Lung cancer can be treated by chemotherapy, radiation therapy, surgery or by a arrangement of different treatments. Which treatment is best for the patient is based upon the general health condition of the patient and on the affected location. The therapy prescribed may be curative or palliative. In cases where multiple treatments are prescribed, the therapy given to increase the primary therapy’s effect is called the adjuvant therapy. 

Surgery is usually performed with NSCLC rather with SCLC. Around 10 to 35 percent of lung cancers are treated by surgery. Patients with Stage I or Stage II cancers where the cancer has not spread outside the lungs undergo this. However, this is not a complete cure and may reoccur. Also if the patient suffers from severe lung or heart diseases, doctors recommend against the operation as the chances of survival get limited. The site and size of tumor decides what procedure needs to be performed a lobectomy, a pneumonectomy, a wedge resection or a lymphadenectomy. The surgery is done under general anesthesia and includes complications like bleeding and infection. It requires hospitalization and follow up care for months. The patient may have weakness, pain and difficulty in breathing following the surgery. 

Radiation therapy is used for treating both NSCLC and SCLC in cases where surgical elimination of tumor is not an option like cancer in trachea or lymph node or patient is not fit enough to undergo surgery. Here high-energy X-rays and several other kinds of rays are directed to the affected area through a machine or injected inside the body to shrink and limit the development of cancer cells. It can be performed as curative, palliative or adjuvant therapy. A method of placing a small radioactive pellet inside the cancer or near its airways with the help of a bronchoscope is called brachytherapy. Radiotherapy given in along with administered chemotherapy can extend lifespan.

Gamma knife is an external radiation used in treating single brain metastases. Here the tumor is exposed to multiple radiation beams from many directions for the prescribed time with the head held in position by a firm frame, reducing the exposure of radiations on non cancerous tissues. Before taking external radiation one must do simulation, a process that maps out the definite locations where radiation needs to be delivered or the treatment ports with the help of computers, precise measurements and CT scans. Depending on the criticality, the process may take half-an-hour to 2 hours and external radiation anywhere between four days to several weeks. 

People with severe lung diseases along with lung cancer must not take radiotherapy as it further reduces the functioning of lungs. Though it does not carry any major risks like in surgery but the patient may feel drained out and display shortage of energy with low white blood cell count and blood platelet levels. Exposure of digestive organs to radiation can cause diarrhea, vomiting and nausea. 

Chemotherapy can be given by itself, as an adjuvant after surgery or along with radiotherapy. Chemotherapy treats both SCLC and NSCLC and is a process where drugs are administered to the patient for stopping the development ofcancerous cells or killing them. Amongst all chemotherapeutic drugs, platinum-based drugs are considered most effective for lung cancers. For SCLC cases where the tumors are spread in various body parts, chemotherapy is the best option as it increases the patient’s survival time. Though not as effective for NSCLC but if NSCLC has metastasized, it prolongs the lifespan.

Chemotherapy can be dispersed in the form of pills, as intravenous infusion or as a combination of both. A combinations of chemotherapy medications used in a series of treatment is called a cycle and may be administered from weeks up to months with gaps in-between the cycles. However, as chemotherapy kills noncancerous cells also, the patient may experience side-effects like higher susceptibility to infection, difficulty in clotting of blood, hair and weight loss, vomiting, nausea, diarrhea, mouth sores and fatigue. The side effects usually vary from person to person based on the dose and drug combinations. Certain medicines are available that can prevent and treat these side effects. These side effects usually disappear on recovery. 

SCLC can spread to one’s brain. Therefore, people reacting well to the treatment are given radiation therapy to the head to give micrometastasis that do not display any symptoms or are detectable with MRI scans or CT. Common side effects are nausea, fatigue and short-term memory loss.

Lung cancer that returns back after treatment is termed as relapsed or recurrent. Recurrent cancers limited to one spot in the lung are usually treated with surgery. Recurrent tumors rarely respond to previously administered chemotherapy drugs which are generally platinum-based drugs. Second-line chemotherapy is given for such cases and is effective in prolonging the lifespan.

Drugs like erlotinib and gefitinib are known as targeted therapy drugs that specifically target the cancer cell without causing too much damage to the other non-cancerous cells. They target the epidermal growth factor receptor (EGFR) that promotes division of cell. This protein is present in abnormally on the exterior of few non-small cell lung cancers. Antiangiogenesis is a kind of drug that blocks growth of new blood vessel in area and due to less supply of oxygen cancer cells die. This is given one every 2 to 3 weeks intravenously.

However, this drug causes bleeding, and is not suitable for using in patients coughing up blood, incase the cancer has reached the brain, or if people who received anticoagulation therapy. 

Cetuximab are antibodies binding the epidermal growth factor receptor (EGFR).In NSCLC patients whose tumors express EGFR by immune-histochemical analysis, cetuximab can be added for few patients.

Photodynamic is a new therapy used for various stages and kinds of cancer. In this treatment a photosynthesizing agent is introduced inside the bloodstream some hours after surgery. Certain wavelengths of lights are directed to the cancer site and nearby tissues which activate these photosensitizing agents, resulting in destruction of tumor cells due to production of toxins.

Radiofrequency ablation is an alternate treatment to surgery, especially in the initial stages of lung cancer. Here, a needle is introduced inside the cancer from the skin. Radiofrequency energy is transferred to the needle tip where it generates heat killing all cancerous tissues and closes small blood vessels supplying the cancer.

There is no therapy that is a complete cure for lung cancer. Patients are offered several new therapies still at the experimental stage, new drugs and drug combinations tested in clinical trials. Other experimental therapies like immunotherapies involving the usage of vaccines and building up the immune system to fight cancerous cells are being researched.

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