For people with stage I NSCLC that has a higher risk of coming back based on size, location, or other factors , adjuvant chemotherapy after surgery may lower the risk that cancer will return.
New lab tests that look at the patterns of certain genes in the cancer cells may help with this. Studies are now being done to see if these tests are accurate. After surgery, the removed tissue is checked to see if there are cancer cells at the edges of the surgery specimen called positive margins.
This could mean that some cancer has been left behind, so a second surgery might be done to try to ensure that all the cancer has been removed. This might be followed by chemotherapy as well. Another option might be to use radiation therapy after surgery. If you have serious health problems that prevent you from having surgery, you may get stereotactic body radiation therapy SBRT or another type of radiation therapy as your main treatment.
Radiofrequency ablation RFA may be another option if the tumor is small and in the outer part of the lung. Sometimes removing the whole lung pneumonectomy is needed. Any lymph nodes likely to have cancer in them are also removed. The extent of lymph node involvement and whether or not cancer cells are found at the edges of the removed tissues are important factors when planning the next step of treatment.
After surgery, the removed tissue is checked to see if there are cancer cells at the edges of the surgery specimen. This might mean that some cancer has been left behind, so a second surgery might be done to try to remove any remaining cancer. This may be followed by adjuvant additional treatment with chemotherapy chemo , possibly followed by adjuvant immunotherapy with atezolizumab for up to a year.
Another option is to treat with radiation , sometimes with chemo. Even if positive margins are not found, adjuvant chemo is usually recommended after surgery to try to destroy any cancer cells that might have been left behind. As with stage I cancers, newer lab tests now being studied may help doctors find out which patients need this adjuvant treatment and which are less likely to benefit from it. For people whose cancer cells have certain mutations in the EGFR gene, adjuvant treatment with the targeted drug osimertinib might be an option at some point as well.
If you have serious medical problems that would keep you from having surgery, you may get only radiation therapy as your main treatment. Your treatment options depend on the size of the tumor, where it is in your lung, which lymph nodes it has spread to, your overall health, and how well you are tolerating treatment.
For patients who can tolerate it, treatment usually starts with chemo, often combined with radiation therapy also called chemoradiation. Surgery may be an option after this if the doctor thinks any remaining cancer can be removed and the patient is healthy enough.
In some cases, surgery may be an option as the first treatment. This is often followed by adjuvant chemo, which in turn might be followed by adjuvant immunotherapy with atezolizumab for up to a year in some cases.
For people who are not healthy enough for surgery, radiation therapy, which may be combined with chemo, is often used.
Lung cancer screening is recommended for people who meet these criteria:. At least a 30 pack-year smoking history 1 pack-year is the same as smoking 1 pack of cigarettes every day for an entire year. There are different kinds of lung cancer.
This is the most common subtype of cancer, but also much more common in people who never smoked, younger patients, and women. Squamous cell cancer. This is more commonly linked to a history of smoking.
It develops in the airways of the lungs. Large cell carcinoma. Targeted therapies work. This type of cancer treatment is called targeted therapy. And, because there are new and emerging targets being found in research, it is reasonable to do wider testing to look for other mutations as well.
Oral medicines for patients with some of mutations are highly effective; they can shrink tumors significantly, work for a long time, and provide people with lung cancer with a good quality of life.
Immunotherapy helps people with a broad range of lung cancers live longer. Immunotherapy is type of cancer treatment that works by boosting or activating your immune system, so it recognizes and kills cancer cells. Researchers are investigating 4 main kinds of immunotherapies for lung cancer: checkpoint inhibitors, monoclonal antibodies, therapeutic vaccines, and adoptive cell therapy.
For patients with tumors with high levels of a biomarker called PD-L1, pembrolizumab Keytruda works better than chemotherapy as a first therapy. For tumors with low or no expression of PD-L1, drugs such as atezolizumab Tecentriq and nivolumab Opdivo can be effective as second treatments. Sometimes, combining immunotherapy and chemotherapy initially may also improve outcomes. Recent research also showed that giving the checkpoint inhibitor durvalumab Imfinzi after radiation therapy improved the time until the cancer progressed in people with locally advanced NSCLC.
There are a number of clinical trials that are also investigating how immunotherapy can be combined with surgery for patients with early-stage, curable lung cancer. The two main types of lung cancer are small cell lung cancer and non-small cell lung cancer. These categories refer to what the cancer cells look like under a microscope. Non-small cell lung cancer is more common than small cell lung cancer. If you have lung cancer especially non-small cell lung cancer , your doctor may run tests external icon to find out if you have a change in your genes genetic mutation.
The results of these tests help your doctor know which treatments will work best for you. If lung cancer is diagnosed, other tests are done to find out how far it has spread through the lungs, lymph nodes, and the rest of the body.
This process is called staging. The type and stage of lung cancer tells doctors what kind of treatment you need. Lung cancer is treated in several ways, depending on the type of lung cancer and how far it has spread.
People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. People with small cell lung cancer are usually treated with radiation therapy and chemotherapy. Doctors from different specialties often work together to treat lung cancer. Pulmonologists are doctors who are experts in diseases of the lungs.
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