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Lung cancer treatments

The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 1, 2021.

At Cancer Treatment Centers of America® (CTCA), we target lung tumors with a wide variety of lung cancer treatments and technologies, including chemotherapy, immunotherapy, interventional pulmonology, radiation therapy, surgery and targeted therapy. Your lung cancer treatment team may consist of several doctors, each of whom practices a specific area of medicine. They work in collaboration to answer your questions and recommend treatment options based on your individual needs.

Your team may include a:

  • Pulmonologist
  • Thoracic surgeon
  • Medical oncologist
  • Radiation oncologist

Any symptoms related to the lungs are first investigated by a pulmonologist, a doctor who has expertise in the respiratory system. If surgery is needed, you may need to consult with a thoracic surgeon, a physician who diagnoses and operates on cancer of the lungs. Medical oncologists have received special training to diagnose and treat cancer using drugs such as chemotherapy, hormonal therapy, biologic therapy and targeted therapy, while radiation oncologists use radiation therapy, or high-energy rays, to treat cancer.

The type of treatment a patient receives for lung cancer may depend on the type of lung cancer and whether the disease has metastasized (spread) to distant organs. The types of lung cancer and their treatments include those below.

Small cell lung cancer: may be aggressive and may require immediate treatment. Treatments for small cell lung cancer include:

  • Chemotherapy
  • Immunotherapy
  • Laser therapy
  • Radiation therapy
  • Surgery

Non-small cell lung cancer (NSCLC): is the most common form of lung cancer. Treatments for non-small cell lung cancer include:

  • Chemotherapy
  • Cryotherapy
  • Immunotherapy
  • Laser therapy
  • Photodynamic therapy
  • Radiation therapy
  • Surgery
  • Targeted therapy

Metastatic lung cancer: is generally treated based on which part of the body the cancer first formed, so metastatic lung cancer is often treated as an advanced form of the disease, even if it spread to distant parts of the body. Immunotherapy and targeted therapy may be recommended to treat metastatic lung cancer. Other treatment options may depend on where the cancer has spread. For instance:

  • Options for brain metastases include radiation therapy, chemotherapy and/or steroids.
  • If the cancer has spread to the bone, radiation therapy or targeted therapy may be recommended.

Types of lung cancer treatments include:

Chemotherapy for lung cancer

Chemotherapy is a treatment that uses powerful drugs to kill cancer cells.

Cancerous cells grow much faster than normal cells, and chemotherapy works by preventing their growth and division. However, it may also cause damage to your normal cells.

To treat lung cancer, chemotherapy is administered intravenously (IV) through your arm. Sometimes an IV called a central venous catheter (CVC), such as a PICC (peripherally inserted central catheter) line or port, is installed to create a more durable injection site. If you receive your chemotherapy as an injection, it only takes a few minutes, whereas receiving a chemotherapy infusion may take several hours or more to complete. Chemotherapy is performed at a hospital, doctor’s office or chemotherapy clinic.

Your sessions are cycled so that you have time to recover after each treatment. Usually, chemotherapy cycles are from three to four weeks in duration, with drugs administered anywhere from one to three or more days before you receive a treatment break. This cycle then repeats until your full course of treatment is done. Your cycle length, the number of treatments and side effects all vary based on your individual case, the combination of chemotherapy medications being used, and how successful the treatment is at eradicating the cancer. Lung cancer chemotherapy treatments are used in three primary ways:

  • Neoadjuvant or primary systemic lung cancer chemotherapy may be used before surgery to destroy cancer cells. It also allows the oncologist to determine the effect of a particular lung cancer treatment regimen on the tumor.
  • Adjuvant chemotherapy is a type of lung cancer treatment used after surgery or radiation to target cancer cells that were not removed during lung cancer surgery, and helps prevent the cancer from spreading to other parts of the body.
  • Systemic chemotherapy, meaning the circulation of chemotherapy drugs through the bloodstream to cancer cells through the body, plays an important role in the treatment of locally advanced or metastatic lung cancer.

Throughout your lung cancer treatment, your care team will continually monitor the impact of chemotherapy on the disease, with physical exams, blood tests and imaging.

Immunotherapy for lung cancer

Immunotherapy is designed to stimulate the body’s immune system to attack and kill cancer cells. Checkpoint inhibitors, a form of immunotherapy, work by blocking signaling proteins that allow cancer cells to hide from the immune system. The U.S. Food and Drug Administration has approved certain immunotherapy and checkpoint inhibitor drugs to treat specific cases of lung cancer. The drugs may be used alone or in combination with other therapies, such as surgery or chemotherapy.

Interventional pulmonology for lung cancer

Minimally invasive procedures to diagnose and treat lung cancer are referred to as interventional pulmonology. These procedures use endoscopic techniques in which a long, thin tube with a lighted microscope on the end, such as a bronchoscope, is inserted down the throat to view your internal organs and tissues.

These procedures may be used to remove airway obstructions or fluid buildup around the lungs, treating cancer symptoms such as:

  • Coughing
  • Chest pain
  • Shortness of breath

Interventional pulmonology addresses four primary areas: central airway obstruction, advanced airway diagnostics, pleural effusion and treatment-related side effects.

