Treatments

Lung Cancer Treatments

Your care team will tailor your lung cancer treatment plan to your unique needs. Lung cancer treatment depends on your overall health, the extent of the disease and your tolerance for different therapies.

Your Lung Cancer Treatment Team

Northwestern Medicine offers comprehensive, compassionate care in modern, patient-centered facilities. Your cancer care team may include:

  • Advanced practice nurses
  • Advanced practice providers
  • Clinical and research nurses
  • Geneticists
  • Medical oncologists
  • Nutritionists
  • Pathologists
  • Pulmonary rehabilitation therapists
  • Pulmonologists
  • Radiation oncologists
  • Radiologists
  • Smoking cessation specialists
  • Social workers
  • Thoracic surgeons

Our multidisciplinary team is dedicated to listening and responding to patient concerns, promoting well-being and treating each person with respect and compassion. The Supportive Oncology Program at Robert H. Lurie Comprehensive Cancer Center at Northwestern Medicine works with clinical scientists who conduct clinical trials aimed at improving the psychosocial health of adults with cancer. Our services include:

  • Clinical psychologists
  • Coordinators of supportive oncology education
  • Fertility preservation program navigators
  • Registered dietitians
  • Nurse navigators
  • Psychiatry team
  • Social workers

Cancer Care Closer to Home

Addressing cancer is a multistep journey that may require many visits. During treatment, you need to focus your energy on getting healthy, not getting to the next appointment. That’s why treatment and support services at Northwestern Medicine are conveniently located throughout Chicago and the surrounding suburbs, so you can get access to all the expertise and support you need, close to home.

Depending on your diagnosis, your care team may recommend a single treatment or a combination of therapies. Treatment options include the following:

Surgery

Many times, surgery is the first step in treating cancer, followed by other courses of treatment, such as radiation or chemotherapy. The type of surgery your care team may recommended depends on the size, location and stage of your lung cancer. Advances in minimally invasive surgery are making many types of surgeries safer and easier on patients. Our surgical team performs minimally invasive procedures whenever possible. This may include using the da Vinci® Surgical System, a robotics-assisted, minimally invasive approach that enables your physician to make smaller incisions for less blood loss, fewer complications and faster recovery.

Other common surgeries for lung cancer treatment include:

  • Segmental or wedge resection (removal of only a small part of the lung)
  • Lobectomy (removal of an entire lobe of the lung)
  • Pneumonectomy (removal of the entire lung)

Northwestern Medicine Ambulatory Precision Lung Sparing (A-PLUS) Surgery
This advanced technology can diagnose and treat early-stage lung cancer in a minimally invasive outpatient procedure.

Northwestern Medicine Multidisciplinary Lung Nodule Program
The Northwestern Medicine Multidisciplinary Lung Nodule Program specializes in the evaluation, risk assessment and management of pulmonary (lung) nodules detected on imaging. The program’s mission is to provide evidence-based, timely and personalized care for patients with lung nodules.

Northwestern Medicine Robotic Thoracic Surgery
Northwestern Medicine surgeons are pioneers and national leaders in robot-assisted thoracic surgery, a revolutionary advancement in minimally invasive surgery.

Chemotherapy

If you are diagnosed with cancer, Northwestern Medicine cancer care specialists may recommend chemotherapy as part of your treatment. Chemotherapy uses anticancer medications to destroy cancerous cells in your body or stop them from reproducing or growing.

It has been used for many years, and it is one of the most common treatments for cancer. Chemotherapy may be used alone for some types of cancer, or in combination with other treatments, such as radiation or surgery.

Targeted Therapy

Commonly talked about as a treatment for patients who have certain abnormalities in their tumors that can be found through biomarker testing. Biomarker testing looks for changes in the tumor's DNA. These changes can be mutations, additions, deletions or rearrangements in the DNA. Some lung cancer treatments can "target" these changes directly. These lung cancer treatments often cause fewer side effects because they focus on targeting what is exactly wrong with the cancer cell, instead of killing normal, healthy cells too. These therapies attack specific targets on or in the tumor cells. Not every person is eligible for targeted therapies for lung cancer. Your doctor might order a special test of your tumor called molecular testing or biomarker testing. Talk to your doctor about your testing options and treatment recommendations.

Immunotherapy for Non-Small Cell Lung Cancer

Immunotherapy is the use of medicines to help a person’s own immune system to recognize and destroy cancer cells more effectively.

Immune checkpoint inhibitors
An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses “checkpoint” proteins on immune cells, which act like switches that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system.

