Lung Cancer Treatment and Survival Rate

January 24, 2025

This page was reviewed under our medical and editorial policy by Jyoti Malhotra, M.D., M.P.H., associate professor, Department of Medical Oncology & Therapeutics Research, City of Hope^® Orange County Lennar Foundation Cancer Center; and Jae Y. Kim, M.D., associate professor, Division of Thoracic Surgery, Department of Surgery, City of Hope Cancer Center Duarte; and Arya Amini, M.D., associate professor, Department of Radiation Oncology, City of Hope Cancer Center Duarte 

People diagnosed with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) have several surgical and therapy options available to them. The specific treatments the care team recommends will vary based on the type of lung cancer the patient has, its stage (tumor size and how far it has spread) and the individual’s treatment preferences. Doctors also consider the patient’s age and overall health when prescribing a treatment plan.

For NSCLC, which accounts for about 80% to 85% of lung cancer diagnoses, the presence of certain gene mutations (changes) and symptoms, such as coughing or trouble breathing, also help shape the doctor’s treatment recommendations.

Who Treats Lung Cancer?

The lung cancer care team works together to find the most targeted, least invasive treatment for each patient, with the goal of preserving their lung function and quality of life. This care is coordinated by a multidisciplinary team working together to determine the optimal treatment options for the individual.

The lung cancer care team may include these doctors:

• Thoracic surgeons, who perform operations on conditions of the chest cavity and lungs
• Pulmonologists, who are trained to treat lung diseases
• Medical oncologists, who use a variety of medicines, including chemotherapy, immunotherapy and targeted drug therapy, to help treat cancer
• Radiation oncologists, who specialize in the different types of radiation therapy used to treat cancer

Lung Cancer Treatments

To treat lung cancer, the care team may recommend procedures that directly remove or destroy cancerous cells and/or systemic medications to target cancer cells in the lungs and throughout the body.

Lung Cancer Surgery

Surgery is a main treatment of choice for NSCLC that is in its early stages. It also may be combined with other therapies to treat cancer that is locally advanced, meaning it has spread to nearby areas but not to distant parts of the body.

For patients diagnosed with SCLC, the disease has usually spread too far beyond the lung for surgery. However, SCLC that is diagnosed before it has spread beyond the lung, area lymph nodes or the region between the lungs may be treated with a combination of surgery and therapies like chemotherapy and radiation therapy.

Patients may be considered for lung cancer surgery if diagnostic tests reveal that enough healthy lung tissue would remain after the operation to allow for proper lung function.

There are several types of surgical treatments for lung cancer.

Lobectomy: This is the removal of an entire lobe of the lung. This is the most common type of surgery to treat lung cancer.

Segmentectomy: This is the removal of a large segment of a lobe of the lung.

Wedge resection: This is the removal of a piece of lung (smaller than a segment).

Pneumonectomy: This is the removal of the entire lung on one side.

Sleeve resection: This involves removing part of the airway, with or without the lobe of the lung, and sewing the airway back together. This procedure is usually done to avoid removing the entire lung.

Sleeve lobectomy: This is a sleeve resection with lobectomy during which the entire lobe of the lung containing the cancer tumor is removed along with part of the airway (bronchi), followed by the reattachment of the remaining airway ends.

How Is Lung Cancer Surgery Done?

Surgery to treat lung cancer is performed using either an open lung surgery technique called thoracotomy or with minimally invasive techniques such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery. Doctors sometimes recommend minimally invasive surgery to help reduce the side effects that may result from lung surgery, such as pain and scarring.

The technique depends on the patient, the type of cancer and the surgeon. Patients are put to sleep during each type of operation using general anesthesia medications.

Robotic-assisted surgery: This minimally invasive operation is performed through several small incisions. This procedure uses a tiny video camera to view the inside of the chest, as well as robotically controlled instruments that surgeons operate with hand and foot controls.

VATS: This is also performed through small incisions. Surgeons insert long instruments and a tiny video camera through the incisions, allowing them to perform the same procedures as in a thoracotomy without having to spread the ribs.

Thoracotomy: This is traditional open surgery, in which a large incision is made in the chest and the ribs are spread in order to reach the lung tissue.

Radiation Therapy

Radiation therapy plays a pivotal role in the treatment of lung cancer of all stages. For patients with early-stage lung cancer, radiation therapy may lead to long-term positive outcomes.

Lung cancer radiation therapy is the main treatment for NSCLC when surgery is not an option because of tumor size or location. It is also used before surgery to help shrink the cancer tumor, after surgery to help ensure all the cancer is destroyed or to treat NSCLC that has spread (metastasized) to other parts of the body. Radiation therapy may be given alone or alongside chemotherapy.

For patients diagnosed with SCLC with limited spread, the doctor may prescribe radiation therapy to shrink the tumor and destroy cancer cells in nearby lymph nodes, sometimes in combination with chemotherapy. In more advanced SCLC, radiation therapy may be used after the patient finishes chemotherapy. Sometimes radiation therapy is used to reduce the risk of the cancer spreading to the brain.

