How to Treat Non-Small Cell Lung Cancer

  • 4 years ago
https://www.cancer.org/cancer/lung-cancer/treating-non-small-cell/by-stage.html

Treatment Choices for Non-Small Cell Lung Cancer, by Stage

The treatment options for non-small cell lung cancer (NSCLC) are based mainly on the stage (extent) of the cancer, but other factors, such as a person’s overall health and lung function, as well as certain traits of the cancer itself, are also important.

If you smoke, one of the most important things you can do to be ready for treatment is to try to quit. Studies have shown that patients who stop smoking after a diagnosis of lung cancer tend to have better outcomes than those who don’t.

Treating occult cancer

For these cancers, malignant cells are seen on sputum cytology but no obvious tumor can be found with bronchoscopy or imaging tests. They are usually early-stage cancers. Bronchoscopy and possibly other tests are usually repeated every few months to look for a tumor. If a tumor is found, treatment will depend on the stage.

Treating stage 0 NSCLC

Because stage 0 NSCLC is limited to the lining layer of airways and has not invaded deeper into the lung tissue or other areas, it is usually curable by surgery alone. No chemotherapy or radiation therapy is needed.

If you are healthy enough for surgery, you can usually be treated by segmentectomy or wedge resection (removal of part of the lobe of the lung). Cancers in some locations (such as where the windpipe divides into the left and right main bronchi) may be treated with a sleeve resection, but in some cases they may be hard to remove completely without removing a lobe (lobectomy) or even an entire lung (pneumonectomy).

Treating stage I NSCLC

If you have stage I NSCLC, surgery may be the only treatment you need. This may be done either by taking out the lobe of the lung that has the tumor (lobectomy) or by taking out a smaller piece of the lung (sleeve resection, segmentectomy, or wedge resection). At least some lymph nodes in the lung and in the space between the lungs will also be removed and checked for cancer.

Treating stage II NSCLC

People who have stage II NSCLC and are healthy enough for surgery usually have the cancer removed by lobectomy or sleeve resection. Sometimes removing the whole lung (pneumonectomy) is needed.

Any lymph nodes likely to have cancer in them are also removed. The extent of lymph node involvement and whether or not cancer cells are found at the edges of the removed tissues are important factors when planning the next step of treatment.

After surgery, the removed tissue is checked to see if there are cancer cells at the edges of the surgery specimen. This might mean that some cancer has been left behind, so a second surgery might be done to try to remove any remaining cancer. This may be followed by chemotherapy (chemo). Another option is to treat with radiation, sometimes with chemo.

Treating stage IIIA NSCLC

Treatment for stage IIIA NSCLC may include some combination of radiation therapy, chemotherapy (chemo), an