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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.
It may be given after surgery (called adjuvant therapy) to kill any remaining microscopic areas of cancer.

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

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 develops slowly and causes few or no symptoms until very late stages. However, in some cases, it can be extremely agressive and cause rapid death. The cancer may spread to other parts of the body, including the bone, liver, small intestine, and brain.

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, but cure rates are much lower than earlier stage NSCLC
Patients with stage IV disease 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

Secondhand smoke and lung cancer

Reviewed last on: 9/14/2009
Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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.

National Cancer Institute. Lung Cancer Home Page. Bethesda, MD: U.S. National Institutes of Health. Accessed August 3, 2008

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 Jul 2;361(1):32-9.

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 Jun;135(6):1596-609.

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