Chemotherapy is a treatment that may be used for non-small cell lung cancer. It’s often used in combination with other treatment types. Chemotherapy is associated with a variety of risks and benefits.

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In the United States, lung cancer is the second most common type of cancer in both sexes as well as the leading cause of cancer deaths, according to the American Cancer Society (ACS). Research indicates that about 85% of all diagnoses of lung cancer are non-small cell lung cancer (NSCLC).

Several different treatments can be used for NSCLC. One of these is chemotherapy (chemo), which uses drugs that destroy cancer cells or slow down their growth. Below, we explore more about how chemo is used for NSCLC.

Learn more about non-small cell lung cancer.

The exact schedule for chemotherapy treatments can vary based on many factors, including:

Chemo treatments are typically given in cycles. One cycle is a period of treatment followed by a period of rest. The rest period provides your body time to recover from the effects of the therapy.

Chemo is typically given intravenously (IV) directly into the bloodstream. A catheter or a port, which allows healthcare professionals to give treatment without repeated needle sticks, may be utilized. Sometimes a pump may be used as well.

You may receive chemo during a hospital stay. However, many people have their chemo as outpatients at a clinic or hospital. That means you get to go home afterward.

There are several different chemo drugs that may be used for NSCLC. Often, chemo for NSCLC involves the use of platinum-based chemo drugs, including carboplatin or cisplatin.

Carboplatin and cisplatin work by damaging a cell’s DNA, preventing it from dividing and leading to cell death. Generally speaking, research published in 2019 suggests there’s no difference between carboplatin- or cisplatin-based chemo in terms of overall survival.

Examples of other chemo drugs used for NSCLC, according to the ACS, include:

Sometimes combinations of chemo drugs may also be used. This typically includes a platinum-based chemo drug along with another chemo drug.

Depending on your individual situation, chemo for NSCLC can have different goals. For example, chemo may be used to help destroy the cancer, control the cancer, or prevent the cancer from coming back.

Some instances where chemo may be used during NSCLC treatment include:

Chemo is often used in combination with other NSCLC treatments, such as radiation therapy (chemoradiation). Immunotherapy and targeted therapy drugs may also be used along with chemo drugs.

Sometimes chemo may be used to help alleviate NSCLC symptoms. This is called palliative chemo and is typically done for advanced cancers. It can help shrink the cancer to ease pain and other symptoms.

Chemo targets the growth and division of cells. This mostly affects cancer cells, which tend to grow and divide more rapidly than other cells in the body. However, healthy cells that grow and divide quickly can also be affected, such as cells in the:

  • bone marrow
  • digestive system
  • hair follicles

Because of this, chemo for NSCLC can cause side effects like:

Some chemo drugs used for NSCLC, such as cisplatin or paclitaxel, can also lead to peripheral neuropathy. This can cause symptoms like a tingling sensation, pain, or a sensitivity to cold.

Chemo can help eliminate the cancer or prevent it from spreading further. For example, a small 2021 study showed that having maintenance chemo after an initial chemo course improved both progression-free and overall survival in people with advanced NSCLC.

Chemo can also allow other treatments to be done, such as shrinking a tumor with chemo to make it easier to remove via surgery. One older systematic review showed that neoadjuvant chemo for NSCLC boosted overall and recurrence-free survival as well as time until recurrence.

A 2022 clinical trial showed that, compared to chemo alone, adding immunotherapy to neoadjuvant chemo led to longer event-free survival and an increased number of people who showed a lack of signs of cancer in biopsy samples after surgery. Those participating in the clinical trial were living with stage IB–stage IIIA resectable NSCLC.

Chemo can also help prevent cancer from coming back after treatment, such as when adjuvant therapy is used to kill remaining cancer cells after surgery. A 2017 American Society of Clinical Oncology (ASCO) publication notes that adjuvant chemo after surgery can give a survival benefit.

In addition to side effects, there are also other risks associated with chemo. Some of these are late effects.

While many of the side effects of chemo get better after your treatment ends, late effects can appear in the months or years after your treatment ends. A few examples of late effects associated with NSCLC chemo include:

Chemo drugs could also interact with medications or supplements you’re taking. Because of this, it’s vital to let your healthcare professional know the medications, both prescription and over-the-counter, and supplements you’re taking.

Receiving a diagnosis of NSCLC can feel overwhelming. It’s completely normal to have a lot of questions about your cancer and how it will be treated.

Some examples of questions to ask about chemo include:

  • Why is chemo being recommended for my treatment?
  • What are the goals of my treatment?
  • Are there any alternatives to chemo? If so, what are they? How may they affect my outlook?
  • Will any other treatments be used in addition to chemo? If so, what are they?
  • Which chemo drugs will be used?
  • How will my chemo be given?
  • How many cycles of chemo are planned?
  • Where will I receive my chemo?
  • How long does each treatment last? How much time is between treatments?
  • What side effects can I expect from this chemo?
  • Is there anything I can do to prevent or reduce the severity of chemo side effects?
  • When should I call you about side effects? When should I go to the hospital?
  • Are there any late effects associated with my chemo drugs?

The outlook for people with NSCLC receiving chemo can depend on several factors, including:

  • the stage of your NSCLC
  • the type of chemo you receive
  • other treatments you receive in addition to chemo
  • how the cancer responds to the chemo and other treatments
  • your age and overall health

Every person with NSCLC is different. Because of this, it’s important to ask your care team about your specific outlook. They can take the factors above into account and give you a better idea of your individual outlook.

What is the best chemotherapy for non-small cell lung cancer?

Platinum-based chemo drugs are often used for NSCLC. However, the “best” chemo for you depends on many factors, such as your age and overall health, the stage of your cancer, and other treatments that you receive.

What is the life expectancy of a person with non-small cell lung cancer?

Five-year survival rates are statistics that estimate the percentage of people with a specific type and stage of cancer who are alive 5 years after diagnosis. The 5-year survival rates for NSCLC diagnosed between 2012 and 2018 are:

  • overall: 28%
  • localized to the lung: 65%
  • regional spread: 37%
  • distant spread (metastasis): 9%

What is the first-line treatment for non-small cell lung cancer?

Surgery, sometimes followed by adjuvant therapy, is often the first-line treatment for many early stage lung cancers. For cancers in later stages where surgical removal is not an option, first-line treatment can involve some combination of:

How fast does non-small cell lung cancer spread?

A 2019 study indicated that the median doubling time of NSCLC was about 230 days. However, some cancers doubled in as few as 19 days. Doubling time is an estimate of the amount of time it takes for a tumor to double in size.

NSCLC is the most common type of lung cancer. Chemo is one of the potential treatments for NSCLC.

Platinum-based chemo is most often used when chemo is recommended, although other chemo drugs may be prescribed as well. Chemo is also often given along with other treatments like radiation therapy and immunotherapy.

Receiving chemo is associated with a variety of different risks and benefits. It’s helpful to ask your care team about potential risks and benefits prior to starting treatment.