Boston, Massachusetts
Raphael Bueno
Pleural Specialist | Thoracic Surgery
Expertise: Pleurectomy and Decortication Extrapleural Pneumonectomy
Languages: English
Asbestos-Related Lung Cancer Treatment
Table Of Contents
The primary goal of curative treatment for asbestos-related lung cancer is to remove and kill cancer cells to prevent its spread. For patients in advanced stages of disease progression, treatment may focus on palliative care or reducing symptoms to improve quality of life.
Written by Suzanne Dixon, MPH, MS, RDN | Medically Reviewed by Dr. Andrea Wolf | Edited by Walter Pacheco | Last Update: November 26, 2025
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How Is Asbestos Lung Cancer Treated?
Asbestos-related lung cancer treatment can involve various forms of surgery, chemotherapy and radiation. When you receive a lung cancer diagnosis, your doctor will explain what type of tumor you have. There are two main types of lung cancer: Small cell and non-small cell.
Small cell and non-small cell lung cancers grow, spread and react to treatments differently. When you receive your diagnosis, your doctor will also explain the stage your cancer is at in terms of its progression. Your specific cancer type will play an important role in determining the best treatment plan for you.
Exposure to asbestos is strongly associated with causing lung cancer, mesothelioma and several other severe respiratory diseases. Asbestos is the most common occupational risk factor for lung cancer, and workplace exposure significantly increases the chance of developing the disease.
Staging
The stage a patient’s cancer has progressed to may limit treatment options. Lung cancer can spread to the lymph nodes and distant organs as it progresses, making treatment increasingly difficult. The earlier the diagnosis, the more treatment options there are. This increases the likelihood of successful treatment.
Non-small cell lung cancers are commonly classified with a 4-stage system. A higher stage indicates more advanced disease.
Small cell lung cancer is staged using a 2-stage system: Limited stage or extensive stage. In limited stage, the cancer is only found in a single lung and possibly nearby lymph nodes. In extensive stage, the tumor has spread to both lungs or other organs.
Surgery
Surgery’s goal is to remove a tumor and nearby cancerous tissue, ideally eliminating the disease completely. The tumor’s size, its location and how far the cancer has spread affects how much tissue is removed.
Types of surgery for lung cancer include: Wedge resection, lobectomy and pneumonectomy. Wedge describes the shape of the portion of lung and tissue removed in a wedge resection. A lobectomy removes a lobe, or section, of a lung. A pneumonectomy removes an entire lung.
If the cancer is found in an early stage when spread is limited, curative surgery is preferred for its statistically high success rates. However, in advanced-stage cancer where a cure is unlikely, palliative surgery may be performed to relieve symptoms and make patients more comfortable.
In addition to a patient’s cancer stage, doctors look at the cancer’s type before recommending a curative surgery approach. Coexisting conditions, such as heart disease, could make a patient ineligible for surgery.
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See My OptionsSurgery for Non-Small Cell Lung Cancer
Surgery patients with non-small cell lung cancer can experience a 50-75% chance of relapse-free 5-year survival. In most cases, non-small cell lung cancers are removed through lobectomy. If the patient has poor lung function, however, doctors may remove only a small wedge of the lung via surgical resection.
Surgery for Small Cell Lung Cancer
Surgery is an option only in a few special cases of small cell lung cancer. This is because small cell lung cancer spreads much more aggressively than non-small cell lung cancer. Although surgical treatment for small cell is rare, studies have reported positive results for the small percentage of patients with very limited disease.
Exclusive Content
Dr. Jacques Fontaine: Treatment Options for Lung Cancer
The treatment for lung cancer is based on the type of lung cancer, whether it’s small cell or non small cell. And then within non small cell, there are different types, adenocarcinoma, squamous cell carcinoma, and neuroendocrine tumors. And then, as you may know, each one then gets subdivided depending on the protein that’s overexpressed on it, or if there’s certain genetic mutations that we find on it. So the treatment is based on the type of lung cancer, its genetic fingerprint, but also on the stage of the lung cancer.
