Treatment depends on the cancer's stage as well as the patient's condition, lung function, and other factors. (Some patients may have other lung conditions, such as emphysema or COPD—chronic obstructive pulmonary disease.) If the cancer has not spread, surgery is usually the treatment of choice. There are three types of surgery:
Wedge resection removes only a small part of the lung.
Lobectomy removes one lobe of the lung.
Pneumonectomy removes an entire lung.
Lymph nodes are also removed and examined to see if the cancer has spread.
Some surgeons use video-assisted thoracoscopy (VATS) to remove small, early-stage tumors, especially if the tumors are near the outer edge of the lung. (VATS can also be used to diagnose lung cancer.) Because the incisions for VATS are small, this technique is less invasive than a traditional "open" procedure.
Because surgery will remove part or all of a lung, breathing may be more difficult afterwards, especially in patients with other lung conditions (emphysema, for example). Doctors can test lung function prior to surgery and predict how it might be affected by surgery.
Depending on how far the cancer has spread, treatment may include chemotherapy (the use of anticancer drugs) and radiation therapy. These may be given before and/or after surgery.
When the tumor has spread significantly, chemotherapy may be recommended to slow its growth, even if it cannot cure the disease. Chemotherapy has been shown to ease symptoms and prolong life in cases of advanced lung cancer.
Radiation therapy can relieve symptoms, too. It is often used to treat lung cancer that has spread to the brain or bones and is causing pain. It can also be used alone or with chemotherapy to treat the lung cancer that is confined to the chest.
People who may not withstand surgery due to other serious medical problems may receive radiation therapy, with or without chemotherapy, to shrink the tumor.
In specialized cancer centers, cancerous tissue may be tested for specific genetic abnormalities (mutations). Doctors may then be able to treat the cancer with a "targeted therapy." These therapies can derail the cancer's growth by preventing or changing chemical reactions linked to particular mutations. For example, some target therapies prevent cancer cells from receiving chemical "messages" telling them to grow.
Knowing about specific genetic mutations can help predict which therapy will be best. This strategy can be especially helpful in certain patients, such as women with adenocarcinoma of the lung who have never smoked.
Even after treatment has been completed, lung cancer patients must return for regular follow-up appointments. Even if the cancer was initially "cured," it can return months or even years later.