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Can Lung Cancer Be Cured?

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Updated May 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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Question: Can Lung Cancer Be Cured?
A question I'm asked often is, "can lung cancer be cured?" What if it's caught early? Can surgery or chemotherapy cure lung cancer? As with many questions regarding lung cancer, an honest answer requires a careful explanation.
Answer:

This is a difficult question, because the answer can be yes or no depending upon how you define cure. Before explaining what this means, and because hope is so important in the setting of cancer, it's important to keep in mind a few things:

  • Long-term survival with lung cancer is sometimes possible, especially when the disease is caught in the early stages.
  • Some people survive many years even with stage 4 lung cancer.
  • There are reported cases -- though rare -- in which lung cancer has spontaneously regressed.
  • Even if a lung cancer is not curable, it is almost always treatable.

What Does Cure Mean?

In the truest sense of the word, lung cancer can't be "cured." What this means is that there is always a chance (in some cases this is very small) that lung cancer can recur, even many years or decades after it is originally found. The longer someone lives without evidence of cancer (with no evidence of disease (NED)), the lower the likelihood that it will come back.

There are actually very few cancers in which people can be declared "cured" in the pure sense of the word, and most of these are blood-related cancers such as leukemia in children. Lung cancer, instead, is similar to other "solid tumors" such as breast cancer and colon cancer in which long term remission is possible, but physicians are hesitant to use the word cured.

An example to help explain this, is that people who have survived lung cancer for 5 years, have a persistent risk of death from lung cancer up to 18 years after their diagnosis. Recurrence is more likely in those with adenocarcinoma than squamous cell lung cancer; more likely if the cancer has spread to lymph nodes, and more likely to recur if surgery is not done.

One exception in the literature is people who have stage 1A lung cancer with no vascular invasion -- meaning the tumor is very small and has not extended into any blood vessels. In this case if there is no evidence of cancer after 5 years, it appears the word cure may be used.

Can Early Stage Lung Cancer be Cured With Surgery?

In general, surgery offers the best chance for long-term survival from lung cancer. As noted above, when surgery is done at any early stage, has not spread to lymph nodes or blood vessels, doctors may sometimes use the word cure.

Surgery may done for those with stage 1, stage 2 and stage 3A non-small cell lung cancer. In a large study, among people with stage 1A lung cancer, 16% had a recurrence in the first 5 years, with the risk of recurrence after 5 years being 4.8%.

In another study, 87% of people who had successful surgery with lymph node dissection, and were alive 5 years after their diagnosis, survived another 5 years cancer free. Within this group:

  • For people with N0 disease (no spread of cancer to lymph nodes), 89% remained cancer free.
  • 84% of people with N1 disease (spread of cancer to lymph nodes near the initial tumor) were cancer-free.
  • 65% of those with N2 disease (spread of cancer to lymph nodes further away from the cancer) were disease-free.

Can Chemotherapy Cure Lung Cancer?

In general, chemotherapy is not used with curative intent for people with lung cancer. There are two primary reasons chemotherapy may be used. One is as an adjuvant therapy. For example, if someone has lung cancer surgery, chemotherapy may be given as an additional treatment just in case any lung cancer cells have spread to other regions of the body -- but are unable to be detected by imaging studies.

The other primary approach is as a palliative therapy. This is a treatment that's given to extend life or reduce symptoms, but not meant to cure a disease.

The role of chemotherapy for lung cancer is very important to understand. A recent study found that almost 70% of people with lung cancer didn't understand that chemotherapy was not at all likely to cure their cancer.

Can Lung Cancer be Cured With Radiation?

Stereotactic body radiotherapy (SBRT), known popularly as "cyber knife" procedures, may have effectiveness similar to surgery in some people with early stage lung cancer, and whose cancers can't be treated with surgery. In a small study of patients who survived 5 years frollowing SBRT, 25% had a later recurrence of their disease.

What About Stage 4 Lung Cancer?

With lung cancer that is stage 4 (or stage 3B) the goal of treatment is not usually a cure, but rather extending life and controlling symptoms. That said, and especially with some of the newer targeted therapies for lung cancer such as Tarceva (erlotinib) or Xalkori (crizitonib), some people are able to live a long time, sometimes many years, while treating their cancer as they would another chronic disease such as kidney disease or diabetes.

Though rare, long-term survival is sometimes possible even when lung cancer has spread. There are reports of more than a dozen people who have lived 10 years or more after brain metastases from lung cancer have been treated. A recent report also suggests that treating metastases at multiple sites with stereotactic body radiotherapy may be a way of improving long-term survival for some people with stage 4 lung cancer in the future.

What About Natural Cures?

The internet is rampant with links to so-called "natural cures" for cancer. Unfortunately, studies to date fail to show a survival benefit for any of these approaches. At best, some of the products may help with symptoms related to lung cancer and it's treatments, but at worst, may interfere with chemotherapy, may drain already strained cancer patients of their finances, and even, be dangerous.

It's unfortunate that quack remedies and false advertising has undermined alternative treatments in many ways. Administered by licensed professionals who specialize in integrative medicine, some of these treatments, such as acupuncture or ginger for chemotherapy induced nausea, may help people cope with the symptoms of conventional medical treatment for cancer, and in doing so, improve quality of life.

Further Reading:

Sources:

Haruki, T. et al. Spontaneous regression of lung adenocarcinoma: Report of a case. Surgery Today. 2010. 40(12):1155-8.

Hubbard, M. et al. Five-year survival does not equal cure in non-small cell lung cancer: a Surveillance, Epidemiology, and End Results-based analysis of variables affecting 10- to 18- year survival. Journal of Thoracic and Cardiovascular Surgery. 2012. 143(6):1307-13.

Maeda, R. et al. Late recurrence of non-small cell lung cancer more than 5 years after complete resection: incidence and clinical implications in patient follow-up. Chest. 2010. 138(1):145-50.

Maeda, R. et al. Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer. Journal of Thoracic Oncology. 2010. 5(8):1246050.

Matsuo, Y. et al. Preliminary report of late recurrences, at 5 years or more, after stereotactic body radiation therapy for non-small cell lung cancer. Journal of Thoracic Oncology. 2012. 7(2):453-6.

Onishi, H. et al. Stereotactic body radiotherapy for metachronous multisite oligo-recurrence: a long-surviving case with sequential oligo-recurrence in four different organs treated using locally radical radiotherapy and a review of the literature. Pulmonary Medicine. 2012 Oct 23. (Epub).

Shahidi, H., and P. Kvale. Long-term survival following surgical treatment of solitary brain metastasis in non-small cell lung cancer. Chest. 1996. 109(1):271-6.

Weeks, J. et al. Patients' expectations about effects of chemotherapy for advanced cancer. The New England Journal of Medicine. 2012. 367(17):1616-25.

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