What is chemotherapy?

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. These drugs interfere with the way cancer cells grow and divide. They also affect normal cells. This causes side effects.

Your cancer doctor and nurse will talk to you about the aims of your treatment. Chemotherapy can be used along with other treatments or on its own.

The chemotherapy you have depends on:

  • the type of lung cancer
  • the stage of the cancer
  • how side effects are likely to affect you.

Your doctor may talk to you about having chemotherapy as part of a clinical trial.

What chemotherapy drugs are used for lung cancer

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.

Chemotherapy for small cell lung cancer (SCLC)

Chemotherapy is usually the first treatment for small cell lung cancer (SCLC). You may have it:

  • at the same time as radiotherapy (chemoradiation), if the cancer has not spread to other parts of the body
  • before radiotherapy to try to shrink the cancer
  • on its own to control advanced cancer, help you live longer and improve symptoms.

Chemotherapy may also be given after surgery to try to get rid of any remaining cancer cells. But surgery is not usually possible for SCLC.

The chemotherapy drugs used for SCLC are usually cisplatin or carboplatin, along with a second chemotherapy drug such as etoposide.

Limited-stage SCLC (Stage 1-3)

If the cancer is small enough and you are well enough to cope with side effects, chemoradiation is the most effective treatment. If you cannot have both treatments at the same time, you can have chemotherapy first followed by radiotherapy.

Extensive-stage SCLC (Stage 4)

At first, you usually have chemotherapy on its own. Some people may have it along with an immunotherapy drug, such as atezolizumab.

If chemotherapy has helped reduce the cancer you may have radiotherapy to the chest afterwards.

Your doctor may also talk to you about having radiotherapy to the brain to help prevent a secondary cancer. This is called prophylactic cranial radiotherapy (PCR).

If you need more treatment

If the cancer comes back or is growing, and you are well enough, you can usually have more chemotherapy with different drugs.

Your doctor may recommend a combination of the chemotherapy drugs cyclophosphamide, adriamycin, and vincristine (CAV). Or you may have a drug called topotecan instead of CAV. You take topotecan as a tablet.

Chemotherapy for non-small cell lung cancer (NSCLC)

Chemotherapy to treat non-small cell lung cancer (NSCLC) may be given:
  • on its own, or with a targeted or immunotherapy drug – this can help control advanced cancer, help you live longer and improve symptoms
  • after surgery or radiotherapy to reduce the risk of the cancer coming back (called adjuvant chemotherapy)
  • before surgery or radiotherapy to shrink the cancer (called neo-adjuvant chemotherapy)
  • with radiotherapy (chemoradiation) if surgery is not suitable and the cancer is locally advanced
  • with radiotherapy (chemoradiation) before surgery
  • after treatment with targeted therapy drugs if they are no longer working.

Maintenance chemotherapy for NSCLC

If chemotherapy with pemetrexed and cisplatin helped shrink or control the cancer, some people may continue with chemotherapy. This is sometimes called maintenance treatment.

Instead of stopping chemotherapy after a few cycles, you carry on having pemetrexed every 3 weeks. You have it for as long as it is controlling the cancer, and the side effects are not causing you problems.

If you need more treatment

If the cancer comes back or is growing, and you are well enough, you can usually have more chemotherapy with different drugs.

For NSCLC that comes back, your doctor may recommend docetaxel on its own, or with a targeted therapy called nintedanib. Chemotherapy may also be given with an immunotherapy drug.

Your treatment will depend on the drugs you had for your first treatment. If the cancer comes back some time after it was first treated, your doctor may advise having cisplatin or carboplatin again.

Having chemotherapy for lung cancer

Chemotherapy can be given in different ways, depending on your treatment plan. Your chemotherapy nurse will explain what is involved.

Usually chemotherapy is given in a chemotherapy day unit or outpatient clinic. But depending on the type of chemotherapy, some people may stay in hospital to have it.

Most of the drugs are given into a vein (intravenously). Some chemotherapy drugs, such as topotecan, are given as tablets.

A nurse gives you chemotherapy through a small tube (cannula) placed into a vein in your hand or arm. The drugs are given through a drip (infusion), or as an injection into the vein.

Some people have chemotherapy through a soft, plastic tube into a vein in their chest (called a central line). Or they may have it through a PICC line into a vein in their arm.

You have chemotherapy into the vein as 1 to 2 sessions of treatment, usually over 3 weeks. This makes up a cycle of chemotherapy. Each session will take a few hours.

Your doctor or nurse will explain more about this. You usually have 4 to 6 cycles of chemotherapy.

Possible side effects of chemotherapy for lung cancer

Chemotherapy drugs cause different side effects. These can usually be well controlled with medicines. Your doctor or nurse will tell you about the most likely side effects and how they can be controlled or managed. Most side effects usually go away once treatment has finished. 

We have more information about the side effects of chemotherapy.

Getting support

Macmillan is also here to support you. If you would like to talk, you can:

About our information

  • References

    Below is a sample of the sources used in our lung cancer information. If you would like more information about the sources we use, please contact us at  cancerinformationteam@macmillan.org.uk

    National Institute for Health and Care Excellence (NICE). Lung cancer – Diagnosis and management. Clinical guideline 2019.

    Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. 2018.

    European Society for Medical Oncology (ESMO). Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. 2017.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr David Gilligan, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

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