Lung Cancer Treatment – Lung Disease and Modern Cancer Therapy

When selecting a treatment for lung cancer, the treating physicians place great emphasis on the patient’s individual situation. The key factors in assessing the patient’s situation are

• the patient’s overall health,
• the stage of the cancer, and
• the type of carcinoma.

Small-cell carcinomas, for example, usually respond better to chemotherapy than non-small-cell carcinomas. The latter are generally treated primarily with surgery in stages 1 and 2.

In general, the goal of any lung cancer treatment is to improve the patient’s quality of life and reduce symptoms. The stage of the cancer is not the decisive factor in this regard.

However, if the cancer has not yet metastasized, the chances of complete removal and recovery are higher.

Early detection is crucial for the course of treatment. A decision by the Joint Federal Committee (G-BA) on lung cancer screening for heavy smokers is expected in the first half of 2025.

Image of lung cancer cells under a microscope © Kateryna_Kon | AdobeStock

Surgical removal of tumors is the treatment of choice, especially for non-small cell carcinomas. The goal of the procedure is to completely remove the lung tumor.

However, if the tumor has already invaded adjacent organs or formed metastases, surgery is often no longer an option. The patient must also be in sufficiently good health. If the patient also has chronic obstructive pulmonary disease (COPD), doctors generally advise against surgery. In such cases, patients are often already too weak.

Your specialist will discuss with you whether surgery is possible. Beforehand, you will undergo a thorough examination, X-rays will be taken, and the various treatment options for your lung cancer will be explained to you. 

This means that surgery is generally only an option if the lung cancer has not yet progressed too far. In later stages, when the tumor has already metastasized or spread to other organs, combined or alternative therapies such as chemotherapy, radiation therapy, or immunotherapy are usually used.

Lung surgery can save lives. For this to be possible, the patient must be in good overall health. © www.MedicalGraphics.de/ CCBY-ND 4.0

Chemotherapy involves the use of drugs that slow down cell division. This inhibits tumor growth. These drugs are called cytostatic agents and can reach cells throughout the body via the bloodstream.

Chemotherapy plays the most significant role in the treatment of small-cell lung cancer. This treatment can lead to a cure in the early stages of the disease. It is often used in addition to surgery. It can then shrink the tumor beforehand or target any remaining tumor tissue that could not be removed during surgery.

Chemotherapy can also be used palliatively. If the tumor is inoperable or if distant metastases are already present in stages 3 and 4, a cure is no longer possible. The medications administered then alleviate symptoms and improve the patient’s quality of life. The goal is also to prolong the patient’s life.

Doctors frequently use chemotherapy for lung cancer when surgery is not possible or the tumor has already spread. In such cases, it serves as the sole treatment or is used in combination with other procedures.

Since cytostatic drugs can attack not only cancer cells but also healthy cells, the treatment is tailored to each individual to achieve the best possible balance between efficacy and tolerability.

In radiation therapy, doctors direct high-energy radiation beams specifically at the tumor. The radiation damages the tumor’s DNA, causing the cancer cells to die. It is primarily used in two situations:

• for inoperable, non-small-cell lung cancer without distant metastases, and
• as postoperative radiation therapy for affected lymph nodes.

Today, radiation therapy is performed using a linear accelerator. This has significantly fewer side effects than the cobalt radiation source previously used.

Conventionally, radiation is delivered from outside the body through the skin. In contrast, there is also internal radiation therapy, also known as brachytherapy. In this method, the radiation source is placed directly next to the tumor.

This form of radiation therapy may be used for lung cancer when the bronchial carcinoma threatens to narrow the airways.

Experience has shown that simultaneous treatment with chemotherapy and radiation therapy ensures better control of the tumor. However, due to the increased risk of side effects, this type of lung cancer treatment should only be administered on an inpatient basis.

Radiochemotherapy is often more effective than treatment with radiation therapy or chemotherapy alone.

Before starting chemoradiotherapy, doctors carefully assess lung function to better evaluate potential risks. In many cases today, this combination therapy is also supplemented with targeted or immuno-oncology therapies to further increase efficacy and create personalized treatment options.

Specialized clinics and lung cancer centers also offer this form of treatment for non-small-cell lung cancer. In some cases, it is also used for the rare form—small-cell lung cancer. 

Immunotherapy involves the use of specialized drugs, most commonly immune checkpoint inhibitors. These intravenously administered medications ensure that the cancer cells’ camouflage is exposed, allowing the body’s own immune system to identify and fight them on its own. 

The therapy is often used in combination with other treatments, such as chemotherapy. 

Immunotherapy can also cause unwanted side effects. For example, the boost in immune function may cause healthy tissue to be attacked as well.

Immunotherapies are used particularly in advanced stages of non-small cell lung cancer and are often based on findings from current clinical trials. These studies help develop new active ingredients and combination therapies that can prolong survival. After treatment is completed, regular follow-up care is important to monitor the success of the therapy and detect possible relapses early.

