Recent studies focussed on symptoms and supportive care in lung cancer suggest that new approaches to monitoring symptoms should be advocated. There is emerging evidence for benefit in taking a pro-active approach to symptom control from at early point in the disease trajectory. Furthermore, for the first time a proportion of patients with advanced lung cancer are being treated for extended periods with new drugs including targeted agents. There is still relatively little experience with these newer drugs but they have side-effect profiles which require new symptom management approaches. Furthermore their medium and longterm toxicities are still not defined and thus a vigilant approach, which could include symptom monitoring, is warranted.