Non-Small Cell Lung Cancer

Non-small cell lung cancer is a common disease. It is usually treated by surgery (taking out the cancer in an operation) or radiation therapy (using high-dose x-rays to kill cancer cells). However, chemotherapy may be used in some patients.

The prognosis (chance of recovery) and choice of treatment depend on the stage of the cancer (whether it is just in the lung or has spread to other places), tumor size, the type of lung cancer, whether there are symptoms, and the patient's general health.

Once lung cancer has been found (diagnosis), more tests will be done to find out if the cancer has spread from the lung to other parts of the body (staging). A doctor needs to know the stage to plan treatment. Click here to learn about lung cancer staging.

Many different treatments and combinations of treatments may be used to control lung cancer, and/or to improve quality of life by reducing symptoms.

Surgery is an operation to remove the cancer. The type of surgery a doctor performs depends on the location of the tumor in the lung. An operation to remove only a small part of the lung is called a segmental or wedge resection. When the surgeon removes an entire lobe of the lung, the procedure is called a lobectomy. Pneumonectomy is the removal of an entire lung. Some tumors are inoperable (cannot be removed by surgery) because of the size or location, and some patients cannot have surgery for other medical reasons.

Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Even after cancer has been removed from the lung, cancer cells may still be present in nearby tissue or elsewhere in the body. Chemotherapy may be used to control cancer growth or to relieve symptoms. Most anticancer drugs are given by injection directly into a vein (IV) or by means of a catheter, a thin tube that is placed into a large vein and remains there as long as it is needed. Some anticancer drugs are given in the form of a pill.

Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells. Radiation therapy is directed to a limited area and affects the cancer cells only in that area. Radiation therapy may be used before surgery to shrink a tumor, or after surgery to destroy any cancer cells that remain in the treated area. Doctors also use radiation therapy, often combined with chemotherapy, as primary treatment instead of surgery. Radiation therapy may also be used to relieve symptoms such as shortness of breath. Radiation for the treatment of lung cancer most often comes from a machine (external radiation). The radiation can also come from an implant (a small container of radioactive material) placed directly into or near the tumor (internal radiation).

Photodynamic therapy (PDT), a type of laser therapy, involves the use of a special chemical that is injected into the bloodstream and absorbed by cells all over the body. The chemical rapidly leaves normal cells but remains in cancer cells for a longer time. A laser light aimed at the cancer activates the chemical, which then kills the cancer cells that have absorbed it. Photodynamic therapy may be used to reduce symptoms of lung cancer--for example, to control bleeding or to relieve breathing problems due to blocked airways when the cancer cannot be removed through surgery. Photodynamic therapy may also be used to treat very small tumors in patients for whom the usual treatments for lung cancer are not appropriate.

Complementary therapies are healing philosophies, approaches, and therapies used in addition to traditional treatments. If you are interested in pursuing complementary treatments, you should discuss their possible value and side effects with your medical doctors.

Clinical trials (research studies) to evaluate new ways to treat cancer are an option for many lung cancer patients. In some studies, all patients receive the new treatment. In others, doctors compare different therapies by giving the new treatment to one group of patients and the usual (standard) therapy to another group. Through research, doctors are exploring new and possibly more effective ways to treat lung cancer.