Lung cancer, just like any other cancer, is divided into four stages. Stage one being the earliest stage four being the most advanced. Stage one lung cancer is when the cancer is quite small and it’s only in the lung. It has not traveled to the lymph nodes and has not traveled to any other organs.
The best treatment for stage one lung cancer is to remove it with surgery.
We no longer have these days to do a big incision. We can do it with little incisions, a three d camera, and long thin instruments called robotic surgery. We used to have to remove the whole lung or a whole lobe or a third of the lung, but that’s no longer the case. If we’re able to catch the cancer when it’s still quite small stage one, we can now remove only a segment of lung, a smaller anatomic portion of the lung, which allows the patients to have a better quality of life, leaves them with more lung capacity so that they can breathe better.
For patients who cannot tolerate having surgery for their stage one lung cancer, or who simply don’t want surgery, the alternative to surgery, albeit with a slightly lower success rate, is radiation, what we call SBRT or stereotactic body radiation, which is high dose pinpoint radiation over three to five days targeted specifically to the cancer. And that is a good alternative to surgery for patients who are too old, too sick, or simply don’t want surgery. The results are very good, not as good as surgery. Unfortunately, most patients who get diagnosed with lung cancer have already stage two or stage three disease.
Stage two or stage three disease means that the cancer cells have left the tumor in the lung and have actually traveled to the lymph nodes. Lymph nodes are the normal filters of the blood. We all have lymph nodes from our head to our feet. And it’s the first place that cancer goes to when it leaves an organ, whether we’re dealing with lung or breast or colon cancer, it’s the first place that cancer propagates to, goes to.
And if you have cancer cells in the lymph nodes, in the filters of the blood, you can safely assume that there’s a few microscopic cancer cells that have gone through that filter into the bloodstream and may have gone elsewhere in the body. In fact, when we take patients to the operating room for stage two or stage three cancer, the majority of them already have microscopic cancer cells that have gone to the brain or the bones or the liver that we just cannot see on a PET scan or a CAT scan, or an MRI. The fact that the cancer is in the lymph nodes and the filters of the blood, we can assume or predict that a few of these cancer cells are already out there.
So surgery is a good way to control the disease locally, to remove the tumor in the lung and in the lymph nodes. However, if we want to achieve a high cure rate, we have to give cancer medication that goes in the bloodstream to go catch those cancer cells, those microscopic cancer cells we can’t see on CAT scan that may be elsewhere in the body. And that is systemic therapy. So for stage two and stage three disease, in addition to surgery, a patient must get systemic therapy. Cancer therapy that goes through your whole system, chemotherapy, immunotherapy, ADC, radiopharmaceuticals. For patients with stage four disease, metastatic disease, when the tumor has already gone to other organs, we may not be able to cure the patients, but we certainly have good treatment options.
These treatment options are systemic treatment options.
That could be standard chemotherapy, it could be immunotherapy, it could be targeted therapy or pills, it could be antibody drug conjugates, which is the antibody antigen, or it could be radiopharmaceuticals. And when these treatment options are given, majority of the time they work and the tumor shrinks. And rarely the tumor can completely go away or go in complete remission in rare circumstances.
However, unfortunately, these tumor cells outsmart the treatment we give them and they develop a resistance.
Like bacteria or viruses can develop a resistance. Cancer cells can also develop a resistance to the treatment we give them. And after they’ve already shrunk or even disappeared on CAT scan, a few months or a year or two later, they start growing again. And we see them again on a CAT scan because they’ve grown resistant. So then we give them a different type of treatment. Maybe by then we have a new treatment that’s come on the market that’s effective.
Or maybe patients can also get investigational treatment, meaning a clinical trial. Clinical trials is when we administer patients experimental or investigational treatments. Those treatments in general are quite safe because they’ve already been tested in animal models or tested in phase one studies, and we’re now rolling them out to a larger population. And this allows patients to get medications that are not otherwise available on the market, medications that are not Medications that are not FDA approved, that may not be given outside of an academic university hospital.
