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How Is Lung Cancer Treated?

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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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: 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  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. 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: Doing light exercise 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 Staying hydrated with water 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.  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. Thanks for your feedback! 9 Sources Health.Com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Lung Association. Lung cancer care providers. Centers for Disease Control and Prevention. How is lung cancer diagnosed and treated? Siddiqui F, Vaqar S, Siddiqui AH. Lung cancer. In: StatPearls. StatPearls Publishing; 2024. National Cancer Institute. Non-small cell lung cancer treatment. National Cancer Institute. Five-year survival rate.  National Cancer Institute. Brachytherapy to treat cancer. Lilenbaum RC. Patient education: Non-small cell lung cancer treatment; stage IV cancer (beyond the basics). In: Schild SE, Vora SR, eds. UpToDate. UpToDate; 2024. National Institute on Aging. What are palliative care and hospice care? National Cancer Institute. Small cell lung cancer treatment.

Northwestern Develops Successful Double-lung Transplant Technique For Cancer Patients

For decades, double lung transplants were not considered a viable option for treating lung cancer. 

"It had been done, but it had always failed," said Ankit Bharat, chief of thoracic surgery at Northwestern Medicine. "When you took out the lungs, the cancer cells would spread to the rest of the body, and it would come back a matter of months after the transplant."

But after developing a new technique to replace damaged lungs during the height of the COVID-19 pandemic, Northwestern Medicine's Canning Thoracic Institute has now performed more than 40 successful lung transplants on cancer patients in just two and a half years.

The operation has a 100% success rate for lung cancer patients today, and in January the hospital completed its first transplant on a patient with lungs affected by both COVID-19 and lung cancer.

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Art Gillespie, a captain with the University of Chicago Police Department, contracted COVID-19 in March 2020 while visiting his uncle in a nursing home. While hospitalized with the virus, Gillespie discovered he had Stage 1 lung cancer.

Art Gillespie at home in Chicago with generations of family photos on May 23. He received a double lung transplant after one lung was damaged by lung cancer and the other by COVID-19. The cancer diagnosis came in 2020.

TERRENCE ANTONIO JAMES, CHICAGO TRIBUNE

Though he received treatment for COVID and chemotherapy, he developed pulmonary fibrosis, a disease that causes scarring in the lungs and makes it difficult to breathe. Ultimately, Gillespie had two-thirds of his right lung removed to treat the cancer, and, despite the operation, needed daily oxygen.

Later, Gillespie received a one-to-two-year life expectancy prognosis.

"2022 was primarily me just becoming much more sick," Gillespie said. "My quality of life at that point was pretty impacted. My ability to do anything, even speaking, was very taxing."

Bharat said that Gillespie was a good candidate for a double lung transplant, especially because the transplant treatment for lung cancer had been directly developed from the technique for COVID-affected lungs.

While lung transplants had typically been performed by removing the lungs one by one, cutting first the vein that takes blood from the heart to the lungs and then the vein that takes it back, surgeons had to figure out a way that would prevent COVID bacteria from moving from the lungs to the heart, according to Bharat.

Doctors developed a technique to cut the veins simultaneously and later discovered the same technique could stop the spread of cancer cells.

"We had to make the same modifications for lung cancer," said Rade Tomic, a pulmonologist at Northwestern Medicine who also worked on the transplant treatment. "We had to make sure we didn't spread the cancer, or let it enter the bloodstream."

Doctors also implemented a second step that worked to ensure the removal of cancerous cells and COVID-19 bacteria from the rest of the chest. After the lungs are removed, doctors irrigate the remaining airway and chest cavity.

Gillespie said he was initially resistant to the double transplant. He'd already had a lung surgery, and did not want to undergo another major operation. But it ultimately seemed like the only option.

Gillespie had the operation in January after being placed on the transplant list in September. He is on the way to a full recovery, he said, and hopes to return to work in the near future.

"I'm a grandfather," Gillespie said. "The first thing I thought about was having that additional time to spend with (my grandkids), and watch them grow. That's just an indescribable benefit."

Tomic said these new transplant techniques will have a far-ranging and widespread impact. The treatment is already being used for other conditions such as pulmonary fibrosis, and is a lifesaving intervention for later-stage lung cancer patients who may not have another option, he said.

"The goal is to help the patient, give them a chance at a new life and an opportunity to get their life back," Tomic said. "They are going to have a much, much longer survival than they would've had without the lung transplantation."

Pediatric cancer is on the rise, with some types becoming more common Pediatric cancer is on the rise, with some types becoming more common

More than 15,000 children in the United States likely will be diagnosed with cancer in 2023, based on estimates from the National Cancer Institute.

While rare, cancer is the fourth leading cause of death in children and adolescents from 1 to 19 years old. And a new study published in the Journal of the National Cancer Institute shows pediatric cancer is rising overall.

The study evaluated nearly 250,000 pediatric cancer cases over a more than 15-year period. It found rates of leukemia, lymphoma, and several other cancers increased during that time, while melanoma rates fell.

Northwell Health collaborated with Stacker to analyze the data on rising cases of pediatric cancer. The overall rate of cancer cases increased to 177 per million in 2019 from 165 per million in 2003, the study found.

Rises in pediatric cancers may be due to various factors, such as changes in how cancer is reported. For example, the increase in cancer rates may be due to the more prominent use of electronic pathology reporting to cancer registries, which has grown more common in the last 20 years.

The good news is survival rates have increased dramatically since the 1970s. Treatment for leukemia, for example, used to be one-size-fits-all—every child got the same treatment. Now, doctors can tailor the treatment for children with leukemia based on their molecular changes. Personalized treatments, including cellular therapies and targeted immunotherapies, have significantly improved pediatric cancer survival rates. While this study didn't look at survival rates, one researcher behind it hopes that the study can be used to help design tests for new treatments and to give insight into the growing number of childhood cancer survivors.

"Cancer survivors need long-term care," Dr. David A. Siegel, M.D., told the journal HemOnc Today. "That's important for physicians to keep in mind as they think about these questions going forward."

Yuganov Konstantin // Shutterstock Groups most impacted by pediatric cancer

Rates of different cancer types varied based on a number of factors, including age, gender, race or ethnicity, and which part of the country a patient was located.

Compared by age, pediatric cancer rates were highest among infants under 1. Male children had higher rates of cancer than female children due to a mixture of immune-related, genetic, and hormone-related mechanisms. Children living in large cities also have higher cancer rates. According to a 2022 study in Switzerland, exposure to traffic-related air pollution has direct links to childhood leukemia.

Northwell Health Some cancers are becoming more common

According to the National Cancer Institute, other environmental exposures have also been linked to the rise in pediatric cancers. For example, exposure to ionizing radiation, which most commonly comes from X-ray machines and other medical devices as well as radioactive material found in soil, can lead to cancer in children.

Thyroid carcinomas, which saw the highest levels of growth, may be rising due to advanced technology leading to increased detection and overdiagnosis. This type of cancer is very low risk and doesn't often need treatment. Overdiagnosis occurs when screening tests lead to a diagnosis when detection and treatment are unnecessary. The rise of certain lymphoma cancers may be attributed to the World Health Organization's 2008 redefinition of certain cancers and their diagnostic criteria. Alternatively, melanoma cases may have decreased due to public health interventions concerning sun protection, resulting in less ultraviolet light exposure.

Additional writing by Kelly Glass. Story editing by Ashleigh Graf. Copy editing by Kristen Wegrzyn.

 

This story originally appeared on Northwell Health and was produced and distributed in partnership with Stacker Studio.

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