Drugs that target these checkpoints (called checkpoint inhibitors) can be used to treat some people with non-small cell lung cancer (NSCLC).

PD-1/PD-L1 inhibitors

  • Nivolumab (Opdivo), pembrolizumab (Keytruda), and cemiplimab (Libtayo) target PD-1, a protein on certain immune cells (called T cells) that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.
  • Atezolizumab (Tecentriq) and durvalumab (Imfinzi) target PD-L1, a protein related to PD-1 that is found on some tumor cells and immune cells. Blocking this protein can help boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

These drugs can be used in different situations to treat NSCLC. In some cases, before one of these drugs can be used, lab tests might need to be done on the cancer cells to show they have at least a certain amount of the PD-L1 protein (which would mean these drugs are more likely to work).

  • Nivolumab can be used along with chemotherapy as a first treatment before surgery in people with certain early-stage NSCLCs.
  • Pembrolizumab, atezolizumab, or cemiplimab can be used (sometimes with chemo) as part of the first treatment in some people with metastatic NSCLC. Nivolumab can also be an option as the first treatment in some people. It is given along with CTLA-4 inhibitor ipilimumab (Yervoy), which is described below, sometimes along with chemo as well.
  • Nivolumab, pembrolizumab, and atezolizumab can also be used in people with certain types of advanced NSCLC whose cancer starts growing again after chemotherapy or other drug treatments.
  • For people with stage III NSCLC who cannot have surgery or chemotherapy with radiation, pembrolizumab or cemiplimab can be given as the first treatment.
  • Durvalumab can be used in people with stage III NSCLC whose cancer cannot be removed with surgery and has not gotten worse after they have received chemotherapy with radiation (chemoradiation). The goal of treatment with this drug (also called consolidation therapy) is to keep the cancer from getting worse for as long as possible.
  • Atezolizumab can be used in people with stage II or early-stage III NSCLC who have already been treated with surgery followed by chemotherapy. The use of this drug after surgery is known as adjuvant therapy.

All of these drugs are given as an intravenous (IV) infusion. Depending on the drug, they might be given every 2, 3, 4, or 6 weeks.

Radiation Therapy

Gamma Knife® Radiosurgery
Gamma Knife radiosurgery (stereotactic radiosurgery) delivers a single, large dose of radiation to a specific target in the lungs with surgical precision. The radiation reacts on a molecular level with the cancer cells and stops their reproduction, killing the cancer. This approach minimizes the damage to surrounding healthy tissue and has reduced side effects, so that patients can return to their daily activities more quickly.

Intensity Modulated Radiation Therapy
Intensity modulated radiation therapy (IMRT) tailors the dose of radiation to fit to the unique shape of a tumor. This highly precise approach uses computer-controlled linear accelerators to maximize the therapy's impact on a malignant tumor, while reducing the effects radiation can have on your healthy tissues and organs.

Treatment with IMRT is slightly longer than that with conventional radiation, but generally produces fewer side effects.

Proton Therapy
Proton beam therapy is a type of external-beam radiation therapy (EBRT) treatment that uses protons instead of X-rays to deliver radiation directly to cancer cells. Proton therapy has been shown to be effective in treating certain types of cancerous tumors and some non-cancerous tumors and malformations, such as tangled blood vessels.

The Northwestern Medicine Proton Center is the first facility of its kind in Illinois. Proton therapy may be a powerful addition to your cancer treatment plan. This advanced form of radiation treatment can precisely target tumors and cause less damage to the surrounding healthy tissue. This is especially important if you have cancer near critical organs or structures, and if you’ve previously received radiation therapy or when treating pediatric cancers. For certain cancer types, you may experience fewer side effects with proton therapy and can maintain a better quality of life compared to standard X-ray radiation.

Palliative Medicine

Side effects from cancer treatment can impact your quality of life and how your body responds to treatment. Northwestern Medicine is home to a diverse team of palliative medicine specialists who work with your cancer care team to help relieve your pain and manage your symptoms. The palliative medicine specialists may help:

  • Treat pain and other physical symptoms of cancer, such as fatigue, nausea, trouble sleeping, poor appetite, breathing difficulties and weight loss
  • Treat any emotional symptoms, such as depression and anxiety
  • Improve your body’s ability to tolerate cancer treatments
  • Help you better understanding tests, procedures and other options
  • Guide you and those who care for you to helpful resources

From your initial diagnosis and continuing throughout your care, your palliative care team will support you during your cancer journey.