Sometimes patients who get diagnosed with lung cancer, with stage two or stage three lung cancer, are rushing to start treatment, want to get it out immediately with surgery, or rushing to start systemic treatment. But in fact, it’s actually wiser to wait to get all the information from the tumor, all the data from the tumor, such as molecular testing, genetic fingerprinting of the tumor, looking for protein overexpression, to know exactly what type of tumor it is and are there specific targets on that tumor that we can use more appropriate, more effective medication? So although yes, it’s important to try to start cancer treatments immediately, it is best and wiser and better in the long term to wait a few extra days or a week or two more to be able to get all the information from the biopsies, from the molecular testing, get to see a specialist in a major cancer center to start with the right treatment from day one and not any treatment yesterday.
Lung cancer, just like any other cancer, is divided into four stages. Stage one being the earliest stage four being the most advanced. Stage one lung cancer is when the cancer is quite small and it’s only in the lung. It has not traveled to the lymph nodes and has not traveled to any other organs.
The best treatment for stage one lung cancer is to remove it with surgery.
We no longer have these days to do a big incision. We can do it with little incisions, a three d camera, and long thin instruments called robotic surgery. We used to have to remove the whole lung or a whole lobe or a third of the lung, but that’s no longer the case. If we’re able to catch the cancer when it’s still quite small stage one, we can now remove only a segment of lung, a smaller anatomic portion of the lung, which allows the patients to have a better quality of life, leaves them with more lung capacity so that they can breathe better.
For patients who cannot tolerate having surgery for their stage one lung cancer, or who simply don’t want surgery, the alternative to surgery, albeit with a slightly lower success rate, is radiation, what we call SBRT or stereotactic body radiation, which is high dose pinpoint radiation over three to five days targeted specifically to the cancer. And that is a good alternative to surgery for patients who are too old, too sick, or simply don’t want surgery. The results are very good, not as good as surgery. Unfortunately, most patients who get diagnosed with lung cancer have already stage two or stage three disease.
Stage two or stage three disease means that the cancer cells have left the tumor in the lung and have actually traveled to the lymph nodes. Lymph nodes are the normal filters of the blood. We all have lymph nodes from our head to our feet. And it’s the first place that cancer goes to when it leaves an organ, whether we’re dealing with lung or breast or colon cancer, it’s the first place that cancer propagates to, goes to.
And if you have cancer cells in the lymph nodes, in the filters of the blood, you can safely assume that there’s a few microscopic cancer cells that have gone through that filter into the bloodstream and may have gone elsewhere in the body. In fact, when we take patients to the operating room for stage two or stage three cancer, the majority of them already have microscopic cancer cells that have gone to the brain or the bones or the liver that we just cannot see on a PET scan or a CAT scan, or an MRI. The fact that the cancer is in the lymph nodes and the filters of the blood, we can assume or predict that a few of these cancer cells are already out there.
So surgery is a good way to control the disease locally, to remove the tumor in the lung and in the lymph nodes. However, if we want to achieve a high cure rate, we have to give cancer medication that goes in the bloodstream to go catch those cancer cells, those microscopic cancer cells we can’t see on CAT scan that may be elsewhere in the body. And that is systemic therapy. So for stage two and stage three disease, in addition to surgery, a patient must get systemic therapy. Cancer therapy that goes through your whole system, chemotherapy, immunotherapy, ADC, radiopharmaceuticals. For patients with stage four disease, metastatic disease, when the tumor has already gone to other organs, we may not be able to cure the patients, but we certainly have good treatment options.
These treatment options are systemic treatment options.
That could be standard chemotherapy, it could be immunotherapy, it could be targeted therapy or pills, it could be antibody drug conjugates, which is the antibody antigen, or it could be radiopharmaceuticals. And when these treatment options are given, majority of the time they work and the tumor shrinks. And rarely the tumor can completely go away or go in complete remission in rare circumstances.
