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Chemotherapy for Lung Cancer: What To Expect

Medically reviewed by Leonora Valdez, M.D.
Written by Aminah Wali, Ph.D.
Posted on April 10, 2024

Following a diagnosis of lung cancer, you may have questions about what treatments you might need. Various treatment options are available for different types of cancer. For lung cancer, chemotherapy is a common one. Chemotherapy drugs — also called chemo drugs or just chemo — destroy quickly dividing cells such as cancer cells.

If you have questions or concerns about going through chemotherapy, understanding how the process works is a first step. In this article, we’ll cover what you can expect during chemotherapy treatment. Your oncologist (cancer specialist) can discuss any further concerns you may have about treatment and can tell you what type of chemotherapy you may need.

What Is Chemotherapy?

Chemotherapy uses powerful drugs to kill cancer cells, slow their growth, or prevent them from spreading. The drugs used in chemotherapy can be delivered in several ways, including:

  • Orally (by mouth)
  • Intravenously (through a vein)
  • With an injection into a specific area of the body
  • Topically (applied to the skin)

The type of chemo a person receives depends on what type of cancer they have. Topical options, for example, are generally used for treating types of skin cancer.

Chemo treatment schedules vary widely — they can be a single session, weekly, every few weeks, or even monthly, depending, again, on the type of cancer, the goal of therapy, and how a person responds to treatment.

Who Needs Chemotherapy for Lung Cancer?

Chemotherapy is not right for everyone with lung cancer. Whether your oncologist will recommend it depends on what type of lung cancer you have and how advanced it is. Because chemotherapy can destroy healthy cells as well as cancer cells, the process is very hard on the body. Therefore, some people with lung cancer who are in poor overall health may not be able to tolerate chemotherapy.

Non-Small Cell Lung Cancer

Non-small cell lung cancer (NSCLC) — the most common type of lung cancer — may be treated with surgery as well as chemotherapy.

If the cancer is in its early stages — when tumor cells are only within the lung — a doctor may recommend surgery alone.

In other cases, however, a person may undergo chemotherapy before lung cancer surgery. This is called neoadjuvant chemotherapy and aims to shrink the tumor to make it easier to surgically remove.

Chemotherapy can also be used as adjuvant therapy — this is, after surgery to kill any remaining cancer cells that may have been missed during the operation.

If you have advanced or metastatic NSCLC — meaning the tumor cells have spread to other parts of the body — you’ll probably need to have chemotherapy to destroy the cancer cells located throughout your body. A person may undergo chemotherapy together with immunotherapy — treatment that affects how the immune system works — as well, in some cases, as radiation therapy. Having all three types of therapy is often the best option for people with more advanced NSCLC that has spread to lymph nodes but not to other organs.

Small Cell Lung Cancer

Small cell lung cancer (SCLC) is an especially aggressive form of cancer, meaning it tends to spread quickly. Most people diagnosed with SCLC will need to undergo chemo, even if they’re at an early stage of the disease.

If you have limited-stage SCLC — meaning the cancer is only in the lung and nearby lymph nodes — your doctor will likely recommend chemotherapy together with radiation therapy. This will give you the best chance at eliminating as many cancer cells as possible.

On the other hand, in people with extensive-stage SCLC, the tumor cells have already spread farther away to other organs. In these cases, your doctor may prescribe chemotherapy together with immunotherapy. This treatment combination gives people with extensive-stage SCLC a better chance at survival.

Common Chemotherapy Treatment Regimens

There are several different types of chemotherapy drugs. A treatment regimen (treatment plan) can use a combination of multiple drugs. Which combination you’ll get depends on what your doctor thinks will work best for your particular type of cancer.

A chemotherapy treatment for SCLC typically involves one of the following drug combinations:

  • Cisplatin plus etoposide
  • Carboplatin plus etoposide

These drugs may be used for both limited-stage and extensive-stage SCLC. However, people with extensive-stage SCLC may also be treated with immunotherapy in addition to chemotherapy to improve their outcome.

For people with NSCLC, carboplatin, cisplatin, and etoposide may also be used during treatment. Several other chemotherapy drugs may be used as well, including:

  • Albumin-bound paclitaxel (Abraxane)
  • Docetaxel (Taxotere)
  • Gemcitabine (Infugem, Gemzar)
  • Paclitaxel
  • Pemetrexed (Infugem, Pemfexy, Pemrydi RTU)
  • Vinorelbine (Navelbine)

The exact treatment regimen your doctor will recommend will depend on your specific case of lung cancer and your overall medical condition. Don’t hesitate to ask your doctor any questions about the chemotherapy drugs that you’ll be taking.

Read more about specific medications, including chemotherapy drugs, in this list of treatments for lung cancer.

What Happens During a Chemotherapy Session?

Most chemotherapy drugs are given to you intravenously, meaning that a needle is used to deliver the drugs directly to your bloodstream. However, chemo for lung cancer may also be administered orally or with an injection. Which type you might get can depend on your doctor’s recommendation.

If you’re having your chemo administered with an IV, treatment generally requires visiting a hospital or smaller clinic. During treatment with chemo delivered via an IV, you’ll sit down while your health care provider inserts a needle under your skin to deliver the therapy. You’ll usually have to stay for a few hours while the treatment finishes. If your treatment regimen uses any drugs that have an oral option, you’ll also take your pills during this time.

After treatment is over, you’ll go home and recover. You may need treatment every week, or you might go for treatment once every three to four weeks, depending on the regimen. The time from one treatment session to the next is called a cycle of chemotherapy.

Your full treatment regimen will involve several cycles of chemotherapy over a period of time. You’ll usually need about four to six cycles of chemotherapy to start. You’ll work with your oncologist to develop a custom treatment plan based on your case, and they’ll let you know how many chemotherapy cycles you can expect.

Side Effects of Chemotherapy for Lung Cancer

Because chemotherapy can kill any quickly dividing cell, it can harm some healthy cells as well as tumor cells. This can affect the cells of the bone marrow and decrease the number of blood cells in your body, potentially causing you to:

  • Feel weak or tired
  • Bleed or bruise easily
  • Get sick easily from infections

Depending on the exact treatment regimen, chemotherapy can also lead to a number of health problems. Common side effects of chemotherapy include:

  • Hair loss
  • Gastrointestinal problems, including constipation or diarrhea
  • Loss of appetite
  • Nausea and vomiting
  • Painful mouth sores

Certain drugs may cause more specific side effects, such as sensitivity to cold. You may also experience a burning or tingling sensation in your hands and feet.

Side effects of chemotherapy can make you feel very sick and may be difficult to deal with. If you have trouble tolerating some of the side effects, you can reach out to your cancer care team for help. They may be able to make changes to your treatment plan that can help reduce the side effects of chemotherapy.

Preparing for Treatment

Thinking about going through chemotherapy and dealing with side effects may make you feel worried or even scared. While this is completely normal, know that you’re not alone — your cancer care team is there to support you throughout your treatment journey. You can help prepare for chemotherapy by talking to your health care provider about what lies ahead. They will discuss the treatment options that might be best for you and can hopefully improve your outcome.

Talk With Others Who Understand

On MyLungCancerTeam, the social support network for people with lung cancer and their loved ones, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand.

Do you have more questions about chemotherapy for lung cancer? Share your insights in the comments below, or start a conversation by posting on your Activities page.

    Posted on April 10, 2024
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    Leonora Valdez, M.D. received her medical degree from the Autonomous University of Guadalajara before pursuing a fellowship in internal medicine and subsequently in medical oncology at the National Cancer Institute. Learn more about her here.
    Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

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