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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65917_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65917_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65917_"><span class="title" itemprop="name">Non-Small Cell Lung Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: April 8, 2021.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062956__447">This PDQ cancer information summary has current information about the treatment of non-small cell lung cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062956__448">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062956__118"><h2 id="_CDR0000062956__118_">General Information About Non-Small Cell Lung Cancer</h2><div id="CDR0000062956__118.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062956__119">Non-small cell lung cancer is a disease in which malignant
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(cancer) cells form in the tissues of the lung. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__123">There are several types of non-small cell lung cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__262">Smoking is the major risk factor for non-small cell lung cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__266">Signs of non-small cell lung cancer include a cough that doesn't go away and shortness of breath.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__270">Tests that examine the lungs are used to diagnose and stage non-small cell lung cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__476">If lung cancer is suspected, a biopsy is done.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__127">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__130">For most patients with non-small cell lung cancer, current
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treatments do not cure the cancer. </a></div></li></ul></div><div id="CDR0000062956__119"><h3>Non-small cell lung cancer is a disease in which malignant
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(cancer) cells form in the tissues of the lung. </h3><p id="CDR0000062956__121">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> are a pair of cone-shaped breathing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> in the chest. The lungs bring <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a> into the body as you breathe in. They release <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538147/" class="def">carbon dioxide</a>, a waste product of the body’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>, as you breathe out. Each
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lung has sections called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobes</a>. The left lung has two
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lobes. The right lung is
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slightly larger and has three lobes. Two
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tubes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046493/" class="def">bronchi</a> lead from the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> (windpipe) to the right and
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left lungs. The bronchi are sometimes also involved in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445043/" class="def">lung cancer</a>. Tiny air sacs called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046209/" class="def">alveoli</a> and small tubes called
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046494/" class="def">bronchioles</a> make up the inside of
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the lungs.<div id="CDR0000062956__292" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20respiratory%20system%2C%20showing%20the%20trachea%20and%20both%20lungs%20and%20their%20lobes%20and%20airways&p=BOOKS&id=569441_CDR0000466533.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466533.jpg" alt="Respiratory anatomy; drawing shows right lung with upper, middle, and lower lobes; left lung with upper and lower lobes; and the trachea, bronchi, lymph nodes, and diaphragm. Inset shows bronchioles, alveoli, artery, and vein." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the respiratory system, showing the trachea and both lungs and their lobes and airways. Lymph nodes and the diaphragm are also shown. Oxygen is inhaled into the lungs and passes through the thin membranes of the alveoli and into the bloodstream (see inset).</p></div></div></p><p id="CDR0000062956__276">A thin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membrane</a> called the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045842/" class="def">pleura</a> covers the outside of each lung and lines the inside wall of the chest <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a>. This creates a sac called the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046222/" class="def">pleural cavity</a>.
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The pleural cavity normally contains a small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> that helps the lungs move smoothly in the chest when you breathe. </p><p id="CDR0000062956__122">There are two main types of lung cancer: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung cancer</a> and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045327/" class="def">small cell lung cancer</a>. </p><p id="CDR0000062956__325">See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information about lung cancer:</p><ul id="CDR0000062956__326"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062947/">Small Cell Lung Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000790953/">Childhood Tracheobronchial Tumors Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000790954/">Childhood Pleuropulmonary Blastoma Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062825/">Lung Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258019/">Lung Cancer Screening</a></div></li></ul></div><div id="CDR0000062956__123"><h3>There are several types of non-small cell lung cancer.</h3><p id="CDR0000062956__125">Each type of non-small cell lung cancer has different kinds of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> cells. The cancer
