ESMO Patients Guide
What are the treatment options for NSCLC? Aims of treatment In early-stage NSCLC, when the cancer is confined to the lung and therefore considered to be curable, the main treatment is surgical resection (Postmus et al., 2017). For locally advanced NSCLC, multimodal therapy is usually adopted to help shrink or in some cases completely remove the cancer (Eberhardt et al., 2015). For metastatic NSCLC, when the cancer has spread to other parts of the body, and cure is not an option, various systemic anti-cancer treatments may be used in an attempt to slow down tumour growth and improve symptoms and quality of life – this is called supportive or palliative care (Planchard et al., 2018).
Overview of treatment types
Treatments for NSCLC include surgery, radiotherapy, chemotherapy and targeted therapies
The treatment you receive will depend on the stage and type of cancer, as well as your general health and treatment preferences, which will be discussed together with your doctor. You may have a combination of treatments. The main types of treatment are listed below: • Surgery may be possible to remove NSCLC if it is diagnosed at an early stage. The type of operation that is offered will depend on the size and location of the cancer (Postmus et al., 2017) : --
A wedge or segment resection is the removal of a very small amount of the lung; this is sometimes offered if the cancer is at a very early stage
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A lobectomy is the removal of one of the lobes of the lung; it is the standard surgical treatment for NSCLC
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A pneumonectomy is the total removal of one of the lungs; it is a more complex surgical resection than lobectomy or wedge (segment) resection.
• Chemotherapy works by disrupting the way that cancer cells grow and divide. However, these drugs can also affect normal cells. Chemotherapy can be given before or after surgery for NSCLC. Some people have chemotherapy at the same time as radiotherapy – this is called chemoradiotherapy. Chemotherapy may be given to try to cure the cancer or to prolong life and control symptoms (palliative care) (Postmus et al., 2017; Planchard et al., 2018). • Targeted therapies and antiangiogenic therapies are drugs that block specific signalling pathways in cancer cells that encourage them to grow (Novello et al., 2016).
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