Radiation therapy is used as palliative therapy for both types of lung cancer to help shrink tumors and relieve symptoms.

Types of radiation therapy for lung cancer include those listed below.

External beam radiation therapy: EBRT uses a machine to send radiation from outside the body to the cancer cells. Treatments last for a few minutes at a time, usually for three to seven weeks, although this may vary.

Intensity-modulated radiation therapy: IMRT is a type of EBRT that uses 3D technology to aim the radiation beams from several angles. It also adjusts the beams’ strength to help limit damage to nearby tissues or structures.

Brachytherapy: This is a type of internal radiation therapy that delivers radioactive material to lung cancer tumors that may be blocking an airway. Currently, EBRT is the preferred radiation therapy method for lung tumors, and brachytherapy isn’t typically used as a lung cancer treatment.

Stereotactic body radiation therapy: SBRT, or stereotactic ablative radiotherapy (SABR), is a type of EBRT that may be deployed for early-stage cancers if surgery is not an option. It uses highly focused beams to deliver high-intensity radiation over fewer treatment sessions (usually one to five).

Stereotactic radiosurgery: SRS is a type of stereotactic radiation therapy that may be used alone or along with surgery. It delivers high-intensity radiation directly to the tumor in one session (which may be repeated) and is often used for a tumor that is in one spot or that has spread to the brain.

Chemotherapy

Chemotherapy for lung cancer uses drugs to interfere with cancer cells’ ability to grow and divide. Different drug combinations work in different ways to fight cancer cells.

Chemotherapy for NSCLC may be used before surgery to shrink the tumor, after surgery to destroy any remaining cancer, or as the main treatment when surgery is not an option because of cancer tumor size or location. It is also given if lung cancer has spread to other parts of the body like the brain, liver, bones or adrenal glands. It may be given alone or alongside radiation therapy.

People diagnosed with SCLC usually receive chemotherapy alongside radiation therapy when the cancer’s spread is limited. Chemotherapy is also used alone or with immunotherapy treatments if SCLC has spread more extensively.

Microwave Ablation

Sometimes patients with lung cancer are not candidates for surgery because they are not healthy enough, the tumor is located in a challenging location or the disease is too advanced. In these cases, doctors may recommend a treatment called microwave ablation, which is similar to radiofrequency ablation.

With microwave ablation, heat is applied to the tumor using electromagnetic waves, resulting in tissue death. Microwave ablation involves a needle-like instrument known as a probe or a bronchoscope that is typically used to deliver the electromagnetic waves to the tumor. The patient is given local anesthesia to numb the nerves or general anesthesia to put them to sleep during the procedure.

Photodynamic Therapy

Photodynamic therapy is an interventional pulmonology procedure that combines drug therapy with laser light therapy to shrink tumors and help open obstructed airways.

The entire process takes several days to complete. A few days prior to the procedure, a drug called Photofrin^® (porfimer sodium), which tends to gather in cancer cells more than in normal cells, is injected into a vein. Because porfimer sodium is a photosensitizer, when light of a certain wavelength hits it, it produces a type of oxygen that destroys cancer cells where the drug has gathered. To deliver this light, a laser is attached to a bronchoscope that is inserted down the throat and into the lung. The laser light is aimed at the tumor to activate the drug and destroy the cancer cells.

Photodynamic therapy is a treatment for lung cancer that is typically used for early stages of the disease. It may be an option for both SCLC and NSCLC.

Immunotherapy

Cancer immunotherapy is a treatment that harnesses parts of the patient’s own immune system to fight cancer. One way that cancer cells grow out of control is by “tricking” the immune system into not attacking them. Immunotherapy works by helping the body’s immune system recognize and destroy cancer cells.

Different immunotherapy treatments work differently. Some boost the body’s overall immune response. Others work by injecting manmade versions of immune system proteins into the body. Lung cancer immunotherapy drugs have been approved for treating some types of lung cancer, and in some cases these treatments work better than conventional chemotherapy.

Immunotherapy for lung cancer is sometimes used in combination with chemotherapy for SCLC that has spread too far outside the lungs for treatment with surgery or radiation therapy. It is also used to treat small cell lung cancer that has returned (recurred), either alone or alongside other therapies. A combination of immunotherapy drugs is usually given.

For NSCLC, immunotherapy may be used at every stage of the disease. It is often given either before or after surgery (or both) for early-stage NSCLC. For more advanced cancer or cancer that returns at a distant site, immunotherapy may be recommended as a main treatment in combination with other therapies like chemotherapy, radiation therapy and targeted drug therapy.

