Lung Cancer treatment

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Once lung cancer has been diagnosed, a multidisciplinary committee evaluates each case individually to offer the treatment with the greatest possibility of a cure.

The committee is made up of all the professionals directly linked to the disease diagnosis and treatment process, such as specialists in pulmonology, radiology, nuclear medicine, pathology, medical oncology, radiotherapy, thoracic surgery, molecular biology and advanced nursing practice in lung cancer.

Once agreed, the physician responsible informs the patient of the decision and explains the treatment.

The type of treatment is chosen based on the following factors:

There are several types of therapeutic approaches that can be taken for lung cancer, either individually or in combination, depending on the extent of the disease and the biological properties of the tumour:

  • Surgery
  • Non-surgical treatment
  • Other treatments
  • Palliative treatment

Surgical procedures aim to completely eliminate all tumour cells and cure the disease. The location and size of the tumour determine the extent of surgery required. DDepending on the case, additional treatment may be included before or after: radiotherapy, chemotherapy, immunotherapy or other targeted therapies. Surgery offers the best chance of cure and is indicated for patients with early stage lung cancer who have good overall health. Around 30% of patients with lung cancer can benefit from surgical treatment.

After selecting this approach, the type of surgery to be carried out is assessed:

Lung lobectomy

Lobectomy. Surgical procedure involving removal of the lobe of the lung containing the tumour. The right lung is divided into three lobes (upper, middle and lower), while the left comprises two lobes (upper and lower). A lobectomy, accompanied by removal of the lymph nodes, is the standard treatment for early stage lung cancer.


Pneumonectomy. Surgery to remove an entire lung. This operation is performed on tumours located in the bronchi, the lung’s main airways, or when the tumour affects more than one lobe.

Lung segmentectomy

Segmentectomy. Each lobe is in turn composed of several segments. When the tumour is small and located in a peripheral area of the lung, then just the affected segment can be removed and the rest of the lobe preserved. Segmentectomies are carried out in patientswith benign tumors, of low malignancy or those cancers of less than 2 cm in size that can ensure safe oncological margins. It is also indicated in cases of lung metastasis due to a cancer originating in another organ, or in those patients who would not tolerate a broader lung resection given their overall condition.

Sublobar resections of a lung

Atypical sublobar resection. This involves removing a portion of the affected lung lobe. As with segmentectomies, they are carried out in patients with benign or low malignancy tumours, in cases of lung metastasis due to a cancer originating in another organ, or in those patients who would not tolerate a broader lung resection given their overall condition. It can also be carried out in lung cancers of less than 2 cm in size that can ensure oncologic safety margins or that, due to the patient's physical condition, the other surgical options are not advisable.

As with any other surgery, that of lung cancer involves risks and complications. Some of the most common are:

  • Infection
  • Accumulation of air between the lung and the chest wall (pleural cavity) that can cause a collapse of the lung (tension pneumothorax)
  • Bleeding (haemorrhage)
  • Tube opening between a bronchiole and the pleural cavity that leads to the filtration of air or fluid into the surgical area (broncho-pleural fistula)
  • Accumulation of pus in the chest cavity (empyema)

There may be other risks, depending on the state of health of the individual. It is important to consult the medical team of any doubts before this procedure.

Nowadays, there are numerous therapeutic options available to treat lung cancer:

Intravenous chemotherapy bag

Chemotherapy is still one of the most widely used systemic treatments for lung cancer, either on its own or in combination with other therapies. It works by inhibiting cell division for both tumour and healthy cells. Thus, adverse or side effects associated with this treatment may be experienced.

Chemotherapy is generally administered intravenously, although in some cases it can be provided orally. It can be given as a combination of two or more drugs (polychemotherapy) or just one (monotherapy).

Among the most widely used drugs are platinum derivatives (cisplatin and carboplatin), antifolates (pemetrexed), taxanes (paclitaxel and docetaxel), vinorelbine, gemcitabine and etoposide. The number of treatment cycles depends on the patient and the tumour stage, although generally 4-6 cycles are administered.

Sample tube and antibodies for Ro (or SS-A) and La (or SS-B) test

Immunotherapy is one of the most important advances that has proven to be effective in the treatment of lung cancer. It consists of administering a drug that stimulates the patient's own immune response, to recognise and destroy the tumour. It can be performed on its own or in combination with chemotherapy. Selection is based on markers evaluated in the tumour sample.

Immunotherapy is generally better tolerated than chemotherapy, but it can also have unwanted side effects due to the stimulation of the immune system.

Immunotherapy is provided intravenously in different administration regimens (every 2, 3 or 4 weeks). It is indicated for the treatment of advanced non-small cell lung cancer, as well as small cell lung cancer. It can also be given as adjunctive treatment before or after surgery.

Drug with a target and an arrow

Targeted, or oral, therapy has also revolutionised the treatment of this disease. This treatment blocks the growth of certain tumours with very specific genetic properties.

Tumours for which targeted treatments are currently available include those with alterations in the EGFR, ALK, RET, ROS1, and METex14 genes. Other genes with targeted therapies not yet authorised in Spain are KRASG12C, BRAFV600E, NTRK, EGFR and HER2 exon 20 insertions.

Unlike chemotherapy, many of these treatments are administered orally and are better tolerated. To find out if the patient can be treated with any of these biological treatments, a molecular study is performed on the tumour sample to determine the probability of response to treatment.

Radiotherapy symbol

Radiation therapy or radiotherapy delivers high-energy X-rays to kill cancer cells. It is used often in lung cancer and can be given alone or in combination with chemotherapy or immunotherapy to: shrink the tumour before surgery; kill cancer cells after surgery; or alleviate symptoms of the tumour spreading outside the lung, such as to the brain or bones.

Each specific treatment administered has different side effects. These must be reported by the doctor or advanced practice nurse before starting treatment. Early identification and prevention can improve associated symptoms.

  • Chemotherapy. Among the side effects that may appear are: fatigue (asthenia), a change in the taste of food, nausea, vomiting, hair loss, inflammation of the mucosa of the mouth, fever, constipation or diarrhoea, abdominal and muscle pain, hives and nail lesions. If you have any questions, you should discuss them with your medical team. 
  • Immunotherapy This can cause inflammation or abnormality in any organ or tissue, such as endocrine organ dysfunction and thyroid or adrenal glands failure. Among the most common side effects are: fatigue (asthenia), itching, skin redness and muscle and joint pain. If you have any questions, you should discuss them with your medical team. 
  • Targeted therapy Side effects are very variable, depending on the type of therapy administered. Each patient has to receive therapeutic education tailored to the type of personalised treatment being administered.
  • Radiotherapy. This may lead to skin irritation, inflammation of the oesophageal mucosa (oesophagitis or difficulty swallowing) and fatigue. Pneumonitis (lung tissue inflammation) may appear months after the treatment is over and may be accompanied by increased respiratory distress. If you have any questions, you should discuss them with your medical team. 

Cancer is associated with a wide range of physical problems but it also entails emotional ones. Lung cancer treatment must focus on all of these aspects.

Various studies have shown that palliative treatment not only improves the quality of life in patients with advanced lung cancer but it can also help them live longer.

Palliative care helps alleviate physical symptoms, such as pain, while also addressing the emotional and spiritual anxiety felt by patients and their families.

What is Cancer?

General information about Cancer

Read more

Substantiated information by:

David Sánchez Lorente
Laureano Molins López-Rodó
Mari Carmen Rodríguez Mues
Noemí Reguart Aransay
Nuria Viñolas Segarra
Ramón Marrades Sicart

Published: 20 February 2018
Updated: 26 September 2023

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.


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