpatient procedure using local anesthesia. It may be a good option for someone with non-small cell lung cancer who can't tolerate surgery or whose tumor is small and near the outer part of the lung.

Radiation Therapy

Radiation uses high-energy beams, such as X-rays or protons, to kill cancer cells, both at the primary site or potential metastatic sites. Your doctor may recommend radiation instead of surgery if your lung tumor can't be removed because of its size or location in the lung. Some people with advanced lung cancer receive radiation to relieve pain and improve their symptoms.

These beams may come from a machine that focuses on the tumor. This is called external beam radiation and includes three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and stereotactic radiosurgery (SRS).

Side effects of radiation may include:

  • Fatigue
  • Nausea and vomiting
  • Weight loss
  • Loss of appetite
  • Hair loss
  • Skin changes

Radiation can also damage the lungs, which might cause a cough and shortness of breath. Sometimes those symptoms don't go away completely after treatment.

Radiation may be given before or after surgery and is sometimes combined with chemotherapy. Additionally, this treatment is also used on areas of the body where cancer has spread.

Pain Management

Depending on the location and the size of the tumor, lung cancer can be painful, particularly if it presses against other organs.

 Cancer pain presents differently among people who have it. It can be dull, sharp, achy, or have a burning sensation. It can also range from mild to severe. Options to treat it include:
  • Over-the-counter pain relievers, such as aspirin, acetaminophen, and ibuprofen
  • Opioids, including morphine and oxycodone
  • Other prescription medications, like antidepressants, anti-seizure drugs, and steroids to help relieve pain
  • A nerve block procedure, which is a numbing medicine that's injected into a nerve that can help prevent pain signals from being sent to the brain
  • Integrative therapies, such as massage, acupuncture, physical therapy, and meditation

Mental Health

The stress of living with cancer — or any serious illness — can take a toll on your peace of mind. And addressing those issues can help you live longer. Research suggests that mental health treatment improves lung cancer survival rates.

A therapist may help you process your illness, the prognosis, and the treatment. Research on antidepressants and lung cancer are mixed. Some studies suggest that antidepressants can improve survival rates, and others say they increase the risk of lung cancer.

 Talk to your healthcare team to discuss if this option is right for you.
Treatments such as cognitive behavioral therapy, mind-body interventions like yoga and tai chi, and regular exercise also improve well-being in patients who have advanced lung cancer.

The Takeaway

  • If you've been diagnosed with lung cancer, treatment options depend on the cancer stage and how far it has spread, with different approaches for small-cell and non-small cell lung cancer.
  • Treatments available include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy, each with potential side effects and risks. Discussing those options thoroughly with your healthcare provider is essential.
  • It’s crucial to address mental health during treatment. Therapies and practices such as counseling, cognitive behavioral therapy, and mindfulness exercises can enhance well-being and may even influence survival outcomes.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  6. Targeted Therapies for Lung Cancer. American Lung Association. February 12, 2025.
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  12. MET and Lung Cancer. American Lung Association. January 22, 2025.
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Tingting Tan, MD, PhD

Medical Reviewer

Tingting Tan, MD, PhD, is a medical oncologist at City of Hope National Medical Center.

Dr. Tan's research has been published in multiple medical and scientific journals, including Oncologists, Cancer Cell, and Genes and Development.

A graduate of the Beijing Medical University, Tan holds an M.D. from Peking University Health Science Center and a Ph.D. from Rutgers University. Her training includes fellowships at the University of California San Francisco Cancer Research Institute and the Fox Chase Cancer Center at Temple University.

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Julie Lynn Marks

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Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.

Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.

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