Reviewed by: Gavin Wright, Chair of the VCOG Lung Committee & Thoracic Surgeon, St Vincent’s Health.
On this page: Surgery | After the operation | Chemotherapy | Radiotherapy | Multimodality therapy | Targeted therapy (biological agents) | Prognosis | When cancer can't be cured
Taken from 
Lung cancer booklet (1.3MB)
Many years of treating cancer patients and testing different treatments in clinical trials has helped doctors know what is likely to work for a particular type and stage of cancer. Your doctor will advise you on the best treatment for your cancer.
The main treatments for lung cancer are surgery, radiotherapy and chemotherapy. The choice of treatment will depend on the type of lung cancer you have, whether the cancer has spread beyond the lung, whether your lungs are working properly, your general health, and what you want.
The aim of treatment is to keep you as well and symptom free as possible, even if your cancer cannot be cured.
If your cancer has not spread beyond the lungs, your general health is reasonably good and your breathing capacity is sufficient, the treatment that gives the best chance of cure is surgery.
The most common operation, called a lobectomy, removes the affected part of the lung. Sometimes, the whole lung needs to be removed and this is called a pneumonectomy.
In patients with reduced lung function, smaller parts of the lung are removed to try to preserve breathing capacity. While these operations preserve breathing capacity, there is more likely to be a recurrence.
Your doctor will advise you of the best operation for you.
You will have an intravenous drip for a couple of days, and antibiotics. There will be one or two small tubes in your chest, connected to a plastic box, to drain fluid or air away: this can be uncomfortable but is only temporary. Regular x-rays will be done to make sure your lung or lungs are working properly. You may feel sick (nausea) from the antibiotics and other drugs.
You will have some pain after the operation, which is worst for the first 3 to 4 days. This may last for weeks or longer. Let your doctor or nurse know when you need relief from pain and they will provide pain-relieving drugs.
You will probably go home five to 10 days after the operation. You will receive advice about managing at home from your doctor, nurses, physiotherapist, occupational therapist and social worker.
Recovery can take many weeks for some people; however you may recover more quickly than this. Tingling, numbness or discomfort in the breast area is common and normal for several months after surgery, due to crushing of a nerve between the ribs. These sensations are caused by the nerve ‘waking up'.
Exercise will help you to recover and help with pain that may persist. To begin with, you will do breathing exercises and leg exercises; later, walking or swimming will improve your strength and fitness. Your doctor or physiotherapist will recommend the best exercises for you, and tell you when it is safe for you to begin more vigorous exercise.
If your breathing was not affected before the operation, you will probably find that you can breathe normally, even though you have had a lung or part of a lung removed. People who had breathing problems before the operation may find that they are more breathless afterwards, such as when walking up steps or hills.
This is the treatment of cancer with anti-cancer drugs. The aim is to destroy cancer cells while doing the least possible damage to normal cells. The drugs work by stopping cancer cells from multiplying.
Chemotherapy is the treatment of choice for patients with small cell carcinoma. As this type of cancer spreads quickly, chemotherapy works well in treating it.
Unfortunately, although the initial response is usually good, the cancer may come back (recurrent cancer) and be less sensitive to treatment.
You may also have chemotherapy after surgery to remove the cancer, to increase the chance of cure. This is called ‘adjuvant' chemotherapy.
Some drugs used in chemotherapy can cause side effects. They may include feeling sick (nausea), vomiting, feeling off-colour and tired, and some thinning or loss of hair from your body and head. Generally, these side effects are temporary, and can be prevented or reduced. Tell your doctor or nurse if you have any of them.
The medical oncologist will discuss these and other side effects and risks with you.
Radiotherapy treats cancer by using radiation to destroy or injure cancer cells. The radiation can be targeted onto cancer sites in your body. Treatment is carefully planned to do as little harm as possible to your normal body tissue.
Treatment is painless and may take only two to three minutes. Usually, radiotherapy is given as a number of treatments over a period of weeks. Normal tissues are less likely to be damaged using this method, which is called ‘fractionation'.