Radiation therapy for lung cancer

Radiation treatment involves the use of high-energy rays to destroy lung cancer cells. It’s similar to getting an X-ray, but the dose of radiation delivered to the area is much stronger. It typically doesn’t hurt and only takes a few minutes to complete.

Typically, radiation treatment occurs for five days per week over a period of five to seven weeks. It may take place before and/or after other treatments such as chemotherapy or surgery, but this would depend on your specific case. In addition, radiation is sometimes used palliatively to control symptoms in lung cancers that cannot be treated.

We offer two primary types of radiation therapy lung cancer:

  • External beam radiation therapy (EBRT) delivers high doses of radiation to lung cancer cells from outside the body, using a variety of machine-based technologies.
  • High-dose rate (HDR) brachytherapy (internal radiation) delivers high doses of radiation from implants placed close to, or inside, the tumor(s) in the body.

Lung cancer surgery

In a thoracotomy, the surgeon opens up the chest cavity to gain access to the lungs. An incision is made in the side of the chest, and the ribs are spread apart, allowing the surgeon to remove cancerous tissue from the lungs. Various approaches may be used to perform these surgical procedures, including:

Video-assisted thoracic surgery (VATS): VATS is a minimally invasive technology used to perform a lobectomy or wedge resection without opening the chest. This thoracotomy procedure involves inserting a long, thin tube with an attached camera (thoracoscope) and small surgical instruments into the chest. Using images taken by the camera, the surgeon removes portions of the lung that contain cancerous tissue. VATS typically offers a quicker recovery time and less pain than other types of lung surgery, because no large incision or movement of the ribs is needed. VATS also may be used to biopsy lung tissue and confirm a lung cancer diagnosis. This type of procedure is called a diagnostic thoracoscopy.

Robotic-assisted thoracic surgery: Robotic surgery is another minimally invasive approach to treating lung cancer. The instruments have greater ranges of motion, allowing for more precise movements. The recovery time and pain levels are similar to those resulting from VATS.

The type of surgery you have depends on your lung health, as well as on the extent of the tumor. Your doctor will perform the most comprehensive option your lung function allows in order to increase the chance of treating the cancer.

Your recovery may take weeks to months based on the type of surgery and on your general health. The more intensive the surgery, the longer the recovery time, but expect to spend up to a week in the hospital post-operation.

Surgeries performed through thoracotomy have longer recovery times than the less invasive VATS and robotic-assisted surgeries. With any surgery for lung cancer, the lymph nodes in the area may be removed to determine whether the cancer has spread.

Our surgeons perform four types of surgery to treat lung cancer.

Lobectomy: In this procedure, an entire lobe is removed from the lung. The right lung has three lobes, and the left lung has two. It’s done to remove the lobe of the lung that contains the tumor(s) and is the preferred type of surgery for NSCLC patients. However, if you have diminished lung function, you may not be able to have a lobectomy.

Wedge resection: This procedure is used to remove cancerous tissue from the lung, typically in diagnosing or treating metastasis. The cancerous tumor is removed along with a wedge-shaped portion of the lung tissue surrounding it. A wedge resection may be performed in patients whose reduced lung function won’t allow them to undergo a lobectomy.

Segmentectomy: This surgery is designed to remove cancerous tissue from a lung segment in patients who are not candidates for a lobectomy due to diminished lung function. The lungs have various numbers of segments: three in the right upper lobe, two in the right middle lobe, five in the right lower lobe, four in the left lower lobe and four in the left upper lobe. A segmentectomy involves the removal of the cancerous tumor and a portion of lung tissue larger than what’s removed via a wedge section.

Sleeve lobectomy: Also known as a sleeve resection, this surgery involves the removal of a tumor from a lobe of the lung along with a portion of the bronchus, or airway. After this is done, the two ends of the airway are reconnected. Any remaining lobe is reattached to the airway as well.

Pneumonectomy: This surgery removes an entire lung, which may be necessary if the tumor is located near the middle of the chest.

Targeted therapy

Targeted therapy drugs are designed to attach themselves to specific receptors and proteins unique to cancer cells. Targeted therapy may be used alone, in combination with other types of targeted therapies, or with other lung cancer treatments, such as chemotherapy, radiation therapy or interventional pulmonology.

Lung cancer clinical trials

As part of our commitment to providing new and innovative treatments, our doctors may recommend that lung cancer patients enroll in carefully selected clinical trials. If you meet specific criteria, clinical trials may offer lung cancer treatment options that would otherwise be unavailable to you.

Clinical trials are a key testing ground for determining the effectiveness and safety of new treatments and drugs for many diseases, including cancer.

Each patient is considered for a clinical trial on an individual basis and may qualify at any stage of disease or treatment. Talk to your doctor about whether a clinical trial is a good option for you and ask about the risks and various requirements involved.

Search clinical trials for lung cancer

Next topic: How is lung cancer treated with interventional pulmonology?

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