Disclaimer: This guide provides general information and is not medical, legal, or financial advice. Always consult your healthcare providers, insurer, or attorney for guidance specific to your situation.

A Guide to Lung Cancer Treatment Options

Your doctor may recommend one or more treatments for lung cancer: surgery, chemotherapy, radiation therapy, immunotherapy, or a combination. Understanding what each treatment involves, how it works, and what side effects to expect helps you prepare mentally and physically for the road ahead.

Surgery: Removing the Tumor

Surgery aims to remove the cancerous tumor and surrounding tissue. It’s most effective for early-stage lung cancer that hasn’t spread beyond the lung. The type of surgery depends on tumor size, location, and your overall lung function.

Types of Surgeries

• A wedge resection removes the tumor and a small amount of surrounding healthy tissue. Segmentectomy removes a larger portion of the lung.
• Lobectomy removes an entire lobe of the lung (the right lung has three lobes, the left has two).
• Pneumonectomy removes an entire lung and is only done when necessary.

Many lung cancer surgeries today use minimally invasive techniques with smaller incisions, resulting in shorter hospital stays and faster recovery compared to traditional open surgery.

Chemotherapy: Targeting Cancer Cells Throughout the Body

Chemotherapy uses drugs to kill cancer cells or stop them from growing. Unlike surgery or radiation, which target specific areas, chemotherapy travels through the bloodstream to reach cancer cells throughout the body.

Doctors may use chemotherapy before surgery to shrink tumors, after surgery to kill remaining cancer cells, in combination with radiation therapy, or as the primary treatment when surgery isn’t possible. You may receive chemotherapy in cycles, typically treatment for a few days followed by rest weeks to let your body recover. Many people receive four to six treatment cycles.

Chemotherapy is usually given intravenously through an IV line in your arm or through a port placed under your skin. Some chemotherapy drugs come as pills you take at home. Each treatment session takes a few hours at an infusion center or hospital.

Common side effects may include fatigue (which may worsen over time), nausea and vomiting (though medications can help prevent this), hair loss from certain drugs, increased infection risk due to low white blood cell counts, and appetite changes. Not everyone experiences all side effects, and their severity varies significantly between patients.

Most side effects are temporary and resolve after treatment ends. Your oncology team monitors your blood counts regularly and adjusts treatment if side effects become severe.

Radiation Therapy: Targeting Cancer with High-Energy Beams

Radiation therapy uses high-energy rays to damage cancer cell DNA and stop their growth. It precisely targets tumors while minimizing damage to surrounding healthy tissue. External beam radiation is the most common type for lung cancer.

Doctors may use radiation before surgery to shrink tumors, after surgery to kill remaining cancer cells, combined with chemotherapy, or to relieve symptoms caused by tumors pressing on airways or other structures. Treatment typically occurs five days a week for five to seven weeks. Each radiation session typically takes only 10 to 15 minutes, though you’ll be at the treatment center longer for setup and positioning. The treatment itself is usually painless. You lie still on a table while the radiation machine moves around you, delivering beams to the exact location ofyour tumor.

Side effects could develop gradually and may include fatigue that increases throughout treatment, skin changes in the treatment area similar to sunburn, difficulty swallowing if radiation targets the upper chest, shortness of breath, and cough. Many side effects improve within a few weeks after treatment ends, though some fatigue may linger longer.

Immunotherapy: Helping Your Immune System Fight Cancer

Immunotherapy is a newer treatment approach that helps your own immune system recognize and attack cancer cells. Cancer cells often hide from the immune system, and immunotherapy drugs remove these “disguises”.

Checkpoint inhibitors are the most common immunotherapy for lung cancer. These drugs block proteins that prevent immune cells from attacking cancer. They work particularly well for some patients with advanced lung cancer.

Immunotherapy is given intravenously, typically every two to three weeks. Treatment usually continues as long as it’s working and side effects remain manageable. Some patients may stay on immunotherapy for years.

Immunotherapy side effects generally differ from chemotherapy. They occur because your immune system becomes more active. Common effects may include fatigue, skin rash, diarrhea, and inflammation in various organs like the lungs, liver, or thyroid. While generally milder than chemotherapy side effects, immune-related side effects can be serious and require prompt treatment.

Not all lung cancer patients respond to immunotherapy. Your doctor may test your tumor for specific biomarkers that predict whether immunotherapy will work for you. Testing for PD-L1 expression and tumor mutation burden helps guide treatment decisions.

Combining Treatments for Better Results

Many patients receive more than one type of treatment. Combining treatments often produces better outcomes than a single treatment alone.

Neoadjuvant therapy means treatment before surgery to shrink tumors. Adjuvant therapy is treatment after surgery to reduce recurrence risk. Concurrent therapy delivers chemotherapy and radiation simultaneously. Sequential therapy gives treatments one after another.

Your oncology team considers your specific cancer characteristics, overall health, and treatment goals when recommending a combination approach.

Managing Treatment Side Effects

Side effects are challenging, but many strategies can help. Staying ahead of nausea by taking anti-nausea medication before it becomes severe can provide significant relief. Eating small, frequent meals when appetite is poor can help you stay nourished. Rest when needed, but try tostay as active as possible to maintain strength. Report new or worsening symptoms to your doctor immediately.

Your medical team can adjust medications, provide supportive care treatments, or modify your treatment plan if side effects become too difficult. Never try to manage severe side effects on your own without telling your doctor.

Questions to Ask Your Doctor

Before starting any treatment, ask why your doctor recommends this specific approach and what alternatives exist. Find out how many treatments you’ll need, what side effects to expect, and how the treatment might affect your daily life. Ask what symptoms should prompt an immediate call to the doctor and what happens if the treatment doesn’t work as hoped.

Understanding your treatment plan reduces anxiety and helps you prepare practically and emotionally.

Financial Considerations

Cancer treatment is expensive. Before beginning treatment, speak with the hospital financial counselor about costs, insurance coverage, and assistance programs. For lung cancer patients whose illness resulted from workplace asbestos exposure, legal compensation may help cover treatment-related costs.

Moving Forward

Modern lung cancer treatments are more effective and tolerable than ever before. While treatment is challenging, most patients can maintain a reasonable quality of life during treatment and return to normal activities afterward. Your medical team is there to support you through every step, managing side effects and adjusting your plan as needed.

Focus on taking treatment one day at a time, accepting help from family and friends, and communicating openly with your doctors about how you’re feeling.