Lung cancer
Treatment for lung cancer
Lung cancer treatment depends on the type, stage, grade of the cancer. Learn about each approach, possible side effects.
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Sometimes it is difficult to decide on the type of treatment to have. You may feel that everything is happening too fast, or you might be anxious to get started.
Check with your specialist how soon treatment should begin, as it may not affect the success of the treatment to wait a short time. Ask them to explain the options, and take as much time as you can before making a decision.
Know your options – Understanding the disease, the available treatments, possible side effects and any extra costs can help you weigh up the options and make a well-informed decision. Check if the specialist is part of a multidisciplinary team and if the treatment centre is the most appropriate one for you – you may be able to have treatment closer to home, or it might be worth travelling to a centre that specialises in a particular treatment.
Record the details – When your doctor first says you have cancer, you may not remember everything you are told. Taking notes can help. If you would like to record the discussion, ask your doctor first. It is a good idea to have a family member or friend go with you to appointments to join in the discussion, write notes or simply listen.
Ask questions – If you are confused or want to check anything, it is important to ask your specialist questions. Try to prepare a list before appointments (see page 63 for suggestions). If you have a lot of questions, you could talk to a cancer care coordinator or nurse.
Consider a second opinion – You may want to get a second opinion from another specialist to confirm or clarify your specialist’s recommendations or reassure you that you have explored all of your options. Specialists are used to people doing this. Your GP or specialist can refer you to another specialist and send your initial results to that person. You can get a second opinion even if you have started treatment or still want to be treated by your first doctor. You might decide you would prefer to be treated by the second specialist.
It’s your decision – Adults have the right to accept or refuse any treatment that they are offered. For example, some people with advanced cancer choose treatment that has significant side effects even if it gives only a small benefit for a short period of time. Others decide to focus their treatment on quality of life. You may want to discuss your decision with the treatment team, GP, family and friends.
Should I join a clinical trial?
Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments and ways of diagnosing disease to see if they are better than current methods. For example, if you join a randomised trial for a new treatment, you will be chosen at random to receive either the best existing treatment or the modified new treatment. Over the years, trials have improved treatments and led to better outcomes for people diagnosed with cancer.
You may find it helpful to talk to your specialist, clinical trials nurse or GP, or to get a second opinion. If you decide to take part in a clinical trial, you can withdraw at any time.
Treatment for lung cancer will depend on the type of lung cancer you have, the stage of the cancer, how well you can breathe (your lung function) and your general health. All treatments chosen for you will be expected to be safe and effective.
Understanding the aim of treatment
For early or locally advanced non-small cell lung cancer (stages 1–3 NSCLC) or limited-stage small cell lung cancer (stages 1–3 SCLC), treatment may be given with the aim of making the cancer go away. This is called curative treatment.
Because lung cancer causes vague symptoms or even no symptoms in the early stages, most people are diagnosed when the cancer is advanced (stage 4 NSCLC, stage 4 SCLC or extensive disease). This means the cancer has spread outside the lung to other parts of the body.
When cancer is advanced, the aim of treatment is often to maintain quality of life by controlling the cancer, slowing down its spread and managing any symptoms. This is called palliative treatment.
Sometimes palliative treatment can significantly shrink or control the cancer, helping people to live as fully and as comfortably as possible for many months or years. NSCLC and SCLC are treated in different ways (see table).
Treatment options by type of lung cancer and stage
| Non-small cell lung cancer (NSCLC) | |
| early (stage 1 or 2) | Usually treated with surgery, and for stage 1, a type of high-dose targeted radiation therapy called stereotactic body radiation therapy (SBRT). Stage 2 is sometimes treated with chemotherapy or immunotherapy before or after the surgery. |
| locally advanced (stage 3) | Can be treated with surgery and chemotherapy, or with radiation therapy and chemotherapy (without surgery). Immunotherapy may also be used. With some gene mutations, targeted therapy is starting to be used. Treatment will depend on where the cancer is in the lung, the number and location of lymph nodes with cancer and whether a surgeon can safely remove all of the visible cancer. |
| advanced (stage 4) | Depending on the symptoms, palliative drug treatment (targeted therapy, chemotherapy or immunotherapy), palliative radiation therapy, SBRT, or a combination of treatments may be used. This depends on the cancer cell type, how much the cancer has spread, the symptoms and the molecular test results. |
| Small cell lung cancer (SCLC) | |
| limited disease (stages 1–3) | Usually treated with chemotherapy and radiation therapy (called chemoradiation). Sometimes, surgery may be used for stage 1 disease. |
| extensive disease (stage 4) | Mainly treated with palliative chemotherapy, with or without immunotherapy. Palliative radiation therapy may also be given to the primary cancer in the lung and to other parts of the body where the cancer has spread to help control symptoms such as pain. |
Find out more about the types of treatments:
Sources and references
This edition has been developed by Cancer Council NSW on behalf of all other state and territory Cancer Councils as part of a National Cancer Information Subcommittee initiative. We thank the reviewers of this booklet: Dr Malinda Itchins, Thoracic Medical Oncologist, Royal North Shore Hospital and Chris O’Brien Lifehouse, NSW; Dr Cynleen Kai, Radiation Oncologist, GenesisCare, VIC; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Hospital, Epworth Richmond, and Monash Medical Centre, VIC; Helen Benny, Consumer; Dr Rachael Dodd, Senior Research Fellow, The Daffodil Centre, NSW; Kim Greco, Specialist Lung Cancer Nurse Consultant, Flinders Medical Centre, SA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Marco Salvador, Consumer; Janene Shelton, Lung Foundation Australia – Specialist Lung Cancer Nurse, Darling Downs Health, QLD; Prof Emily Stone, Respiratory Physician, Department of Thoracic Medicine and Lung Transplantation, St Vincent’s Hospital Sydney, NSW; A/Prof Marianne Weber, Stream Lead, Lung Cancer Policy and Evaluation, The Daffodil Centre, NSW. We would also like to thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
Lung cancer
Cancer Council 13 11 20
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