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cells of each type grow and spread in different ways. The types of non-small
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cell lung cancer are named for the kinds of cells found in the cancer and how
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the cells look under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a>:</p><ul id="CDR0000062956__126"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046595/" class="def">Squamous cell
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carcinoma</a>: Cancer that forms in the thin, flat cells lining the inside of the lungs. This is also called epidermoid
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carcinoma.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046316/" class="def">Large cell
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carcinoma</a>: Cancer that may begin in several types of large cells.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046216/" class="def">Adenocarcinoma</a>:
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Cancer that begins in the cells that line the alveoli and make substances such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046274/" class="def">mucus</a>. </div></li></ul><p id="CDR0000062956__278">Other less common types of non-small cell lung cancer are: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476766/" class="def">adenosquamous carcinoma</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476767/" class="def">sarcomatoid carcinoma</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446528/" class="def">salivary gland carcinoma</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044233/" class="def">carcinoid tumor</a>, and unclassified carcinoma.</p></div><div id="CDR0000062956__262"><h3>Smoking is the major risk factor for non-small cell lung cancer.</h3><p id="CDR0000062956__sm_CDR0000752316_5"><div class="milestone-start" id="CDR0000062956__sm_CDR0000752316_1"></div>Anything that increases your chance of getting a disease
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is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for lung cancer.</p><p id="CDR0000062956__sm_CDR0000752316_4">Risk factors for lung cancer include the following:</p><ul id="CDR0000062956__sm_CDR0000752316_2"><li class="half_rhythm"><div> Smoking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748148/" class="def">cigarettes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748824/" class="def">pipes</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748146/" class="def">cigars</a>, now or in the past. This is the most important risk factor for lung cancer. The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer. </div></li><li class="half_rhythm"><div> Being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538647/" class="def">secondhand smoke</a>.</div></li><li class="half_rhythm"><div> Being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046528/" class="def">asbestos</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044303/" class="def">arsenic</a>, chromium, beryllium, nickel, soot, or tar in the workplace.</div></li><li class="half_rhythm"><div>Being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> from any of the following:<ul id="CDR0000062956__sm_CDR0000752316_6"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304766/" class="def">breast</a> or chest.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046554/" class="def">Radon</a> in the home or workplace.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">Imaging tests</a> such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scans</a>.</div></li><li class="half_rhythm"><div>Atomic bomb radiation.</div></li></ul>
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</div></li><li class="half_rhythm"><div> Living where there is air pollution.</div></li><li class="half_rhythm"><div> Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302456/" class="def">family history</a> of lung cancer.</div></li><li class="half_rhythm"><div> Being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infected</a> with the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044366/" class="def">human immunodeficiency virus</a> (HIV).</div></li><li class="half_rhythm"><div> Taking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045328/" class="def">beta carotene</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045916/" class="def">supplements</a> and being a heavy smoker.</div></li></ul><p id="CDR0000062956__sm_CDR0000752316_7">Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.<div class="milestone-end"></div></p><p id="CDR0000062956__275">When smoking is combined with other risk factors, the risk of lung cancer is increased.</p></div><div id="CDR0000062956__266"><h3>Signs of non-small cell lung cancer include a cough that doesn't go away and shortness of breath.</h3><p id="CDR0000062956__268">Sometimes lung cancer does not cause any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. It may be found during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">chest x-ray</a> done for another <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a>. Signs and symptoms may be caused by lung cancer or by other conditions. Check with your doctor if you have any of the following:</p><ul id="CDR0000062956__269"><li class="half_rhythm"><div>Chest discomfort or pain.</div></li><li class="half_rhythm"><div>A cough that doesn’t go away or gets worse over time.
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</div></li><li class="half_rhythm"><div>Trouble breathing.
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</div></li><li class="half_rhythm"><div>Wheezing.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">Blood</a> in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045883/" class="def">sputum</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046274/" class="def">mucus</a> coughed up from the lungs).
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</div></li><li class="half_rhythm"><div>Hoarseness.
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</div></li><li class="half_rhythm"><div>Loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>.</div></li><li class="half_rhythm"><div>Weight loss for no known reason.
