What Treatments Are Available for Lung Cancer
Lung cancer remains one of the most significant global health challenges. Advances in diagnostics and medical technology have expanded treatment possibilities, offering more personalised and effective care than ever before. Understanding the available treatment options is essential for patients and families navigating complex decisions.
This article outlines the main approaches used today, how they are selected, and what factors influence a treatment plan.
Surgery for Lung Cancer
Surgery is often considered when lung cancer is diagnosed at an early stage and has not spread extensively. The goal is to remove the tumour completely while preserving as much healthy lung tissue as possible.
The type of surgery depends on tumour size, location, and overall lung function.
Common procedures include:
- Wedge resection – removal of a small portion of lung containing the tumour
- Lobectomy – removal of an entire lobe of the lung
- Pneumonectomy – removal of an entire lung
- Segmentectomy – removal of a larger portion than a wedge but less than a full lobe
Minimally invasive approaches, such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery, have become more common. These techniques may reduce postoperative pain and shorten recovery time compared with traditional open surgery.
Not all patients are candidates for surgery. Lung function tests, imaging, and overall health assessments help determine whether surgery is appropriate and safe.
Chemotherapy and Systemic Treatment
Chemotherapy uses cytotoxic drugs to destroy rapidly dividing cancer cells. It may be used before surgery (neoadjuvant therapy) to shrink a tumour or after surgery (adjuvant therapy) to reduce the risk of recurrence. In more advanced stages, it may serve as a primary treatment.
Chemotherapy is administered intravenously or orally, typically in cycles. While effective, it can affect healthy cells, leading to side effects such as fatigue, nausea, and lowered immunity. Supportive medications are commonly used to manage these effects.
Systemic therapy may also include newer drug combinations tailored to tumour biology. Treatment decisions are increasingly guided by molecular testing, which identifies genetic mutations within the cancer cells.
Specialist thoracic expertise is essential for interpreting staging results and molecular findings, and for selecting the most appropriate systemic strategy. For more information on comprehensive lung cancer assessment and treatment pathways, visit here https://marcoscarci.co.uk/
Radiotherapy
Radiotherapy uses high-energy radiation to target and destroy cancer cells. It can be used alone or alongside surgery and chemotherapy.
In early-stage patients who are not suitable for surgery, stereotactic body radiotherapy (SBRT) offers a highly precise option. SBRT delivers focused radiation in fewer sessions while minimising exposure to surrounding healthy tissue.
For locally advanced disease, radiotherapy may be combined with chemotherapy to enhance treatment effectiveness. In advanced stages, it can also provide symptom relief, such as reducing pain or easing breathing difficulties caused by tumour obstruction.
Technological advancements have improved targeting accuracy, helping reduce damage to nearby structures such as the heart and oesophagus.
Targeted Therapy
Targeted therapy represents a major development in lung cancer treatment. These drugs are designed to interfere with specific genetic mutations or proteins that drive cancer growth.
Common molecular targets in non-small cell lung cancer (NSCLC) include:
- EGFR mutations
- ALK rearrangements
- ROS1 rearrangements
- BRAF mutations
- KRAS mutations (specific subtypes)
Testing tumour tissue for these mutations is now standard practice in many cases. If a relevant mutation is identified, targeted drugs may offer more precise treatment with fewer systemic side effects compared with traditional chemotherapy.
These medications are often taken orally and may be used in advanced or metastatic disease. Resistance can develop over time, so ongoing monitoring is essential.
Immunotherapy
Immunotherapy works by stimulating the body’s immune system to recognise and attack cancer cells. Unlike chemotherapy, it does not directly target the tumour but modifies immune pathways.
Immune checkpoint inhibitors are the most commonly used immunotherapy agents in lung cancer. They target proteins such as PD-1, PD-L1, or CTLA-4, helping immune cells overcome cancer-related suppression.
Immunotherapy may be used:
- As first-line treatment in advanced non-small cell lung cancer with high PD-L1 expression
- In combination with chemotherapy
- As consolidation therapy following chemoradiation in certain locally advanced cases
Some patients experience durable responses, though not all benefit equally. Side effects differ from chemotherapy and may include immune-related inflammation affecting organs such as the thyroid, lungs, or colon. Careful monitoring is required.
Choosing the Right Treatment Plan
Treatment selection depends on multiple factors. These include cancer type (non-small cell versus small cell), stage at diagnosis, molecular profile, overall health, and patient preference.
Staging plays a central role. Early-stage disease may be treated with surgery alone, while advanced disease often requires a combination of systemic therapies. Multidisciplinary teams, typically including thoracic surgeons, oncologists, radiologists, and respiratory physicians, collaborate to design individualised plans.
Performance status and coexisting medical conditions are also considered. Patients with reduced lung function or cardiovascular disease may require modified approaches. Advances in supportive care have made treatment more accessible to a broader range of individuals.
Clinical trials remain an important option. They provide access to emerging therapies and contribute to ongoing improvements in care standards.
Conclusion
Lung cancer treatment has evolved significantly, offering multiple approaches tailored to tumour characteristics and patient health. Surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy each play distinct roles depending on stage and molecular profile. Careful assessment and multidisciplinary planning are essential to selecting the most appropriate course of action, with treatment increasingly guided by precision medicine principles.
