Non-Small Cell Lung Cancer

General Information | Treatment Options | Prevention | Screening
Additional Resources

Treatment
  • Overview
  • Standard Treatment
  • Clinical Trials
  • Treatment By Stage

There are different types of treatment for patients with non-small cell lung cancer.

Different types of treatments are available for patients with non-small cell lung cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

Six types of standard treatment are used:

Surgery

Four types of surgery are used:

  • Wedge resection: Surgery to remove a tumor and some of the normal tissue around it. When a slightly larger amount of tissue is taken, it is called a segmental resection.
  • Lobectomy: Surgery to remove a whole lobe (section) of the lung.
  • Pneumonectomy: Surgery to remove one whole lung.
  • Sleeve resection: Surgery to remove part of the bronchus.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

Radiosurgery is a method of delivering radiation directly to the tumor with little damage to healthy tissue. It does not involve surgery and may be used to treat certain tumors in patients who cannot have surgery.

The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Laser therapy

Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.

Photodynamic therapy (PDT)

Photodynamic therapy (PDT) is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. Fiberoptic tubes are then used to carry the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue. It is used mainly to treat tumors on or just under the skin or in the lining of internal organs.

Watchful waiting

Watchful waiting is closely monitoring a patient's condition without giving any treatment until symptoms appear or change. This may be done in certain rare cases of non-small cell lung cancer.

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.

Chemoprevention

Chemoprevention is the use of drugs, vitamins, or other substances to reduce the risk of developing cancer or to reduce the risk cancer will recur (come back).

Biologic therapy

Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

New combinations

New combinations of treatments are being studied in clinical trials.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Occult Non-Small Cell Lung Cancer

Treatment of occult non-small cell lung cancer depends on where the cancer has spread. It can usually be cured by surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with occult non-small cell lung cancer.

Stage 0 (Carcinoma in Situ)

Treatment of stage 0 may include the following:

  • Surgery (wedge resection or segmental resection).
  • Photodynamic therapy using an endoscope.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 non-small cell lung cancer.

Stage I Non-Small Cell Lung Cancer

Treatment of stage I non-small cell lung cancer may include the following:

  • Surgery (wedge resection, segmental resection, or lobectomy).
  • External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
  • Surgery followed by chemotherapy.
  • A clinical trial of photodynamic therapy using an endoscope.
  • A clinical trial of surgery followed by chemoprevention.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I non-small cell lung cancer.

Stage II Non-Small Cell Lung Cancer

Treatment of stage II non-small cell lung cancer may include the following:

  • Surgery (wedge resection, segmental resection, lobectomy, or pneumonectomy).
  • External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
  • Surgery followed by chemotherapy, with or without other treatments.
  • A clinical trial of external radiation therapy following surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II non-small cell lung cancer.

Stage IIIA and Stage IIIB Non-Small Cell Lung Cancer

Treatment of stage IIIA non-small cell lung cancer may include the following:

  • Surgery with or without radiation therapy.
  • External radiation therapy alone.
  • Chemotherapy combined with other treatments.
  • A clinical trial of new ways of giving radiation therapy and chemotherapy.
  • A clinical trial of new combinations of treatments.

Treatment of stage IIIB non-small cell lung cancer may include the following:

  • External radiation therapy alone.
  • Chemotherapy combined with external radiation therapy.
  • Chemotherapy combined with external radiation therapy, followed by surgery.
  • Chemotherapy alone.
  • A clinical trial of new ways of giving radiation therapy.
  • A clinical trial of new combinations of treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III non-small cell lung cancer.

Stage IV Non-Small Cell Lung Cancer

Treatment of stage IV non-small cell lung cancer may include the following:

  • Watchful waiting.
  • External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
  • Chemotherapy.
  • Laser therapy and/or internal radiation therapy.
  • A clinical trial of chemotherapy with or without biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV non-small cell lung cancer.

Treatment Options for Recurrent Non-Small Cell Lung Cancer

Treatment of recurrent non-small cell lung cancer may include the following:

  • External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
  • Chemotherapy alone.
  • Surgery (for some patients who have a very small amount of cancer that has spread to the brain).
  • Laser therapy or internal radiation therapy.
  • Radiosurgery (for certain patients who cannot have standard surgery).
  • A clinical trial of biologic therapy or other new treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent non-small cell lung cancer.

Cancer information from the NCI PDQ service