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</div></li><li class="half_rhythm"><div>Feeling very tired.</div></li><li class="half_rhythm"><div>Trouble swallowing.</div></li><li class="half_rhythm"><div>Swelling in the face and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">veins</a> in the neck.</div></li></ul></div><div id="CDR0000062956__270"><h3>Tests that examine the lungs are used to diagnose and stage non-small cell lung cancer.</h3><p id="CDR0000062956__272">Tests and procedures to detect, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> non-small cell lung cancer are often done at the same time. Some of the following tests and procedures may be used:</p><ul id="CDR0000062956__273"><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits, including smoking, and past jobs, illnesses, and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">Laboratory tests</a></b>: Medical procedures that test samples of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, blood, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a>, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitor</a> the disease over time.</div></li><li class="half_rhythm"><div><b>Chest x-ray</b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
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<div id="CDR0000062956__293" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=X-ray%20of%20the%20chest&p=BOOKS&id=569441_CDR0000428438.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000428438.jpg" alt="Chest x-ray; drawing shows the patient standing with her back to the x-ray machine. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film. </p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335080/" class="def">Sputum cytology</a></b>: A procedure in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views a sample of sputum (mucus coughed up from the lungs) under a microscope, to check for cancer cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046612/" class="def">Thoracentesis</a></b>: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.</div></li></ul></div><div id="CDR0000062956__476"><h3>If lung cancer is suspected, a biopsy is done.</h3><p id="CDR0000062956__478">One of the following types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsies</a> is usually used: </p><ul id="CDR0000062956__479"><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045691/" class="def">Fine-needle aspiration (FNA) biopsy</a> of the lung</b>: The removal of tissue or fluid from the lung using a thin needle. A CT scan, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">ultrasound</a>, or other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045720/" class="def">imaging procedure</a> is used to locate the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> tissue or fluid in the lung. A small <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.<div id="CDR0000062956__309" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Fine-needle%20aspiration%20biopsy%20of%20the%20lung&p=BOOKS&id=569441_CDR0000531057.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000531057.jpg" alt="Fine-needle aspiration biopsy of the lung; drawing shows a patient lying on a table that slides through the computed tomography (CT) machine with an x-ray picture of a cross-section of the lung on a monitor above the patient. Drawing also shows a doctor using the x-ray picture to help place the biopsy needle through the chest wall and into the area of abnormal lung tissue. Inset shows a side view of the chest cavity and lungs with the biopsy needle inserted into the area of abnormal tissue." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Fine-needle aspiration biopsy of the lung. The patient lies on a table that slides through the computed tomography (CT) machine, which takes x-ray pictures of the inside of the body. The x-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer. </p></div></div></div><div class="half_rhythm">An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046602/" class="def">endoscopic ultrasound</a> (EUS) is a type of ultrasound that may be used to guide an FNA biopsy of the lung, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>, or other areas. EUS is a procedure in which an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046428/" class="def">endoscope</a> is inserted into the body. An endoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>.<div id="CDR0000062956__315" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Endoscopic%20ultrasound-guided%20fine-needle%20aspiration%20biopsy&p=BOOKS&id=569441_CDR0000466552.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466552.jpg" alt="Endoscopic ultrasound-guided fine-needle aspiration biopsy; drawing shows an endoscope with an ultrasound probe and biopsy needle inserted through the mouth and into the esophagus. Drawing also shows lymph nodes near the esophagus and cancer in one lung. Inset shows the ultrasound probe locating the lymph nodes with cancer and the biopsy needle removing tissue from one of the lymph nodes near the esophagus." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Endoscopic ultrasound-guided fine-needle aspiration biopsy. An endoscope that has an ultrasound probe and a biopsy needle is inserted through the mouth and into the esophagus. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the lymph nodes near the esophagus. The sonogram helps the doctor see where to place the biopsy needle to remove tissue from the lymph nodes. This tissue is checked under a microscope for signs of cancer. </p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045628/" class="def">Bronchoscopy</a></b>: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046496/" class="def">bronchoscope</a> is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.<div id="CDR0000062956__295" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Bronchoscopy&p=BOOKS&id=569441_CDR0000435997.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000435997.jpg" alt="Bronchoscopy; drawing shows a bronchoscope inserted through the mouth, trachea, and bronchus into the lung; lymph nodes along trachea and bronchi; and cancer in one lung. Inset shows patient lying on a table having a bronchoscopy." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Bronchoscopy. A bronchoscope is inserted through the mouth, trachea, and major bronchi into the lung, to look for abnormal areas. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a cutting tool. Tissue samples may be taken to be checked under a microscope for signs of disease.</p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046119/" class="def">Thoracoscopy</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgical</a> procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476929/" class="def">thoracoscope</a> is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a> or lung. If certain tissues, organs, or lymph nodes can’t be reached, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045926/" class="def">thoracotomy</a> may be done. In this procedure, a larger incision is made between the ribs and the chest is opened. </div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046287/" class="def">Mediastinoscopy</a></b>: A surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000549425/" class="def">breastbone</a> and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000514453/" class="def">mediastinoscope</a> is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.<div id="CDR0000062956__296" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Mediastinoscopy&p=BOOKS&id=569441_CDR0000466554.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466554.jpg" alt="Mediastinoscopy; shows mediastinoscope with light and lens inserted into the chest through an incision above the breastbone. Drawing shows right and left lungs, trachea, and lymph nodes. Inset shows anterior mediastinotomy (Chamberlain procedure) with incision beside the breastbone." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Mediastinoscopy. A mediastinoscope is inserted into the chest through an
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incision above the breastbone to look for abnormal areas between the
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lungs. A mediastinoscope is a thin, tube-like instrument with a light
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and a lens for viewing. It may also have a cutting tool. Tissue samples
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may be taken from lymph nodes on the right side of the chest and checked
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under a microscope for signs of cancer. In an anterior mediastinotomy
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(Chamberlain procedure), the incision is made beside the breastbone to
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remove tissue samples from the lymph nodes on the left side of the
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chest.
