Treatment for lung cancer may include one or more of the following therapies:

• Surgery (taking out the cancer). Surgery may involve removing the cancerous tissue (wedge resection), removing the affected lobe of lung (lobectomy), or removing the entire lung (pneumonectomy). Surgery is the most effective treatment for the early-stage non–small cell lung cancers (stage I through stage IIIA). Lung function studies and a lung scan are often done before surgery to predict whether you will have enough remaining lung function after surgery to live a fairly normal life.
• Radiation therapy (using high-dose X-rays to kill cancer cells). Radiation therapy is often used in combination with surgery or chemotherapy or both. Radiation following surgery for stages IIA and IIB (with lymph node involvement) may reduce the risk of cancer recurrence in the chest.
• Chemotherapy (using medications to kill cancer cells). Chemotherapy is the most effective treatment for small cell lung cancer, but it is only a cure in a small number of people. Chemotherapy also may be used to treat more advanced stages (stages III and IV) of non–small cell lung cancer.
• Targeted therapy. Targeted therapies use medications or antibodies to block growth factors that allow some tumors to grow. At present, targeted therapies are used for advanced lung cancer.

If you smoke and have lung cancer, you may increase the benefit of your treatment by quitting smoking, though your long-term outcome (prognosis) may not be affected.

Initial treatment

The choice of treatment and the long-term prognosis of lung cancer depends on the type (non–small cell or small cell) and stage of cancer. Your age, overall health, and quality of life must also be considered. Many people with lung cancer are diagnosed with the disease when the cancer is already in an advanced stage. Only about 15% of lung cancers are diagnosed in the early stages when lung cancer is likely to be cured with surgical treatment. ⁶

Non–small cell lung cancer grows and spreads more slowly; therefore, it has more stages that may respond to each of the three different treatment therapies. Lung surgery (thoracotomy) usually is the standard treatment for non–small cell stage I to stage IIIA cancers. Treatment for non–small cell lung cancer also includes:

• Treatment with a combination of the three therapies.
  • Lung surgery (thoracotomy) takes out the cancer.
  • Radiation therapy follows surgery for stages IIA, IIB, and IIIA (with lymph node involvement) and may reduce the risk of cancer recurrence in the chest.
  • Chemotherapy may be used to treat more advanced stages (stages III and IV). Chemotherapy may also be used after surgery for stages IB, IIA, IIB, and IIIA to reduce the risk of cancer returning.

Small cell lung cancer grows very rapidly in most cases and is more likely to spread (metastasize) to other organs. Treatment for small cell lung cancer includes:

• Chemotherapy, which usually is the standard treatment for this type of lung cancer.
• Radiation therapy, which may help shrink a rapidly growing large tumor that is causing symptoms.

Radiation therapy is combined with chemotherapy to treat small cell cancer that is limited to the chest.

Home treatment measures may help relieve some common side effects of your cancer treatment. For more information, see the Home Treatment section.

If you have recently been diagnosed with lung cancer, you may experience a wide variety of emotions in reaction to your diagnosis. Most people feel some denial, anger, and grief. Other people may have fewer emotions. There is no "normal" or "right" way to react to a diagnosis of cancer; it varies from person to person. You can take steps, though, to manage your emotional reactions to learning that you have lung cancer. You may find that talking with family and friends is comforting, while others may need to spend time alone to understand their feelings about their disease.

If your emotions are interfering with your ability to make decisions about your health and to move forward with your life, it is important to talk with your health professional. Your cancer treatment center may offer counseling services. You may also contact your local chapter of the American Cancer Society to help you find a support group. Talking with other people who have had similar feelings after a diagnosis such as yours can help you accept and deal with your disease.

Complementary therapies

In addition to conventional medical treatment, you may wish to try complementary therapies, such as:

• Acupuncture.
• Herbs.
• Biofeedback.
• Meditation.
• Yoga.
• Visualization.
• Vitamins and nutritional supplements.

Before you try any of these therapies, discuss their possible benefits and side effects with your health professional. Let him or her know if you are already using any such therapies. For more information, see the topic Complementary Medicine.

