Yes; lung cancer that is found early, before it has spread, is often cured with surgery or radiotherapy [1, 2]. In stage 3, with chemotherapy and radiotherapy given together followed by immunotherapy, about 1 in 3 people are alive with no growth of the cancer 5 years later [5]. Stage 4 lung cancer usually cannot be cured and the aim is to control it; but with targeted tablets and immunotherapy, some people live for years [3, 6, 9].
Key points
- The earlier, the better the chance of cure: in the United States, about 2 in 3 people whose cancer is still only in the lung are alive 5 years later [2].
- In stage 3, with chemotherapy and radiotherapy given together followed by a year of immunotherapy, about 1 in 3 people were alive 5 years later with no growth of the cancer [5].
- Stage 4 can be treated too: the aim is long-term control, and some people live for years with well-controlled disease [3].
- Genetic testing of the tumour (for example EGFR and ALK) and a PD-L1 test decide the treatment path; with an ALK-targeted tablet, about 6 in 10 people with advanced disease were alive 5 years later [1, 9].
- The chance of living 5 years with lung cancer that has spread has grown about 5-fold since the 1990s [2].
- Stopping smoking, even after diagnosis, improves the chance of survival [12].
Is malignant lung cancer curable? What does "cure" mean?
Every cancer is a "malignant" tumour, so "malignant lung cancer" simply means lung cancer. When doctors talk about a cure, they mean treatment that aims to remove the disease completely and stop it coming back. This aim is realistic for lung cancer that has not yet spread to distant parts of the body [1].
When cancer has reached distant parts of the body (stage 4), the aim of treatment is usually to control the disease: to stop or slow its growth and ease symptoms [3]. Each person's outlook depends on the stage, the type of lung cancer, genetic changes in the tumour (such as EGFR or ALK), symptoms and their general health [1]. Statistics come from large numbers of patients and cannot say exactly what will happen to one person. Read about stages: What are cancer stages?
How curable is lung cancer? Survival rates by stage
| Stage | What it means | About 30 years ago | Today |
|---|---|---|---|
| Only in the lung | The cancer has not yet spread outside the lung | 5 | More than 6 |
| Spread nearby | It has reached lymph nodes or nearby tissue | 2 | Nearly 4 |
| Spread far | It has reached distant places such as the bones, brain or liver | Fewer than 1 (2 in 100) | 1 |
Compared with people of the same age without cancer; all types of lung cancer together. The "Today" column covers people diagnosed between 2015 and 2021 [2].
Treatment at each stage, in plain words
- 1
Stages 1 and 2 (cancer in the lung or in the lymph nodes next to it)
Surgery is the basis of cure; sometimes chemotherapy, immunotherapy or a targeted tablet is also given before or after it [1]. If surgery is not possible, precise, high-dose radiotherapy (SBRT) is used instead [1]. If the tumour has an EGFR mutation, the targeted tablet osimertinib after surgery helped people live longer: in a large study of people with stage 1 to 3 cancer who had had surgery, nearly 9 in 10 were alive 5 years later [4].
- 2
Stage 3 (more spread within the chest)
If surgery is possible, surgery with chemotherapy and sometimes immunotherapy [1]. If surgery is not possible, chemotherapy and radiotherapy given together, followed by a targeted tablet (for an EGFR mutation) or immunotherapy [1]. In a large study, with a year of the immunotherapy drug durvalumab after chemotherapy and radiotherapy, more than 4 in 10 people were alive 5 years later [5].
- 3
Stage 4 (spread)
Stage 4 lung cancer: can it be treated, and what is the life expectancy?
Stage 4 lung cancer usually cannot be cured, but it can be treated, and the aim is to stop or slow the disease; some people live for years with well-controlled disease [3]. The most important step is genetic testing of the tumour before treatment starts, because it changes the type of treatment and its results [1]. Read more: tumour genetic testing and targeted therapy.
