Chemotherapy for Lung Cancer

Written by Susan Bernstein, Stephanie Langmaid
Medically Reviewed by Sabrina Felson, MD and Jabeen Begum, MD on July 23, 2025
5 min read

Chemotherapy is a form of cancer treatment that uses drugs to kill cancer cells. It's also called chemo.

Your chemotherapy plan depends on the type and stage of lung cancer you have, your overall health, and your personal treatment goals and preferences.

Chemotherapy is the main treatment for small-cell lung cancer (SCLC), but doctors may also use it before or after surgery, or instead of surgery, in non-small-cell lung cancer (NSCLC).

  • Adjuvant therapy is chemo given after lung cancer surgery to treat any remaining cancer.
  • Neoadjuvant therapy is chemo given to shrink the tumor before surgery.

Even elderly people with lung cancer can have this treatment. If you're unable to have surgery for some reason, you may have chemotherapy along with radiation therapy to shrink your tumor.

Chemotherapy is often used along with radiation therapy to treat lung cancer. Together, chemo drugs and radiation may work better to destroy cancer cells. In some people with lung cancer, chemo can keep the tumor small so that the radiation can work better to destroy it. It may also keep cancer cells from returning after radiation therapy.

Chemo and radiation therapy used together can be a powerful weapon against lung cancer, but this combination can have strong side effects.

Up to 15% of people with lung cancer have small-cell lung cancer.

If SCLC is at a limited stage, meaning it's in only one lung or part of your chest, you'll get chemotherapy and radiation therapy together to shrink your tumor.

If SCLC is at an extensive stage and has spread to both lungs or other parts of your body, you'll likely get chemotherapy alone or with immunotherapy. Radiation is used less in this situation, but it can help with your symptoms or keep the cancer from reaching your brain.

SCLC chemotherapy usually includes the EP regimen, which consists of etoposide (Toposar, Vepesid) along with a platinum agent, such as carboplatin (Paraplatin) or cisplatin (Platinol). For extensive-stage SCLC, treatment may include the EP regimen, but another option is a combination of carboplatin and irinotecan (Camptosar).

Up to 90% of people with lung cancer have non-small-cell lung cancer. You may have chemo, sometimes combined with immunotherapy, either before or after surgery for NSCLC. Even if your doctor has taken out your tumor and you've had radiation therapy, it helps to kill cancer cells that may have spread to other parts of your body.

For people with NSCLC, chemo after surgery may help keep the cancer from coming back, especially if you have stage II or stage III lung cancer. If you have stage III cancer that your doctor can't treat with surgery, you may have chemo along with radiation, and possibly also immunotherapy. If NSCLC is stage IV, chemo is the main treatment, although you may have radiation too to help ease your symptoms.

NSCLC chemotherapy usually includes a combination of cisplatin and carboplatin plus either docetaxel (Taxotere), gemcitabine (Gemzar), paclitaxel (Taxol), pemetrexed (Alimta), or vinorelbine (Navelbine). If the cancer returns after your first course of chemo, a different chemo may or may not be recommended or helpful.

For lung cancer, chemotherapy is usually an IV treatment. You may get a quick shot into your vein or an infusion of the drug through a tube, which can take longer. You'll get it either in your doctor's office, clinic, or hospital. You rest while the drugs drip into your vein.

You get chemo in cycles of three to four weeks. Between cycles, you can rest and recover. You may take your drug only once a week or over a few days of each cycle. If the cancer is advanced, you may need four to six cycles of treatment.

Chemotherapy drugs can have many side effects. Which ones you have depend on the drug, dose, or the length of your treatment. They can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Weight loss
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea
  • Tiredness
  • Greater risk of infection
  • Bruises
  • Easy bleeding

Cisplatin, docetaxel, paclitaxel, and vinorelbine may also cause a painful side effect called peripheral neuropathy. You may feel pain, burning, tingling, weakness, or cold sensitivity in your hands or feet. This usually goes away after you're finished with chemo.

Side effects of chemo usually go away after your treatment is complete.

Talk to your doctor about your side effects to see if you can try anything to relieve them, such as:

  • Cooling or cold caps that you can wear during chemo to stop or lessen hair loss
  • Drugs to treat nausea or vomiting
  • Ginger or peppermint teas or candies to also ease chemo-related nausea

Chemo isn't the only drug treatment used for lung cancer. Newer targeted therapies and immunotherapy drugs may be used in some people, either instead of or combined with chemotherapy.

Immunotherapy uses your immune system to fight lung cancer and even wipe it out. Two types of drugs — immune checkpoint inhibitors and bispecific T-cell engagers — help infection-fighting immune cells identify and attach to cancer cells so they can kill them.

Targeted therapy uses drugs designed to attack cancer cells specifically and do less damage to healthy cells. They target proteins that help cancer cells grow out of control. Your doctor may test the cancer cells for certain gene mutations that tell them whether any of these medicines could help you.

 

At what stage is lung cancer most curable?

The earlier lung cancer is diagnosed, the easier it is to cure. For example, stage 0 or stage I NSCLC may be cured with surgery alone.

Is chemotherapy successful for lung cancer?

Chemotherapy can be very successful in treating lung cancer. Many things affect how well someone will respond to treatment, including the type and stage of the cancer and their overall health.

What is the cost of one chemotherapy session?

The cost of a chemotherapy session depends on which drugs you get and what type of health insurance you have. Your insurance provider can explain your coverage. Most medical practices also have a financial department where you can get details about treatment costs.

Is the first chemo painful?

In general, getting chemo is not painful. It may feel uncomfortable when the needle is placed in your arm. If you're getting the medicine delivered through a port, you'll have anesthesia so you don't feel pain.

When the chemo medicine goes into your vein, you might have a mild burning or cooling sensation. If you do feel pain, let the technician know right away.