The short answer
Lung cancer treatment depends on the type and stage. Options include surgery, radiation, chemotherapy, targeted therapy, and immunotherapy, often in combination. Biomarker testing helps choose targeted and immune treatments for non-small cell lung cancer.
Treatment depends on the type and stage of the lung cancer.
Early non-small cell lung cancer may be treated with surgery.
Radiation and chemotherapy are used for many lung cancers, alone or combined.
Targeted therapy and immunotherapy help treat many non-small cell lung cancers.
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This page is for people with lung cancer and those who care for them. It explains how treatment is chosen for each stage and why tumor testing matters.
Two categories, different plans
Lung cancer treatment starts with a basic split. About 8 in 10 lung cancers are non-small cell lung cancer, or NSCLC. It is treated with surgery, radiation, and drug therapy. Often more than one is combined. Small cell lung cancer is less common. It grows faster. It is treated mainly with chemotherapy and radiation, often with immunotherapy. NCI says it can spread early, so it has often spread by the time it is found. This article focuses on NSCLC, the more common type.
Within NSCLC, treatment depends mainly on stage. It also depends on your lung function, overall health, and specific traits of the tumor found through testing.
Stage I and II: surgery first
Early-stage NSCLC is usually treated with surgery. The preferred operation is called a lobectomy. It removes an entire lobe of the lung, along with nearby lymph nodes. For some stage I cancers at higher risk of returning, doctors may add more treatment after surgery. This can include chemotherapy, immunotherapy, or targeted therapy, to lower that risk. This is called adjuvant treatment, meaning it comes after the main treatment. Which drugs are added depends on tumor testing results, discussed below.
Stage III: combining chemotherapy, radiation, and immunotherapy
Stage III NSCLC is locally advanced, and treatment here usually combines more than one approach.
Some stage IIIA cancers can still be removed with surgery. Sometimes chemotherapy or radiation shrinks the tumor first. Most stage IIIB and IIIC cancers cannot be safely operated on. For these, chemotherapy and radiation are given together, called chemoradiation. Afterward, ACS says the standard approach adds an immunotherapy drug called durvalumab, given for up to a year. For tumors with an EGFR mutation, a targeted drug called osimertinib may be added.
Stage IV: testing the tumor before choosing treatment
Once NSCLC has spread to distant organs, treatment shifts to drugs that reach the whole body. Before choosing them, your tumor is tested for specific gene changes. The ones checked most often are EGFR, ALK, ROS1, BRAF, RET, MET, KRAS, and NTRK.
If your tumor carries one of these changes, doctors usually try a targeted therapy pill first. It is aimed at that specific change. These drugs are aimed at the change driving that tumor's growth. Ask your team how their side effects compare with chemotherapy.
If no targetable change is found, doctors check a separate marker called PD-L1. It sits on the surface of some tumor cells. Immunotherapy drugs called checkpoint inhibitors release the brakes your immune system normally has on itself. That lets it attack the cancer. ACS says PD-L1 testing helps guide whether these drugs are used, sometimes along with chemotherapy. Your team will explain which mix fits your tumor.
Why testing comes first
ACS says testing is done before stage IV treatment starts, because a gene change can mean a targeted drug is the first treatment. Skipping testing could mean missing that option. Biomarkers are the gene changes and markers found by tumor testing. Ask directly whether your tumor has been tested and for which genes.
What to ask your team
- What is the exact stage of my cancer, and is surgery part of the plan?
- Has my tumor been tested for EGFR, ALK, ROS1, and other gene changes? What about PD-L1?
- If a targeted therapy or immunotherapy applies to me, how does it compare to chemotherapy for side effects?
- Will I need treatment after surgery or after chemoradiation to lower the risk of recurrence?
- Is a clinical trial a reasonable option for me?
Sources
Common questions
What are the main treatments?
Surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. The combination depends on the type and stage of the cancer and the results of biomarker testing.
When is surgery used?
Surgery is often an option for early-stage non-small cell lung cancer, sometimes with chemotherapy or other treatments before or after.
How is small cell lung cancer treated?
Small cell lung cancer is mainly treated with chemotherapy and radiation, sometimes with immunotherapy. NCI says it grows fast and can spread early.
What are targeted therapy and immunotherapy?
Targeted therapy attacks specific gene changes in the cancer, and immunotherapy helps the immune system fight it. Biomarker testing of non-small cell lung cancer helps decide if these are options.
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Last updated: 2026-08-05Next planned review: 2027-07-07
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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