How Is Non-Small Cell Lung Cancer Treated?

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

Treatment for non-small cell lung cancer (NSCLC) depends on its final staging as well as:

• Your age, overall health, and medical history
• The extent of the disease
• Your lung capacity
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Your lung cancer may be treated with surgery, radiation therapy, chemotherapy, targeted therapies, laser therapy, or a combination of these.

Surgery

Three main types of surgery are most often used in lung cancer treatment. The choice depends on the size and location of the tumor in the lung. It also depends on the extent of the cancer, the general health of the patient, and other factors. If surgery is indicated, the surgeon typically removes a small portion (usually one lobe) of your lung containing the tumor or even the entire lung. This type of lung surgery is called a thoracotomy. Sometimes the surgeon removes the entire lung, but this carries a high risk of  mortality.

The three main types of surgery are:

Segmental or wedge resection – removing a small part of the lung
Lobectomy – removing an entire lobe of the lung
Pneumonectomy – removing an entire lung

Chemotherapy

In most cases, chemotherapy drugs work by interfering with the cancer cells’ ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Your oncologist will design a treatment plan specifically for you. Chemotherapy may be given before other treatments, after other treatments, or alone for lung cancer.

One long-term goal in lung cancer is the development of targeted therapies that only affect the cancer cells, not healthy cells. Targeted therapy involves identifying unique proteins or enzymes that appear only on cancer cells, then designing drugs that interfere with the actions of those chemicals, preventing the cancer cells from growing or reproducing.

Radiation Therapy

Radiation therapy is the use of high-energy radiation to kill cancer cells and shrink tumors. Radiation may also be used with chemotherapy to treat lung cancer. There are two ways to deliver radiation therapy:

• External radiation (external beam therapy) - a radiation therapist uses a machine that sends high levels of radiation directly to the cancer cells. Special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
• Internal radiation (brachytherapy, radiation implants) - radiation is given inside the body as close to the cancer as possible. Substances called radioisotopes that produce radiation may be swallowed, injected, or implanted directly into the tumor. Some of the radioactive implants are called “seeds” or “capsules.”

Internal radiation produces a higher dose of radiation quicker than external radiation. Some internal radiation treatments stay in the body temporarily, while others remain permanently. However, the radioactive substance loses its radiation within a short period of time. Internal and external radiation therapies are sometimes used together.