However, unfortunately, these tumor cells outsmart the treatment we give them and they develop a resistance.
Like bacteria or viruses can develop a resistance. Cancer cells can also develop a resistance to the treatment we give them. And after they’ve already shrunk or even disappeared on CAT scan, a few months or a year or two later, they start growing again. And we see them again on a CAT scan because they’ve grown resistant. So then we give them a different type of treatment. Maybe by then we have a new treatment that’s come on the market that’s effective.
Or maybe patients can also get investigational treatment, meaning a clinical trial. Clinical trials is when we administer patients experimental or investigational treatments. Those treatments in general are quite safe because they’ve already been tested in animal models or tested in phase one studies, and we’re now rolling them out to a larger population. And this allows patients to get medications that are not otherwise available on the market, medications that are not Medications that are not FDA approved, that may not be given outside of an academic university hospital.
Sometimes patients who get diagnosed with lung cancer, with stage two or stage three lung cancer, are rushing to start treatment, want to get it out immediately with surgery, or rushing to start systemic treatment. But in fact, it’s actually wiser to wait to get all the information from the tumor, all the data from the tumor, such as molecular testing, genetic fingerprinting of the tumor, looking for protein overexpression, to know exactly what type of tumor it is and are there specific targets on that tumor that we can use more appropriate, more effective medication? So although yes, it’s important to try to start cancer treatments immediately, it is best and wiser and better in the long term to wait a few extra days or a week or two more to be able to get all the information from the biopsies, from the molecular testing, get to see a specialist in a major cancer center to start with the right treatment from day one and not any treatment yesterday.
Chemotherapy
When there is clear evidence that lung cancer has spread from the initial tumor, chemotherapy is recommended. This treatment is typically not curative for lung cancer, but has been known to reduce the size of tumors and kill cancer cells that have spread to the lymph nodes. For patients, this usually translates to a longer, more comfortable life.
Whether taken intravenously or in pill form, chemotherapy drugs target rapidly dividing cells. This kills cancer cells, but can also affect normal healthy cells including hair follicles, red and white blood cells and the cells that line the stomach.
Because nearly 50% of all patients who have a tumor surgically removed will experience relapse, about 80% of all lung cancer patients are considered for chemotherapy during the course of their treatment.
More than 50%
The percentage of lung cancer patients who may experience a notable reduction in tumor size with modern chemotherapy, including use of targeted agents.
Chemotherapy for Non-Small Cell Lung Cancer
In the earliest stages of non-small cell lung cancer, chemotherapy is sometimes given before surgery to reduce tumor size and eliminate early spreading. Doctors call this approach neoadjuvant chemotherapy. For patients with limited lymph node involvement, chemotherapy can also be given post-surgery to kill any remaining cancer cells. This is known as adjuvant chemotherapy and helps prevent the chance of cancer recurrence.
For later stage cancers when surgery is no longer an option, chemotherapy is often administered with simultaneous radiation therapy. Known as combined chemoradiation therapy, this option often boasts survival rates higher than either treatment given alone or one after the other. This treatment is common if the cancer has spread to the mediastinal lymph nodes, which are located outside of the lung near the trachea and esophagus.
Chemotherapy for Small Cell Lung Cancer
For early-stage small cell lung cancer patients in otherwise good health, doctors recommend combined chemoradiation therapy. Small cell cancers are highly responsive to chemotherapy, and survival is significantly improved when it is combined with early radiation therapy.
Once the cancer enters the extensive stage and spreads to distant organs, doctors typically prescribe a platinum-based chemotherapy regimen. This will involve platinum containing drugs like cisplatin or carboplatin with one or more additional chemotherapy drugs.
As many as 80%
The percentage of small cell lung cancer patients who may respond at least briefly to chemotherapy when the disease has already spread from the chest cavity (extensive stage disease).
