There are many treatments for non-small cell lung cancer. Whether the lung cancer can be cured or not depends on the type and stage. Stages are used to describe how much the lung cancer has worsened or spread.

Stages I and II non-small cell lung cancer have the highest cure and survival rates.

Stage III non-small cell lung cancer can possibly be cured for some patients.

Stage IV non-small cell lung cancer and lung cancer that has returned are usually not able to be cured. Even after successful treatment, non-small cell lung cancer can return and spread to other parts of the body, such as the heart, lungs, or brain.

For patients with lung cancer that cannot be cured, the goals of treatment are to improve a patient’s quality of life and extend survival.

In addition to standard treatments, patients with Stage IV non-small cell lung cancer may receive palliative care. Palliative care mainly treats pain and other symptoms to make a patient more comfortable.

Stages and Treatments

Treatment for non-small lung cancer depends on its stage, or how far advanced the cancer may be.

Stages and treatments for non-small lung cancer are:

Occult stage – In this stage, the non-small lung cancer is too small to be detected.

Stage 0 – This stage is also called carcinoma in situ, which means the earliest stage when the non-small cell lung cancer can be found. Treatment for Stage 0 non-small cell lung cancer may include surgery; photodynamic therapy, which is a type of intensified light treatment; laser therapy; or brachytherapy, which is a type of radiation treatment placed inside the body.

Stage I – In this early stage, the non-small cell lung cancer is only in the lung and has not spread. Treatment for Stage I non-small cell lung cancer may include surgery, chemotherapy, radiotherapy, or radiofrequency ablation, which is a therapy in which the lung tumor is destroyed with the use of intense, directed heat.

Stage II – In this stage, the non-small cell lung cancer is in the lung and has spread to the close-by lymph nodes. Treatment for Stage II non-small cell lung cancer may include surgery, chemotherapy, radiation, targeted therapies, and immunotherapy.

Stage III – In this stage, the non-small cell lung cancer is in the lung and median, or middle, chest lymph nodes. Stage III non-small cell lung cancer is known as locally advanced lung cancer.

Stage III non-small cell lung cancer has two subtypes:

Stage IIIA – In this stage, the non-small cell lung cancer has spread to same side chest lymph nodes. Treatment for Stage IIIA non-small cell lung cancer may include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy.

Stage IIIB – In this stage, non-small cell lung cancer has spread to opposite side chest lymph nodes, or above the collarbone. Treatment for Stage IIIB non-small cell lung cancer may include surgery, chemotherapy, radiotherapy, and immunotherapy.

Stage IV – In this final stage, the non-small cell lung cancer has spread to both lungs, the fluid surrounding the lungs, or other organs or parts of the body, and is considered to be advanced lung cancer.

Stage IV non-small cell lung cancer has two subtypes:

Stage IVA – The non-small cell lung cancer may have spread to the lymph nodes, and there may be one or more additional lung tumors, or the cancer has spread to the fluid around the lungs or heart, brain, or another organ. Treatment for Stage IV non-small cell lung cancer may include surgery, chemotherapy, and radiotherapy.

Stage IVB – The non-small cell lung cancer has spread to multiple organs, such as the brain, kidney, liver, or bone. Treatment for Stage IVB non-small cell lung cancer may include chemotherapy, targeted therapy, and immunotherapy.

Types of Treatments

Treatment for non-small cell lung cancer may include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, laser therapy, and photodynamic therapy.

Surgery (resection) is one of the most common treatments for non-small cell lung cancer. Types of surgery for non-small cell lung cancer include:

Wedge resection, which is removal of a small part of the lung,

Lung lobectomy, which is removal of one of the lobes of the lung, or

Pneumonectomy, which is removal of the entire lung.

The treatment goal of surgery for non-small cell lung cancer is to completely remove the lung tumor and the lymph nodes close to it.

Lymph nodes are part of the immune system, create white blood cells, and filter the lymphatic fluid that maintains fluid levels in your body. Non-small cell lung cancer can spread through the lymph system, so the lymph nodes close to the lung tumor must also be removed.

Chemotherapy is a treatment that uses strong drugs that kill cancer cells, while stopping more cancer cells from growing. Chemotherapy is often used alone for Stage IV non-small cell lung cancer when the cancer has spread outside the lung. Chemotherapy may also be used in combination with surgery or radiation. When used before surgery, chemotherapy is called neoadjuvant therapy. Chemotherapy that is used after surgery to kill any remaining cancer after surgery is called adjuvant therapy. Chemotherapy is administered intravenously, through a vein, or in pill forms. Since chemotherapy can cause other symptoms, such as nausea and vomiting, tiredness, hair loss, and skin and nail changes, controlling these side effects while preventing any complications is an essential part of lung cancer care.

Radiation therapy is the use of X-Rays or other forms of radiation to kill cancer cells. Radiation therapy is often combined with chemotherapy, especially if the lung cancer cannot be treated with surgery. Radiation therapy can also help to alleviate some of the symptoms caused by the cancer as well as relieve cancer pain when the cancer has spread. Like chemotherapy, radiation therapy can also cause side effects that are controlled as an essential part of lung cancer care. Types of radiation therapy for non-small cell lung cancer include stereotactic body radiation therapy; radiofrequency ablation therapy, which destroys tumors; and brachytherapy, which is a type of radiation treatment placed within the body.

The treatment goals of both chemotherapy and radiotherapy are to destroy the cancer cells and to stop the cancer from returning or spreading.

Targeted therapy is a newer treatment that uses drugs designed to target molecules in or on cancer cells that control the growth and survival of the lung cancer. The treatment goal of targeted therapy is to stops the cancer cells and their spread by undoing the processes that allow them to survive.

Some targeted therapies used for non-small cell lung cancer are:

Afatinib
Capmatinib
Certinib
Crizotinib
Dabrafenib
Entrectinib
Erlotinib
Gefitinib
Larotrectinib
Osimertinib
Selpercatinib
Trametinib

Immunotherapy, also known as biologic therapy, is a new treatment for non-small cell lung cancer that uses a patient’s own immune system, or natural defenses, to treat the cancer. The treatment goal of immunotherapy is to increase the ability of the body’s immune system to fight the cancer.

Immunotherapy treatments for non-small cell lung cancer include:

Atezolizumab
Bevacizumab, alone or combined with chemotherapy
Cemiplimab
Ipilimumab 
Nivolumab
Necitumumab 
Pembrolizumab

Other Treatments

Other, less common treatments for non-small cell lung cancer include laser therapy and photodynamic therapy. Laser therapy uses an intensely-focused small beam of light that burns cancer cells and kills them. Photodynamic therapy uses light that activates a drug in the body that kills the cancer cells.

Experimental Treatments

New treatments for non-small cell lung cancer are currently being tested, such as chemoprevention, radiosensitizers, and new combinations of existing therapies.

Palliative Care

In addition to standard treatments, patients with Stage IV advanced non-small cell lung cancer may also be treated with palliative care. Palliative care is used to relieve pain and other symptoms to make a patient more comfortable. Palliative care may also include the use of chest catheters or pleurodesis, which are treatments used to relieve fluid build-up in the space surrounding the lungs.

Long-Term Follow-Up

Ongoing, long-term follow-up is an essential part of the treatment for patients with non-small cell lung cancer because the cancer can reoccur even after it has been treated.

Sources

This content was written by the MediFind Medical Team. Last updated: 6/9/2022