Targeted Therapy

Targeted therapy is based on understanding the genetic makeup of an individual patient’s cancer. To pinpoint the genetic makeup of cancer cells, the care team may perform next-generation sequencing, which is a type of molecular testing. By analyzing the unique genetic makeup of a tumor, cancer experts are able to design more personalized therapies to block cancer growth. They do so by targeting gene mutations in the cancer.

Targeted therapy for lung cancer interrupts the growth and function of cancer cells by zeroing in on certain abnormalities in lung cancer cells. This affects cancer cells only and it helps to reduce damage to healthy cells.

Compared to conventional chemotherapy drugs, medications that target specific mutations often have better response rates. In many cases, targeted therapies are also less toxic to healthy cells, which may mean fewer side effects.

Advanced-stage NSCLC is often treated with targeted drug therapy, either alongside chemotherapy or by itself if chemotherapy has failed to destroy the lung cancer cells. Targeted therapy drugs work by destroying blood vessels that supply nutrients to the tumors. They also help target and inhibit certain cancer-growth-promoting proteins that are produced when genes mutate.

For SCLC, targeted drug therapy is less common, but it may be used if the disease progresses or returns after other treatments like chemotherapy if they fail to successfully shrink the cancer. For instance, the new targeted immunotherapy drug Imdelltra^™ (tarlatamab) may be given to patients who have already had chemotherapy. For some patients, it helps the T cells of the immune system detect a protein on the surface of SCLC cancer cells and destroy them.

Palliative Care

Palliative care helps treat lung cancer and the side effects of cancer therapy, with the goal of making patients more comfortable and improving their quality of life. Having cancer and cancer treatment may cause many effects in the body.

Physical palliative support includes several procedures to relieve the effects of lung cancer on the patient’s ability to breathe and on their heart.

Thoracentesis: This procedure uses a hollow needle placed between the ribs to drain fluid buildup around the lungs.

Pleurodesis: This removes fluid buildup from the lungs using a hollow tube and also includes placement of a substance in the lungs to help reduce new fluid buildup.

Catheter placement: This places one end of a thin, flexible tube in the chest with the other end in a bag that collects excess lung fluid.

Pericardiocentesis: This is the drainage of fluid around the heart with a needle, typically using an imaging technique called an echocardiogram.

Pericardial window: This involves surgical removal of the sac around the heart (pericardium) to enable excess heart fluid to drain into the abdomen (belly) or chest.

Stent placement: This helps open the airway if a tumor is blocking it by inserting a metal tube (stent) with guidance from an instrument called a bronchoscope.

Laser therapy: For this treatment, a doctor attaches a laser to a bronchoscope, which is inserted down the throat, allowing for a targeted laser beam to burn the tumor away and help open up the airway.

Photodynamic therapy (PDT): This laser therapy activates a special cancer-cell-destroying drug, which is given to the patient a few days prior to the procedure.

Palliative care brings the patient’s caregivers into the treatment planning process to ensure that patients and their loved ones receive comprehensive care, including the following.

Emotional support: Mental health and emotional support resources are provided to help patients, their families and caregivers cope with the complex emotions that often accompany a lung cancer diagnosis.

Value-based guidance: Palliative care professionals provide patients and their loved ones with supportive guidance by helping them explore their beliefs about being diagnosed with lung cancer and helping them process the diagnosis.

Day-to-day guidance: Resources and knowledge about medical insurance, financial obligations, legal issues and other practical matters are offered by palliative care experts.

Lung Cancer Survival Rate

The number of people dying from lung cancer has been decreasing as more people quit smoking and take advantage of advances in early detection screening, according to the American Cancer Society.

The survival rate for the disease varies based on a number of factors, including the type, subtype and stage of lung cancer; the patient’s age and overall health when diagnosed; their response to treatment; and whether certain mutations are present in the cancer cells.

The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program Database is often used to measure the five-year relative survival rate for lung cancer, which is the percentage of people with lung cancer who survive for five years or more after diagnosis, compared to the general population.

The NCI reports that the overall five-year relative survival rate for all lung and bronchus cancer stages was 28.1% for people diagnosed between 2015 and 2021, based on SEER data.

This survival rate estimate varies based on whether the disease was diagnosed before it spread outside the lung or bronchus tissue (localized stage), after it spread to area lymph nodes and structures (regional stage) or after it spread to distant parts of the body (distant stage), as detailed below.

Localized: 64.7%

Regional: 37.1%

Distant: 9.7%

Patients should discuss their prognosis with their lung cancer care team to ensure they receive the most personalized and current information.

Learn about the non-small cell lung cancer survival rate

Learn about the small cell lung cancer survival rate

Learn about the carcinoid lung tumor survival rate

The City of Hope Difference

City of Hope takes a team-based approach to patient health and offers access to advanced procedures that are not available at other centers. The cancer center’s benefits include thoracic specialists who are among the top performers when it comes to minimally invasive, lung-sparing surgery for lung cancer. With locations across the country, City of Hope’s premier treatment is available close to home, with same-day appointments at many sites.