The ideal treatment for stage I NSCLC is surgery. New research is helping doctors predict which stage I NSCLC patients will need chemotherapy before or after their surgery and which will not. High-dose radiation therapy may also be used if you or your doctors feel that you would not tolerate surgery.
The optimal treatment for stage II NSCLC is surgery followed by chemotherapy.
For stage IIIA NSCLC cancer, chemotherapy with radiation therapy, or chemotherapy with surgery are the standard treatments. In some cases, chemotherapy, surgery and radiation may be recommended. Research is under way to help doctors decide the best timing for these different treatments. Your treatment team will develop a plan based on your needs and their experience fighting this disease.
Stage IIIB cancer is usually treated with chemotherapy and radiation therapy. Surgery is generally not recommended, but may be considered in specific cases.
Because stage IV cancer has spread to other parts of the body, surgery is only recommended in very select cases and usually is related to palliation (relief) of certain symptoms.
If your cancer at first responded to one type of therapy, but then progressed, your cancer is called recurrent. In these cases, other chemotherapy or targeted therapy drugs may be recommended. Many people experience great improvement with additional treatment, even after their cancer has recurred.
Chemotherapy is used because it fights the cancer throughout the body. If your tumor has a specific mutation, a targeted drug may be used. Newer immunotherapy drugs may be an option for some patients with stage IV disease. If the cancer has spread to your bones, you may be given a medication such as denosumab (Xgeva®), pamidronate (Aredia®) or zolendronic acid (Zometa®) to help strengthen your bones. Radiation may be used to shrink tumors that are causing symptoms.
If your cancer first responded to one type of therapy, but then progressed, your cancer is called recurrent. In these cases, other chemotherapy or targeted therapy drugs may be recommended. Many people experience great improvement with additional treatment, even after their cancer has recurred.
Limited-stage SCLC is typically treated with radiation to the chest and chemotherapy. Prophylactic cranial irradiation (PCI), radiation to the whole brain, may also be offered. The brain is a common site for cancer to come back in patients with SCLC because chemotherapy does not treat cancer that has spread to the brain as effectively as it treats cancer in other parts of the body. PCI is recommended for SCLC patients whose cancer appears to be in remission (no current sign of cancer) as a result of treatment. The treatment uses a lower-dose radiation, and is used to prevent the cancer from recurring. It is important to discuss PCI with your oncologist.
Individuals with extensive-stage SCLC are treated with chemotherapy. Should remission occur, PCI will also be considered for some patients.
This information is not designed to be a substitute for medical advice provided by your treatment team.
Last updated 7/2015
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