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</p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046533/" class="def">Anterior
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mediastinotomy</a></b>: A surgical procedure to look at the organs and tissues between the lungs and between the breastbone and heart for abnormal areas. An incision (cut) is made next to the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. This is also called the Chamberlain procedure.</div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000793499/" class="def">Lymph node biopsy</a></b>: The removal of all or part of a lymph node. A pathologist views the lymph node tissue under a microscope to check for cancer cells.</div></li></ul><p id="CDR0000062956__481">One or more of the following laboratory tests may be done to study the tissue samples:</p><ul id="CDR0000062956__482"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000766166/" class="def">Molecular test</a></b>: A laboratory test to check for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a>, or other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045065/" class="def">molecules</a> in a sample of tissue, blood, or other body fluid. Molecular tests check for certain gene or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosome</a> changes that occur in non-small cell lung cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653117/" class="def">Immunohistochemistry</a></b>: A laboratory test that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to check for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045776/" class="def">markers</a>) in a sample of a patient’s tissue. The antibodies are usually linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzyme</a> or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.</div></li></ul></div><div id="CDR0000062956__127"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000062956__244">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> and treatment options depend on the following:</p><ul id="CDR0000062956__243"><li class="half_rhythm"><div>The stage of the cancer (the size of the tumor and whether it is
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in the lung only or has spread to other places in the body).</div></li><li class="half_rhythm"><div>The type of lung
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cancer.</div></li><li class="half_rhythm"><div>Whether the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutations</a> (changes) in certain genes, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000796875/" class="def">epidermal growth factor receptor (EGFR) gene</a> or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000721259/" class="def">anaplastic lymphoma kinase (ALK) gene</a>.</div></li><li class="half_rhythm"><div>Whether there are signs and symptoms such as coughing or trouble breathing.</div></li><li class="half_rhythm"><div>The patient’s general health. </div></li></ul></div><div id="CDR0000062956__130"><h3>For most patients with non-small cell lung cancer, current
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treatments do not cure the cancer. </h3><p id="CDR0000062956__132">If lung cancer is found, taking part in one of the many <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical
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trials</a> being done to improve treatment should be considered. Clinical trials
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are taking place in most parts of the country for patients with all stages of
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non-small cell lung cancer. Information about ongoing clinical trials is
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available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000062956__134"><h2 id="_CDR0000062956__134_">Stages of Non-Small Cell Lung Cancer</h2><div id="CDR0000062956__134.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062956__135">After lung cancer has been diagnosed, tests are done to
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find out if cancer cells have spread within the lungs or to other parts of the
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body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__317">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__432">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__140">The following stages are used for non-small cell lung
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cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062956__142">Occult (hidden) stage</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__145">Stage 0</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__148">Stage I</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__151">Stage II</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__500">Stage III</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__159">Stage IV</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062956__592">Non-small cell
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lung cancer can recur
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(come back) after it has been treated. </a></div></li></ul></div><div id="CDR0000062956__135"><h3>After lung cancer has been diagnosed, tests are done to
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find out if cancer cells have spread within the lungs or to other parts of the
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body. </h3><p id="CDR0000062956__137">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> or to other parts
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of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the
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staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is
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important to know the stage in order to plan treatment. Some of the tests used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung cancer</a> are also used to stage the disease. (See the <a href="#CDR0000062956__270">General Information</a> section.) </p><p id="CDR0000062956__462">Other tests and procedures
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that may be used in the staging process include the following:</p><ul id="CDR0000062956__138"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body, such as the brain. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the brain, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, and lymph nodes, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> cells in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.<div id="CDR0000062956__294" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=PET%20(positron%20emission%20tomography)%20scan&p=BOOKS&id=569441_CDR0000466545.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466545.jpg" alt="PET (positron emission tomography) scan; drawing shows patient lying on table that slides through the PET machine." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>PET (positron emission tomography) scan. The patient lies on a table that slides through the PET machine. The head rest and white strap help the patient lie still. A small amount of radioactive glucose (sugar) is injected into the patient's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.
