Background Advances in targeted therapy and immunotherapy have changed the landscape of lung cancer treatments, and the experiences of diagnosis, treatment and survival for many patients. Yet less is known about how people with lung cancer and their families experience supportive care needs across diagnosis, treatment, everyday life and longer-term disease control. Aim To explore the impact of new therapeutic options on the supportive care needs people diagnosed with lung cancer and their families. Methods Drawing on hermeneutic inquiry, people diagnosed with lung cancer and nominated family members were recruited from a tertiary cancer centre in Sydney, Australia. Semi-structured interviews were audio-recorded, transcribed verbatim, de-identified and analysed using thematic analysis. Twenty-two participants were recruited 15 people with lung cancer and seven family members. Findings Analysis identified new supportive care concerns not previously identified in earlier studies, represented in the five identified themes. Mapping the Chaos: Making Sense in a Fog of Facts captured the shock, fear and information burden surrounding diagnosis and early treatment. Finding a Reliable Pathway Through a Fragmented System described the need for coordination, navigation and reliable points of contact. Treating cancer versus not supporting the person showed the gap between disease-directed treatment and the broader emotional, practical, family and person-centred support needed to live through cancer. Different Routes to Regaining Control captured diverse strategies for regaining control in life, from expert-level learning to selective information avoidance. Living Longer, Living Differently reflected the new reality of extended survival alongside treatment burden, surveillance and uncertainty. Conclusion Supportive care in lung cancer needs to move beyond treatment delivery to support patients and families as they make sense of care, sustain everyday life and live with uncertainty. Proactive, coordinated and family-inclusive models are needed to recognise lung cancer as both an acute crisis and an ongoing life condition.