Results of treatment in some groups of patients, in large studies:
- EGFR mutation: with osimertinib tablets, half of the patients lived more than 3 years [8]. Read more: treating EGFR-mutated lung cancer.
- ALK gene change: with alectinib tablets, about 6 in 10 patients were alive 5 years later [9].
- No treatable genetic change, high PD-L1: with pembrolizumab immunotherapy alone, about 3 in 10 patients were alive 5 years later [6].
- No treatable genetic change, non-squamous type, any PD-L1 level: with immunotherapy plus chemotherapy, about 2 in 10 patients were alive 5 years later [7].
These numbers come from studies done several years ago; one person's result may be better or worse. Treatments that ease symptoms (palliative care) can be given at any point during treatment [3]. Read more: What is targeted therapy?, What is immunotherapy? and What is metastasis?
How is small cell lung cancer different?
There are two main types of lung cancer, and non-small cell lung cancer is the more common one [1]. Small cell lung cancer has its own treatment [10, 11]:
- Limited stage (stages 1 to 3): chemotherapy and radiotherapy given together, followed by the immunotherapy drug durvalumab. In a large study with this treatment, half of the patients lived more than four and a half years [10].
- Spread (extensive stage): chemotherapy with immunotherapy helps people live longer; in a large study, nearly 2 in 10 patients were alive 3 years later [11].
Read more: Small cell lung cancer: how it differs and how it is treated
What improves the chance of successful treatment?
Stop smoking, now
In a review of studies in people with early-stage lung cancer, continuing to smoke was linked to a higher risk of death and of the cancer coming back; the chance of living 5 years was estimated to be about twice as high in those who stopped after diagnosis as in those who carried on [12]. Read: How much does stopping smoking lower cancer risk?
Genetic testing of the tumour before treatment
Genetic changes such as EGFR and ALK affect the outlook and the choice of treatment [1]. Before treatment for advanced lung cancer starts, ask your doctor whether the tumour has had genetic testing.
Finding it earlier
A yearly low-dose CT scan in people at high risk (heavy smokers) lowers the risk of dying from lung cancer [2]. Check whether you need it: Should I be screened for lung cancer? Know the warning signs too: symptoms of lung cancer.
Complete treatment on time
Finish the course of treatment your doctor has planned and report side effects early so that treatment is not interrupted. Read: Why is complete, uninterrupted treatment important?
Frequently asked questions
What is the life expectancy with lung cancer? How long do people live?
It depends on the stage and the type of cancer. When the cancer is only in the lung, about 2 in 3 people in the United States are alive 5 years later; when it has reached nearby lymph nodes, nearly 4 in 10; and when it has spread far, about 1 in 10 [2]. In cancer that has spread but has a treatable genetic change, the numbers are better; for example, with an ALK-targeted tablet, about 6 in 10 patients were alive 5 years later [9]. These numbers are averages and cannot predict what will happen to one person.
What is the treatment for stage 4 lung cancer?
A targeted tablet if the tumour has a treatable genetic change; otherwise immunotherapy, alone or with chemotherapy; and further drugs if the disease grows [1]. Palliative care, meaning treatments that ease symptoms, can be given at any point during treatment [3]. Read the details in lung cancer treatment by stage.
If I cannot have surgery, can early-stage lung cancer still be treated?
Yes. For people who cannot have or do not want surgery, precise, high-dose radiotherapy (SBRT) is a standard treatment for early-stage disease [1]. Read more: What is radiotherapy?
How long does immunotherapy go on, and does its effect last?
In large studies, pembrolizumab immunotherapy was given for up to about 2 years [6, 7]. In some people the effect lasted for years: about 3 in 10 patients with high PD-L1 were alive 5 years later [6].
Is stopping smoking still worthwhile after diagnosis?
Yes. In people with early-stage lung cancer, continuing to smoke was linked to a higher risk of death and of the cancer coming back; stopping after diagnosis improved the chance of survival [12]. Ask your doctor for help to stop.