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</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046552/" class="def">Bone scan</a></b>: A procedure to check if there are rapidly dividing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>, such as cancer cells, in the bone. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000658018/" class="def">Pulmonary function test</a> (PFT)</b>: A test to see how well the lungs are working. It measures how much air the lungs can hold and how quickly air moves into and out of the lungs. It also measures how much <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a> is used and how much <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538147/" class="def">carbon dioxide</a> is given off during breathing. This is also called lung function test.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000669655/" class="def">Bone marrow aspiration and biopsy</a></b>: The removal of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, and a small piece of bone by inserting a hollow needle into the hipbone or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000549425/" class="def">breastbone</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the bone marrow, blood, and bone under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> of cancer.</div></li></ul></div><div id="CDR0000062956__317"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000062956__317_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000062956__317_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000062956__432"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000062956__432_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000062956__432_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000062956__434">The metastatic tumor is the same type of cancer as the primary tumor. For example, if non-small cell lung cancer spreads to the brain, the cancer cells in the brain are actually <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445043/" class="def">lung cancer</a> cells. The disease is metastatic lung cancer, not brain cancer.</p><div id="CDR0000062956__465" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000062956__140"><h3>The following stages are used for non-small cell lung
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cancer:</h3><div id="CDR0000062956__142"><h4>Occult (hidden) stage</h4><p id="CDR0000062956__483">In the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000363610/" class="def">occult (hidden) stage</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> cannot be seen by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046361/" class="def">imaging</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045628/" class="def">bronchoscopy</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045883/" class="def">sputum</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000661172/" class="def">bronchial washings</a> (a sample of cells taken from inside the airways that lead to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>). Cancer may have spread to other parts of the body.</p></div><div id="CDR0000062956__145"><h4>Stage 0</h4><p id="CDR0000062956__147">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000363611/" class="def">stage 0</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in the lining of the airways. These abnormal cells may become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and spread into nearby normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. Stage 0 may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000752832/" class="def">adenocarcinoma in situ</a> (AIS) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000794892/" class="def">squamous cell carcinoma in situ</a> (SCIS).
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</p></div><div id="CDR0000062956__148"><h4>Stage I</h4><p id="CDR0000062956__249">In stage I, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has formed. Stage I is divided into stages IA and IB.</p><ul id="CDR0000062956__485"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045349/" class="def">Stage IA</a>:<div id="CDR0000062956__534" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IA%20lung%20cancer&p=BOOKS&id=569441_CDR0000520459.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000520459.jpg" alt="Stage IA lung cancer; drawing shows a tumor (3 cm or less) in the right lung. Also shown are the lymph nodes, trachea, pleura, and diaphragm." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IA lung cancer. The tumor is in the lung only and is 3 centimeters or smaller. Cancer has not spread to the lymph nodes.</p></div></div></div><div class="half_rhythm">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a> only and is 3 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller. Cancer has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. </div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682415/" class="def">Stage IB</a>:<div id="CDR0000062956__535" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IB%20lung%20cancer&p=BOOKS&id=569441_CDR0000794784.