Radiation Therapy
Radiation is an effective treatment for non-small cell lung cancer. When applied in early stages for non-small cell lung cancer, radiation therapy is associated with 5-year survival rates between 13% and 39%. While radiation can help with local control, it’s much less effective for small cell lung cancer. This is especially true when it’s already spread extensively.
When lung cancer patients aren’t eligible for surgery, radiation is often recommended. High-energy targeted radiation stops cancerous cell division and reduces the size of tumors. The amount of radiation administered is thousands of times greater than the amount used in X-ray imaging, but treatment is divided into doses to limit the damage done to healthy tissues.
Like surgery, radiation therapy is a local treatment that only affects cells in the treatment area. Response rates for radiation therapy are significantly high, but relapse is common. As a result, it’s more often used palliatively. It’s administered in small doses to reduce pain where tumors have spread. It can also be given to prevent or treat lung cancers that spread to the brain.
Clinical Trials and Emerging Treatments
Clinical trials test new drug combinations to improve treatment success rates while minimizing undesirable side effects. Many experimental or emerging lung cancer treatments are also used to treat other asbestos-related cancers such as mesothelioma, which develops on the lining of the lungs. Clinical trials for these treatments will often accept both lung cancer and mesothelioma patients.
A number of clinical trials studying combinations of immunotherapy and chemotherapy, targeted therapies and gene therapies are currently underway. Ask your doctor for more information about joining a clinical trial or speak with a Patient Advocate.
A 2021 study, for example, reported positive results combining photodynamic therapy with chemotherapy for lung cancer. Researchers reported improved disease control, reduced treatment resistance and increased overall effectiveness in cancer reduction compared to conventional options.
Find Active Mesothelioma Clinical Trials
Try our new clinical trials search tool to find active trials near you. Get help enrolling today.
Find a Clinical TrialAsbestos Lung Cancer Doctors
If you have been diagnosed with asbestos-related lung cancer, you’ll likely see more than one type of doctor. Leading cancer facilities recommend a multimodal approach to treatment, meaning several doctors specializing in different areas will work together to treat one patient.
Specialists Who Work in Multimodal Teams
- Medical Oncologist: An oncologist treats patients with chemotherapy, targeted immunotherapies or a combination of these. Some stage 1 and 2 and most stage 3 and 4 non-small cell lung cancer patients will receive treatment from a medical oncologist as part of multimodal treatment.
- Pathologist: Although this is a physician the patient will probably never meet, the pathologist examines tissue samples to determine if someone has asbestos lung cancer and what type.
- Pulmonologist: A pulmonologist, or pulmonary therapist, specializes in diseases of the lung and bronchial tubes.
- Radiation Oncologist: A radiation oncologist or radiologist specializes in treating lung cancer patients with radiation. Some stage 2 and most stage 3 and 4 non-small cell lung cancer patients receive radiation.
- Thoracic Surgeon: A thoracic surgeon performs operations on the chest.
Because lung cancer is so prevalent — the second-most diagnosed cancer in the United States — there is no shortage of doctors who treat it. The number of doctors who specialize in asbestos-related lung diseases is much smaller. Treating asbestos lung cancer comes with a special set of circumstances and challenges.
Finding the Right Asbestos-Lung Cancer Doctor for You
A growing number of well-regarded specialists who treat this disease are serving patients around the country. We can connect you with doctors such as thoracic surgeon Dr. Raphael Bueno, who is the associate chief of thoracic surgery at Brigham and Women’s Hospital in Boston, or Dr. James Luketich, who is chairman of the University of Pittsburgh Medical Center Lung and Esophageal Surgery Institute.
Pittsburgh, Pennsylvania
James Luketich
Pleural Specialist | Thoracic Surgery
Expertise: Minimally Invasive Surgery Research
Languages: English
With our network of more than 500 of the best mesothelioma specialists around the U.S., our Patient Advocates can help you find the right doctor for you. They also help with insurance, VA claims and answering questions you may have about clinical trials or available resources.
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