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Lung cancer - non-small cell - Treatment

Alternative Names

Cancer - lung - non-small cell; Non-small cell lung cancer; NSCLC; Adenocarcinoma - lung; Squamous cell carcinoma - lung

Treatment:

There are many different types of treatment for non-small cell lung cancer. Treatment depends upon the stage of the cancer.

Surgery is the often the first line of treatment for patients with non-small cell lung cancer that has not spread beyond nearby lymph nodes. The surgeon may remove:

  • One of the lobes of the lung (lobectomy)
  • Only a small part of the lung (wedge or segment removal)
  • The entire lung (pneumonectomy)

Some patients need chemotherapy. Chemotherapy uses drugs to kill cancer cells and stop new ones from growing.

  • Chemotherapy alone is often used when the cancer has spread (stage IV).
  • It may also be given before surgery or radiation to make those treatments more effective. This is called neoadjuvant therapy.
  • It may be given after surgery to kill any remaining microscopic areas of cancer. This is called adjuvant therapy.

Radiation therapy can be used with chemotherapy if surgery is not possible. Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. Radiation may be used to:

  • Treat the cancer, along with chemotherapy if surgery is not possible
  • Help relieve symptoms caused by the cancer, such as breathing problems and swelling.
  • Help relieve cancer pain when the cancer has spread to the bones

The following treatments are mostly used to relieve symptoms caused by NSCLC:

  • Laser therapy - a small beam of light burns and kills cancer cells
  • Photodynamic therapy - uses a light to activate a drug in the body, which kills cancer cells

Support Groups:

For additional information and resources, see cancer support group.

Expectations (prognosis):

The outlook varies widely. Most often, NSCLC grows slowly and at first causes few or no symptoms. The cancer may spread to other parts of the body, including the bone, liver, small intestine, and brain.

However, in some cases, it can be extremely aggressive and cause rapid death. Chemotherapy has been shown to prolong the life and improve the quality of life in some patients with stage IV NSCLC.

Cure rates are related to the stage of disease and whether you are able to have surgery.

  • Stage I and II cancer can be cured with surgery, sometimes in more than 50% of cases.
  • Stage III tumors can be cured in some cases.
  • Patients with stage IV disease or cancer that has returned are almost never cured, and the goals of therapy are to extend and improve the quality of their life.

Complications:

  • Spread of disease beyond the lung
  • Side effects of surgery, chemotherapy, or radiation therapy
  • Reviewed last on: 9/26/2010
  • David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.

References

Alberg AJ, Ford JG, Samet JM; American College of Chest Physicians. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:29S-55S.

American Cancer Society. Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society; 2008.

Bach PB, Silvestri GA, Hanger M, Jett JR. Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:69S-77S.

Jett JR, Schild SE, Keith RL, Kesler KA. Treatment of non-small cell lung cancer, stage IIIB: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:266S-276S.

Johnson DH, Blot WJ, Carbone DP, et al. Cancer of the lung: non-small cell lung cancer and small cell lung cancer. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 76.

Fischer B, Lassen U, Mortensen J, Larsen S, Loft A, Bertelsen A, Ravn J, Clementsen P, Høgholm A, Larsen K, Rasmussen T, Keiding S, Dirksen A, Gerke O, Skov B, Steffensen I, Hansen H, Vilmann P, Jacobsen G, Backer V, Maltbaek N, Pedersen J, Madsen H, Nielsen H, Højgaard L. Preoperative staging of lung cancer with combined PET-CT. N Engl J Med. 2009;361:32-39.

Tassinari D, Scarpi E, Sartori S, Tamburini E, Santelmo C, Tombesi P, Lazzari-Agli L. Second-line treatments in non-small cell lung cancer. A systematic review of literature and metaanalysis of randomized clinical trials. Chest. 2009;135:1596-1609.

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