Your top questions about lung cancer treatment, answered

Have you been diagnosed with lung cancer? You’re not alone. The American Cancer Society (ACS) estimates that more than 238,000 people will get news like yours in 2023. But improvements in cancer care mean that more people are surviving.

That’s because treatment works. New treatments are still being developed. And older treatments are getting better all the time. For example, with advances in technology, radiation therapy can target tumors more precisely.  

If you’ll be starting treatment soon, you probably have many questions. Your cancer care team can be your go-to source for answers. “Your lung cancer team has specialists in medical oncology, radiation oncology, thoracic surgery, and interventional radiology, focused on treating lung cancer,” explains Dhruv Bansal, M.D. He’s an oncologist at St. Luke’s Health System in Kansas City, Missouri. “This gives your team tremendous expertise in answering even the most unusual questions.”

Here are key questions to ask about your treatment plan.

Question #1: What kind of lung cancer do I have?

That’s an important question to ask, because different types of lung cancer are treated in different ways. There are two main types: 

• Small cell lung cancer (SCLC)
• Non–small cell lung cancer (NSCLC). About 80% to 85% of lung cancer diagnoses are NSCLC, according to the ACS. Those are usually treated in different ways.

You’ll also need to know the stage of your lung cancer. That’s based on the size of your tumor and how far it’s spread into surrounding areas or to other parts of your body. For NSCLC, there are five main stages, from 0 to 4. (Stage 0 is the least advanced.)

For SCLC, there are two stages. Limited stage means the cancer hasn’t spread to other parts of the body. Extensive stage means that cancer has spread to tissue outside of the originally affected lung, according to the American Lung Association. 

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Question #2: How much experience do you have in treating this kind of lung cancer?

Your doctor's knowledge and experience can play a role in how they treat you. With treatment advances, being up to date on the latest is vital.

So, ask your doctor how experienced they are in treating lung cancer patients with all of the various treatment options. You can also ask what treatments they’ve given patients and if they’ve been successful. If the doctor is a surgeon, ask:  

• How often do you perform the surgery I need?
• How many of these surgeries have you performed?
• What is your success rate? And what does “success” mean to you?

Question #3: What are my treatment options?

There are many treatment options for lung cancer, according to the Centers for Disease Control and Prevention. Which option is best for you? It depends on the stage and type of lung cancer you have. It could also depend on your age and your general health. Your treatment options include: 

Surgery: For some kinds of lung cancer, a surgical oncologist (a doctor who specializes in treating cancer by using surgery) will make a cut in your chest. The goal of surgery is to remove the cancer and some of the nearby cells and nearby lymph nodes, according to the American Society of Clinical Oncology.

Radiation: During radiation therapy you’ll have high-energy beams aimed at your lung cancer. This can kill the cancer cells or stops them from growing. It can be effective for both types of lung cancer and all stages.  

Chemotherapy: “Chemo” is medication that stops cancer cells from growing. You can take it as pills you swallow. You can receive it by a shot into a vein or muscle. Or the medicine can be placed in the part of your body that’s being targeted, according to the National Cancer Institute. Chemo is used alone or together with radiation. It can also be combined with immunotherapy, targeted therapy, and surgery.  

Immunotherapy: This treatment stops cancer by using your immune system. That’s your body’s way of fighting off sickness. It uses a network of cells that work together to keep you healthy. Immunotherapy is a newer treatment option that’s mostly used for NSCLC.  

Immunotherapy boosts your natural immune system to make it work harder to find (and kill) cancer. Or it can use substances made in a lab that are like your body’s natural immune system components. This helps your body find and attack cancer cells. 

Targeted therapy: These are medications or other substances that target certain cancer cells. They can be used on their own. Or sometimes they can be combined with chemo. Targeted therapy can usually be given as a pill or intravenously (through a tiny tube inserted into your body).  

Question #4: What side effects should I expect?

Everyone reacts differently to cancer treatments. You may experience some side effects. But luckily, there are good ways to deal with them. Discuss any issues with your care team. They can help you find ways to feel better.

All medications may have side effects. Chemotherapy does too. Typical side effects include diarrhea, vomiting, nausea, and muscle pain. You might also experience fatigue and hair loss. If you’re receiving targeted therapy, you may notice fatigue, diarrhea, and nausea and vomiting. “The good news is that most targeted therapies are tolerated better than chemotherapy,” Dr. Bansal says.

People who get radiation often feel fatigued. Another side effect is skin irritation on your chest that may look like a sunburn. Most side effects with radiation therapy stop once treatment stops, says the ACS.

With immunotherapy, the side effects depend on factors like what treatment you’re receiving and your health before starting treatment. “The most common side effects are itching, skin rash, and diarrhea,” Dr. Bansal explains.

Recovery from surgery can take weeks to months, according to the ACS. Possible side effects include pneumonia, blood clots, and infections in the area where the surgery was performed.

Question #5: Should I get a second opinion?

Are you puzzled about which treatment to choose — or not sure you’ve explored all your options? Then it might be worth seeking a second opinion. “Getting a second opinion from a reputable cancer center is always encouraged,” Dr. Bansal says. It’s even more important if you have a rare type of lung cancer with fewer treatment options.

Other reasons to seek a second opinion: Your hospital doesn’t have a specialist in lung cancer treatment. Or you and your doctor don’t seem to be communicating well.

Don’t be shy. Keep asking questions to learn more about the best care for you. Lung cancer treatment continues to get better. Make sure you know about all the latest options that may be right for you.

Additional sources:
Lung cancer statistics: American Cancer Society
Lung cancer staging: American Lung Association
Lung cancer diagnosis and treatment: Centers for Disease Control and Prevention
Surgery: American Society of Clinical Oncology
Chemotherapy: National Cancer Institute
Radiation side effects: American Cancer Society
Surgery side effects: American Cancer Society
Seeking second opinion: American Cancer Society

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