Treatments
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When you have lung cancer, you want to be treated by a comprehensive team of doctors from multiple specialties. Studies show that multidisciplinary care, especially at a center like Columbia Cancer with a specific lung cancer program, can improve outcomes.
Your treatment for lung cancer will depend on the type you have.
- Non-small cell lung cancer treatment often starts with surgery to remove the tumor, followed by chemotherapy and other medications and precise radiation therapy.
- Small cell lung cancer is often treated with chemotherapy and radiation, sometimes at the same time or one after the other.
You may also receive therapy to empower your immune system against cancer cells or targeted therapy to attack changes in the genetic code of your cancer.
Surgery
For early non-small cell lung cancer, surgery may give you the best chance for a cure. Surgery is not available to you if you have advanced stage cancer.
You must pass pulmonary function tests to qualify for surgery. These tests determine if you’ll have enough healthy lung tissue left after surgery. People with more healthy lung tissue tend to do better with more extensive surgery. Removing more of your lung can provide a greater chance of a cure.
You might also have tests to check your heart and other organs to make sure you’re healthy enough to have an operation.
Your thoracic surgeon will determine which type of surgery you have, based on your tumor’s size and location, how well your lungs are working, and your health in general. All surgeries require general anesthesia and typically use an incision between the ribs on the side of your chest, called a thoracotomy. Your surgeon will also remove nearby lymph nodes to determine if cancer has spread.
Here are the types of surgery you might have.
- Pneumonectomy. Removing the entire lung.
- Lobectomy. Removing a lobe, an entire section of your lung.
- Segmentectomy, or wedge resection. Removing part of a lobe.
- Sleeve resection. Removing some cancers lodged in your lungs’ large airways.
Learn More About Lung Cancer Surgery
Medication
Chemotherapy
Chemotherapy uses medications (chemicals) to stop cancer growth and spread and to prevent cancer from recurring by causing rapidly dividing cancer cells to become damaged and die. Our challenge is finding the best combinations and sequence of the latest and most effective drugs that treat these cancers. We are leading this emerging science.
Chemotherapy “systemic” medicine—it interferes with all fast-dividing cells in your body. This is why it causes side effects like hair loss.
You’ll either get chemotherapy through an IV in our infusion center or perhaps through a pill, depending on the medication.
Chemotherapy drugs are designed to kill cancer and are generally given in cycles, with a period of treatment followed by a period of rest.
You might have chemotherapy before surgery (neoadjuvant) to shrink the tumor and make it more operable. You also might have it in combination with radiation therapy.
Non-small cell lung cancer
Most people with advanced non-small cell lung cancer, or NSCLC, have chemotherapy.
If your NSCLC has spread to lymph nodes in your chest and you’re still recommended for surgery, you may benefit from having chemotherapy before surgery. The treatment aims to shrink the tumor to make it more operable.
Small cell lung cancer
Because most people are diagnosed with small cell lung cancer after it’s spread, most people with this type of lung cancer have systemic chemotherapy as the first line of treatment. It’s also common to have chest radiation at the same time. This is called concurrent chemoradiation.
Immunotherapy
Your immune system is powerful. We now know how to harness that power to fight cancer. Our medical oncologists are using immunotherapy strategies alone and in combination with other treatments—backed by research being done in our labs and clinics. We are learning to better predict and select the best immunotherapy for your individual biology and unique cancer type.
You might have immunotherapy in combination with traditional treatments or afterward, depending on the type and stage of your cancer.
We also offer a wide range of clinical trials that evaluate new immunotherapies, before they are widely available. You should discuss with your doctor and care team if a clinical trial may be right for you.
Targeted Therapy
Non-small cell lung cancer has genetic mutations that we can target with specific drugs. By identifying specific mutations or characteristics in your cancer, we identify drugs that target those areas. These targeted therapies are usually most effective at killing your individual cancer. We also have an array of clinical trials for different targetable mutations.
Radiation Therapy
Radiation therapy causes cancer cells to break or die by targeting the DNA with high-energy particles, such as X-rays, gamma rays, electron beams, or protons. Radiation oncology specialists direct these particles to the tumor site from outside of your body to precisely target cancer cells, often sparing nearby tissue. You might hear this called external beam radiation therapy.
You might have radiation therapy before surgery to shrink your tumor or instead of surgery if you’re not a good candidate. You might also have radiation therapy aimed at sites of metastasis.
Clinical Trials
You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of lung cancer patients. Columbia Cancer offers several lung cancer clinical trials. You can talk to your care team about whether a clinical trial is an option for you.