What to think about during initial treatment

Your quality of life becomes a critical issue when considering your treatment options. Be sure to discuss your personal preferences with your oncologist when he or she recommends treatment.

You may be interested in participating in research studies called clinical trials. Clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. People who do not want standard treatments or are not cured with standard treatments may want to participate in clinical trials. These are ongoing in most parts of the United States and in some other countries around the world for all stages of lung cancer.

Treatment for advanced-stage lung cancer is intended to control your symptoms and increase your comfort (palliative care), but it will not cure your cancer.

For more information about specific lung cancer treatments, see the topics:

• Lung Cancer, non–small cell—Health Professional Information [Cancer.gov].
• Lung Cancer, non–small cell—Patient Information [Cancer.gov].
• Lung Cancer, small cell—Health Professional Information [Cancer.gov].
• Lung Cancer, small cell—Patient Information [Cancer.gov].

Ongoing treatment

After initial treatment for lung cancer, it is important to receive follow-up care.

• Your oncologist will schedule regular checkups, usually every 3 to 4 months, depending on the therapies used in initial treatment. After 2 to 3 years, regular checkups will occur less often but more than just once a year, depending on your medical history.
• Checkups include a physical exam, blood tests, chest X-rays, and any other laboratory tests recommended by your oncologist. A CT scan is usually done every 3 to 6 months for the first 2 to 3 years, and then once a year after that.

Radiation therapy may be used to prevent small cell lung cancer from growing in the brain. This is called prophylactic cranial irradiation (PCI). PCI may be most beneficial if you have limited small cell lung cancer and have had successful treatment with chemotherapy and radiation therapy to the chest.

Your emotional reactions may continue throughout the course of your treatment depending on your prognosis, the treatment methods used, and your quality-of-life decisions.

Treatment if the condition gets worse

The long-term outcome (prognosis) for recurrent lung cancer is poor, and treatment focuses on palliative care.

Treatment to help control your symptoms (such as pain, coughing up blood (hemoptysis), shortness of breath, and weakness) may include:

• Radiation therapy.
• Chemotherapy.
• Chemotherapy combined with radiation therapy.
• Surgery, if your cancer has spread to your brain.
• Laser surgery or internal radiation therapy (brachytherapy).
• Radiation applied directly to the tumor during surgery.

Radiation therapy may be used to:

• Shrink tumors that cause difficulty swallowing.
• Reduce tumors that block your airway and cause difficulty breathing.
• Relieve pain from cancer that has spread to your bones or spinal cord.

Additional treatment measures

• Oxygen therapy may relieve your shortness of breath (dyspnea). It is usually used at the end stage of your disease, but it may also be used for pneumonia or other treatable conditions.
• Thoracentesis is used to remove fluid from around your lungs (pleural effusion). A large pleural effusion may cause pain and shortness of breath.
• Pleurodesis is used to prevent fluid buildup around your lungs. Pleurodesis is a procedure using talc or other medications that are applied to the lining around your lungs. Pleurodesis may be done surgically or with a tube inserted into your chest to inject a talc slurry into the space around your lungs. The irritated tissue reacts by producing scar tissue, which helps block fluid buildup around your lungs. Pleurodesis is commonly used to treat fluid buildup around your lung that returns after repeated thoracentesis.
• The use of indwelling (tunneled) pleural catheters to help relieve recurrent or persistent pleural effusion is becoming more common.
• Treatments that burn (cauterize) selected areas of obstructed airways or that place stents—small, coiled, wire-mesh tubes that can be inserted into an obstructed airway and expanded to hold it open—are also becoming more common.

Complementary therapies

In addition to conventional medical treatment, you may wish to try complementary therapies, such as:

• Acupuncture.
• Herbs.
• Biofeedback.
• Meditation.
• Yoga.
• Visualization.
• Vitamins and nutritional supplements.

Before you try any of these therapies, discuss their possible benefits and side effects with your health professional. Let him or her know if you are already using any such therapies. For more information, see the topic Complementary Medicine.