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000794784.jpg" alt="Two-panel drawing of stage IB lung cancer; the panel on the left shows a tumor (larger than 3 cm but not larger than 4 cm) in the right lung. Also shown are the pleura and diaphragm. The panel on the right shows a primary tumor (4 cm or smaller) in the left lung and cancer in (a) the left main bronchus and (b) the inner membrane covering the lung (inset). Also shown is (c) part or all of the lung has collapsed or has pneumonitis (inflammation). The carina and a rib (inset) are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IB lung cancer. The tumor is larger than 3 centimeters but not larger than 4 centimeters. Cancer has not spread to the lymph nodes; OR the tumor is 4 centimeters or smaller. Cancer has not spread to the lymph nodes and one or more of the following is found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).</p></div></div></div><div class="half_rhythm">The tumor is larger than 3 centimeters but not larger than 4 centimeters. Cancer has not spread to the lymph nodes.</div><div class="half_rhythm"><b><i>or</i></b></div><div class="half_rhythm">The tumor is 4 centimeters or smaller and one or more of the following is found: <ul id="CDR0000062956__484"><li class="half_rhythm"><div>Cancer has spread to the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a>, but has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482344/" class="def">carina</a>. </div></li><li class="half_rhythm"><div>Cancer has spread to the innermost layer of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membrane</a> that covers the lung. </div></li><li class="half_rhythm"><div>Part of the lung or the whole lung has collapsed or has developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a>. </div></li></ul></div><div class="half_rhythm">Cancer has not spread to the lymph nodes.</div></li></ul></div><div id="CDR0000062956__151"><h4>Stage II</h4><p id="CDR0000062956__252">Stage II is divided into stages IIA and IIB.</p><ul id="CDR0000062956__491"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045357/" class="def">Stage IIA</a>:<div id="CDR0000062956__536" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIA%20lung%20cancer&p=BOOKS&id=569441_CDR0000520465.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000520465.jpg" alt="Stage IIA lung cancer; drawing shows a primary tumor (larger than 4 cm but not larger than 5 cm) in the left lung and cancer in (a) the left main bronchus and (b) the inner membrane covering the lung (inset). Also shown is (c) part or all of the lung has collapsed or has pneumonitis (inflammation). The carina, pleura, and a rib (inset) are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIA lung cancer. The tumor is larger than 4 centimeters but not larger than 5 centimeters. Cancer has not spread to the lymph nodes and one or more of the following may be found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).</p></div></div></div><div class="half_rhythm">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is larger than 4 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> but not larger than 5 centimeters. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> and one or more of the following may be found: <ul id="CDR0000062956__493"><li class="half_rhythm"><div>Cancer has spread to the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a>, but has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482344/" class="def">carina</a>. </div></li><li class="half_rhythm"><div>Cancer has spread to the innermost layer of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membrane</a> that covers the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>.</div></li><li class="half_rhythm"><div>Part of the lung or the whole lung has collapsed or has developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a>. </div></li></ul></div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682419/" class="def">Stage IIB</a>:<div id="CDR0000062956__537" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIB%20lung%20cancer%20(1)&p=BOOKS&id=569441_CDR0000682110.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000682110.jpg" alt="Stage IIB lung cancer (1); drawing shows a primary tumor (5 cm or smaller) in the right lung and cancer in lymph nodes in the same lung as the primary tumor. Also shown are the trachea, main bronchus, pleura, and diaphragm." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIB lung cancer (1). The primary tumor is 5 centimeters or smaller and cancer has spread to the lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus.</p></div></div></div><div class="half_rhythm">The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following may be found:<ul id="CDR0000062956__495"><li class="half_rhythm"><div>Cancer has spread to the main bronchus, but has not spread to the carina. </div></li><li class="half_rhythm"><div>Cancer has spread to the innermost layer of the membrane that covers the lung.</div></li><li class="half_rhythm"><div>Part of the lung or the whole lung has collapsed or has developed pneumonitis. </div></li></ul></div><div class="half_rhythm"><b><i>or</i></b><div id="CDR0000062956__538" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIB%20lung%20cancer%20(2)&p=BOOKS&id=569441_CDR0000795027.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000795027.jpg" alt="Stage IIB lung cancer (2); drawing shows (a) a primary tumor (larger than 5 cm but not larger than 7 cm) in the left lung (top inset) and (b) a separate tumor in the same lobe of the lung as the primary tumor. Also shown is cancer that has spread to (c) the chest wall and the membranes covering the lung and chest wall (middle inset); (d) the nerve that controls the diaphragm; and (e) the sac around the heart (bottom inset). The pleura, diaphragm, heart, and a rib (middle inset) are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIB lung cancer (2). Cancer has not spread to lymph nodes and one or more of the following is found: (a) the primary tumor is larger than 5 centimeters but not larger than 7 centimeters; and/or (b) there are one or more separate tumors in the same lobe of the lung as the primary tumor; and/or cancer has spread to any of the following: (c) the chest wall and/or the membrane that lines the inside of the chest wall, (d) the nerve that controls the diaphragm, and/or (e) the outer layer of tissue of the sac around the heart.