Survival evidence by stage and treatment (for doctors)
For physicians
Population survival (SEER). Five-year relative survival for lung and bronchus cancer diagnosed in 2015–2021: all stages 28%, localised 65%, regional 37% and distant 10%; versus 48%, 20% and 2% for diagnoses in 1995–1997. LDCT screening reduces the odds of lung cancer death in high-risk people by 16% to 24% [2].
Early stage. ADAURA (adjuvant osimertinib for up to 3 years in resected EGFR-mutated stage IB–IIIA NSCLC): 5-year overall survival 88% vs 78% (HR 0.49; 95.03% CI 0.34 to 0.70), and in stage II–IIIA 85% vs 73% (HR 0.49) [4]. In a meta-analysis of observational studies, continued smoking after diagnosis of early-stage NSCLC was associated with an HR for death of 2.94 (1.15 to 7.54) and an HR for recurrence of 1.86; life-table modelling estimated 5-year survival of 70% in quitters versus 33% in continuing smokers aged 65 [12].
Unresectable stage III. PACIFIC (durvalumab 10 mg/kg every 2 weeks for 12 months after concurrent chemoradiotherapy): 5-year overall survival 42.9% vs 33.4% (HR 0.72; median 47.5 vs 29.1 months) and 5-year progression-free survival 33.1% vs 19.0% [5]. Regimen: durvalumab consolidation (PACIFIC).
Stage IV with a driver alteration. FLAURA: median overall survival 38.6 months with osimertinib vs 31.8 months with gefitinib or erlotinib (HR 0.80; P=0.046) [8]. ALEX: 5-year overall survival 62.5% with alectinib vs 45.5% with crizotinib (HR 0.67; 95% CI 0.46 to 0.98); median PFS 34.8 vs 10.9 months [9].
Stage IV without a driver alteration. KEYNOTE-024 (PD-L1 TPS ≥50%): 5-year overall survival 31.9% with pembrolizumab vs 16.3% with chemotherapy (HR 0.62; median 26.3 vs 13.4 months, with an effective crossover rate of 66%); 82.1% of the 39 patients who completed all 35 cycles were alive at data cutoff [6]. KEYNOTE-189 (non-squamous, any PD-L1 level): 5-year overall survival 19.4% vs 11.3% (HR 0.60) [7].
Small cell lung cancer. ADRIATIC (LS-SCLC after concurrent chemoradiotherapy): median overall survival 55.9 months with durvalumab vs 33.4 months (HR 0.73) [10]. CASPIAN (ES-SCLC, median follow-up 39.4 months): 3-year overall survival 17.6% with durvalumab plus platinum–etoposide vs 5.8% (HR 0.71) [11].
Scientific evidence
Scientific evidence
8 itemsPembrolizumab versus Chemotherapy for PD-L1–Positive Non–Small-Cell Lung Cancer
Pembrolizumab Plus Pemetrexed and Platinum in Nonsquamous Non–Small-Cell Lung Cancer: 5-Year Outcomes From the Phase 3 KEYNOTE-189 Study
Overall Survival with Osimertinib in Untreated, EGFR-Mutated Advanced NSCLC
Overall Survival with Osimertinib in Resected EGFR-Mutated NSCLC
Alectinib versus Crizotinib in Untreated ALK-Positive Non–Small-Cell Lung Cancer
Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer
Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer
Durvalumab plus platinum–etoposide versus platinum–etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial
Related cancer types
Related questions
References
12 referencesShow all references, 6 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
- 3
- 4Overall Survival with Osimertinib in Resected EGFR-Mutated NSCLC
- 5
- 6
- 7
- 8Overall Survival with Osimertinib in Untreated, EGFR-Mutated Advanced NSCLC
- 9
- 10
- 11
- 12
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/questions/is-lung-cancer-curable/