Current approaches to lung cancer treatment offer patients significantly better chances of cure and survival. Thanks to advances in surgery, radiation therapy, and drug therapy, individually tailored treatments are now available that can be considered depending on the stage and type of lung cancer.

Modern treatment approaches—such as adjuvant chemotherapy or immuno-oncology therapies—can alleviate distressing symptoms and improve quality of life. Close collaboration between specialized cancer centers and organizations such as German Cancer Aid also helps ensure that patients with lung cancer receive optimal care and comprehensive treatment.

Despite significant progress, the treatment of lung cancer remains complex and burdensome. Particularly in the case of non-small-cell lung cancer, combining treatment with chemotherapy can cause severe side effects that weaken the body. Furthermore, the best possible treatment always depends on the exact diagnosis of lung cancer, the stage of the disease, and the patient’s overall health.

In advanced stages, additional treatment is often necessary to alleviate symptoms and slow the progression of the disease. Organizations such as the German Cancer Society and the Federal Association for Lung Cancer Self-Help support those affected by providing information and opportunities for exchange to help them cope with the disease and the burdens of treatment.

The cytostatic drugs used in systemic chemotherapy target cell division throughout the entire body. This also leads to unwanted side effects such as hair loss and skin changes, among others.

With the help of targeted therapies, artificially produced antibodies (protein molecules) directly neutralize specific characteristics of cancer cells that drive their growth. In some cases, this can even lead to the complete elimination of certain cells. 

In addition, experts use artificially produced tyrosine kinase inhibitors in this type of lung cancer treatment; these are designed to cut off the tumor’s blood supply and thus specifically prevent its nourishment and further spread. Tyrosine kinase inhibitors and antibodies are prescribed as tablets. 

However, these medications are effective only if specific genetic mutations have first been detected in the tumor cells of a non-small cell carcinoma. Over time, cells may develop resistance. In that case, new tissue tests are necessary. If necessary, there are other medications available that can combat this resistance.

As a cancer patient, you and those around you find yourselves in an exceptional situation. In addition to comprehensive medical care, specialized centers also facilitate connections to other support services, including social and pastoral care. 

There is typically close collaboration with 

• psycho-oncology,
• pastoral care, and 
• social services.

Through social services, for example, patients can also receive help with applications, legal matters, and more. 

Since lung cancer is one of the most common malignant diseases, individually tailored treatment using standard cancer therapies is crucial. Right from the start of treatment, specialized centers emphasize ensuring that patients receive a combination of medical, psychological, and social support.

Supportive therapies such as respiratory physical therapy, nutritional counseling, or psycho-oncological support help alleviate side effects and improve quality of life. To provide optimal treatment for lung cancer, specialized teams work closely together—the attending physician coordinates the various forms of therapy to achieve the best possible outcome.

In cases of advanced lung cancer, doctors face the challenge of finding the best possible treatment to slow the progression of the disease and alleviate distressing symptoms. Today, innovative approaches that go beyond traditional methods are being used for both non-small cell lung cancer and small cell lung cancer.

The treatment of lung cancer increasingly involves personalized therapies in which chemotherapy and immunotherapy are combined or used in a targeted manner. If surgery is not possible, chemotherapy or radiation therapy for lung cancer can limit the spread of the tumor.

For patients with advanced-stage lung cancer, adjuvant chemotherapy is often recommended to reduce the risk of recurrence. In cases of advanced non-small cell lung cancer, a combination with chemotherapy is frequently used to enhance the treatment’s effectiveness.

Supportive therapies also help alleviate side effects and maintain quality of life. According to the German Cancer Research Center and the Federal Association for Lung Cancer Self-Help, interdisciplinary treatment teams are crucial for providing optimal care to people with lung cancer.

The goal of any lung cancer treatment is to provide the best possible care, tailored individually to the diagnosis and treatment plan—regardless of whether the cancer is non-small cell lung cancer or small cell lung cancer. This ensures that lung cancer can still be effectively treated even in advanced stages.

What treatment options are available for lung cancer?
Lung cancer treatment includes surgery, chemotherapy, radiation therapy, and modern targeted therapies. The appropriate treatment depends on the stage and type of tumor.

When is surgery performed for lung cancer?
Surgery is usually an option for early-stage or locally confined lung cancer. It is considered essential for completely removing the tumor.

How does chemotherapy for lung cancer work?
Chemotherapy for lung cancer is often combined with radiation therapy or immunotherapy. It inhibits the growth of cancer cells and is used particularly in cases of advanced lung cancer.

What side effects can lung cancer treatment have?
Depending on the type of treatment, fatigue, hair loss, or nausea may occur. Doctors tailor the treatment to each patient to alleviate distressing symptoms.

What are the chances of recovery from lung cancer?
The prognosis depends on the stage of the disease. If lung cancer is detected and treated early, the chances of recovery are significantly better. Modern treatments extend survival even in advanced stages.