What is chemotherapy?

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It is used for the following:

  • Small cell lung cancer (SCLC), where chemotherapy is usually the main treatment.
  • Non-small cell cancer (NSCLC), where people usually have chemotherapy before or after surgery.
  • Both types of lung cancer, where people sometimes have chemotherapy with radiotherapy. This is called chemoradiation.
  • Controlling symptoms when lung cancer has spread to other parts of the body.

Chemotherapy for small cell lung cancer (SCLC)

Chemotherapy is the main treatment for SCLC.

Depending on your situation, you may have chemotherapy:

  • at the same time as radiotherapy (concurrent chemoradiation)
  • before a course of radiotherapy (sequential chemoradiation)
  • after lung surgery – to get rid of any remaining cancer cells (but surgery is rarely an option for SCLC)
  • on its own – to control advanced cancer, help you live longer and improve symptoms.

Limited-stage SCLC

If you are well enough, chemoradiation is the most effective treatment for limited-stage SCLC. If you cannot cope with the side effects of concurrent chemoradiation, you can have sequential chemoradiation.

Afterwards, you usually have radiotherapy to the brain called preventative cranial radiotherapy (PCR).

Extensive-stage SCLC

For extensive-stage SCLC, you usually have chemotherapy on its own to start with.

If it works well for you, you usually have radiotherapy to the chest afterwards (sequential chemoradiation). Your doctor may also talk to you about having radiotherapy to the brain (PCR).

Chemotherapy for non-small cell lung cancer (NSCLC)

Chemotherapy to treat non-small cell lung cancer may be given:

  • after surgery or radiotherapy – to get rid of any remaining cancer cells and reduce the risk of the cancer coming back (adjuvant chemotherapy)
  • before surgery or radiotherapy – to shrink the cancer (neo-adjuvant chemotherapy)
  • at the same time as radiotherapy (concurrent chemoradiation)
  • on its own – to control advanced cancer, help you live longer and improve symptoms.

Chemotherapy as maintenance treatment for NSCLC

Some people also have chemotherapy as maintenance treatment. This is when chemotherapy is keeping the cancer stable or has shrunk it. Instead of stopping chemotherapy after your course has finished, you have a chemotherapy drug called pemetrexed every three weeks. You have it on its own.

You keep having it for as long as:

  • it is working
  • the side effects are not causing problems.

The aim of maintenance treatment is to keep the cancer under control for as long as possible.

The chemotherapy drugs used

Most people have a combination of at least two drugs. Some people can have treatment with one drug. For both types of lung cancer, you usually have either cisplatin or carboplatin, with one of the following drugs:

Other chemotherapy drugs may also be used. Your doctor or nurse will give you more information.

If you need more treatment

If the cancer comes back, you can usually have more chemotherapy with different drugs.

For small cell lung cancer

For small cell lung cancer you might have:

For non-small cell lung cancer

For non-small cell lung cancer you might have:

  • docetaxel
  • chemotherapy with a targeted therapy drug.

If the cancer comes back some time after you were first treated, your doctor may advise having the same chemotherapy drugs again.

Having chemotherapy for lung cancer

You have the treatment in the chemotherapy day unit and go home after it. Occasionally some people need to stay in hospital for a couple of days.

You have most drugs given into a vein (intravenously). Some of the drugs are given as tablets, such as topotecan.

If you are having chemotherapy into a vein, a nurse will put a small tube (cannula) into a vein in your hand or arm. Or they may put a soft, plastic tube called a central line or PICC line into a vein.

You have chemotherapy into the vein as one or more sessions of treatment. A nurse gives you the chemotherapy drugs through a drip (infusion) or through a syringe.

Each session takes a few hours. After the session, you have a rest period of a few weeks. The chemotherapy session and the rest period together are called a cycle of treatment. Most cycles are 3 weeks. Your doctor or nurse will explain more about this. You usually have 4 to 6 cycles.

We have more information on how chemotherapy is given

Possible side effects of chemotherapy

Chemotherapy can cause side effects. These vary depending on the drugs you have. Your cancer doctor, nurse specialist or pharmacist will explain the side effects that your chemotherapy is likely to cause. We have more information about the side effects of chemotherapy.