To make sure that exactly the same area is treated each time, the radiation therapist will make a number of marks on your skin. These may include a tiny, barely visible tattoo in addition to non-permanent marks.
Radiotherapy may be used to cure some early stage lung cancers. It may be used with chemotherapy to contain cancer that has spread to the lymph nodes.
When lung cancer cannot be cured, radiotherapy can be used to relieve pain and other symptoms, for example pain caused by cancer that has spread to the bones or brain. Treatment that is used to relieve symptoms of disease without attempting to cure disease is called palliative treatment.
Side effects of radiotherapy may include general tiredness and feeling sick (nausea). Skin in the treatment area may become dry and red, but this is unusual with modern techniques.
Other side effects can include problems with swallowing because the throat is inflamed; this becomes better when treatment finishes.
The lung can also become inflamed (this is called ‘pneumonitis'). This is uncommon, but can cause a cough and shortness of breath. If it occurs, it is usually two to three months after treatment finishes, and usually gets better by itself. Sometimes it may need treatment with medication.
Talk with your doctor or the radiotherapy staff about any possible side effects and how to manage them.
For some people, several treatments used together give the best results. Examples are adjuvant chemotherapy after surgery, or chemotherapy and radiotherapy at the same time. This is called multimodality therapy.
Different aspects of your treatment may be supervised by different doctors. Ideally, your treatments and treatment plan will be discussed in a meeting involving the different specialities.
Some people, usually non-smokers, are suitable for a new kind of drug that targets the growth genes and/or the blood-vessel forming genes of the cancer cells. These drugs tend to have not as many side effects as the usual chemotherapy drugs, although they can cause rashes.
Usually targeted therapy will be used after normal chemotherapy no longer controls the disease. Your doctor may order a special gene test to see if your cancer is susceptible to this type of drug.
If your cancer cannot be removed, and surgery or radiotherapy could be unsafe because of your age or frailty, doctors sometimes advise just observing your health and treating any symptoms that occur. This involves regular check-ups with your doctor. If symptoms appear, you will have treatment for them, so any pain or discomfort that occurs will be dealt with.
If your doctor recommends this approach, and you have any questions about it, ask your doctor to explain why they think this is the best approach for you.
As in most types of cancer, the results of treatment are best when the cancer is detected and treated early. People who have surgery in the early stages of lung cancer have a very good chance of cure.
In many people, lung cancer is not found while it can still be operated upon. In people with advanced cancer, palliative treatment with radiotherapy can effectively treat many symptoms.
People who continue to smoke after lung cancer treatment are at risk of further disease. If you need help quitting smoking, speak to your doctor or nurses or contact the Quitline on 13 7848.
If you would like information about your own prognosis, you need to speak to a doctor who knows your medical history.
If your cancer has spread and it is not possible to cure it by surgery, your doctor may still recommend treatment. In this case, treatment may help relieve any symptoms, can make you feel better and may allow you to live longer.
Whether or not you choose to have anti-cancer treatment, symptoms can still be controlled. For example, if you have pain, there are effective treatments for this.
Sometimes fluids build up in the chest because of the spread of the cancer. This can be removed with a needle. If it comes back, it can be treated with surgery to stick the lung to the chest wall.
If an airway becomes blocked by a cancer growing in it or by pressure from outside the airway, this can be relieved. A cancer in an airway can be removed using a laser through the bronchoscope; a stent can relieve external pressure on an airway.
Sometimes, people develop blood in the sputum (haemoptysis). This may be controlled by laser bronchoscopy or radiotherapy, or by blocking the artery to the affected area.
General practitioners, specialists and palliative care teams in hospitals all play important roles in helping people with cancer. For further information, contact the Cancer Council Helpline on 13 11 20 or Palliative Care Victoria on 9662 9644.
A lot of research is being done, especially in these areas:
At the moment, no blood test can detect lung cancer. However, researchers are looking for things that will show which patients are at significant risk of further cancer, so they can be carefully monitored or take preventative chemotherapy.
There is evidence that the survival of lung cancer patients is slowly improving. People with lung cancer often are able to take part in clinical trials, which helps doctors to work out which treatments work best.