</p></div></div></div><div class="half_rhythm">Cancer has not spread to the lymph nodes and one or more of the following is found: <ul id="CDR0000062956__498"><li class="half_rhythm"><div>The tumor is larger than 5 centimeters but not larger than 7 centimeters.</div></li><li class="half_rhythm"><div>There are one or more separate tumors in the same <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> of the lung as the primary tumor. </div></li><li class="half_rhythm"><div>Cancer has spread to any of the following: <ul id="CDR0000062956__499"><li class="half_rhythm"><div>The membrane that lines the inside of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">chest wall</a>.</div></li><li class="half_rhythm"><div>Chest wall.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> that controls the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">diaphragm</a>.</div></li><li class="half_rhythm"><div>Outer layer of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> of the sac around the heart.</div></li></ul></div></li></ul></div></li></ul></div><div id="CDR0000062956__500"><h4>Stage III</h4><p id="CDR0000062956__502">Stage III is divided into stages IIIA, IIIB, and IIIC. </p><ul id="CDR0000062956__503"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045367/" class="def">Stage IIIA</a>: <div id="CDR0000062956__539" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIA%20lung%20cancer%20(1)&p=BOOKS&id=569441_CDR0000521911.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000521911.jpg" alt="Stage IIIA lung cancer (1); drawing shows a primary tumor (5 cm or smaller) in the left lung (top inset) and cancer in lymph nodes around the trachea. Also shown is cancer that has spread to (a) the left main bronchus and (b) the membrane covering the lung (bottom inset). Also shown is (c) part or all of the lung has collapsed or has pneumonitis (inflammation). The carina, pleura, and a rib (bottom inset) are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIA lung cancer (1). The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta (not shown), or where the trachea divides into the bronchi. Also, one or more of the following may be found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).</p></div></div></div><div class="half_rhythm">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is 5 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> on the same side of the chest as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>. The lymph nodes with cancer are around the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044527/" class="def">aorta</a>, or where the trachea divides into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046493/" class="def">bronchi</a>. Also, one or more of the following may be found:<ul id="CDR0000062956__505"><li class="half_rhythm"><div>Cancer has spread to the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a>, but has not spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482344/" class="def">carina</a>. </div></li><li class="half_rhythm"><div>Cancer has spread to the innermost layer of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membrane</a> that covers the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>. </div></li><li class="half_rhythm"><div>Part of the lung or the whole lung has collapsed or has developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a>.</div></li></ul>
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</div><div class="half_rhythm"><b><i>or</i></b><div id="CDR0000062956__540" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIA%20lung%20cancer%20(2)&p=BOOKS&id=569441_CDR0000682116.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000682116.jpg" alt="Stage IIIA lung cancer (2); drawing shows (a) a primary tumor (larger than 5 cm but not larger than 7 cm) in the left lung and cancer in lymph nodes in the lung or near the bronchus on the same side of the chest as the primary tumor. Also shown is (b) separate tumors in the same lobe of the lung as the primary tumor and cancer that has spread to (c) the chest wall and the membranes covering the lung and chest wall (top right inset); (d) the nerve that controls the diaphragm; and (e) the sac around the heart (bottom right inset). The trachea, left main bronchus, diaphragm, heart, and a rib (top right inset) are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIA lung cancer (2). Cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found: (a) the tumor is larger than 5 centimeters but not larger than 7 centimeters; and/or (b) there are one or more separate tumors in the same lobe of the lung as the primary tumor; and/or cancer has spread to any of the following: (c) the chest wall and/or the membrane that lines the inside of the chest wall, (d) the nerve that controls the diaphragm, and/or (e) the outer layer of tissue of the sac around the heart.</p></div></div></div><div class="half_rhythm">Cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:<ul id="CDR0000062956__508"><li class="half_rhythm"><div>The tumor is larger than 5 centimeters but not larger than 7 centimeters. </div></li><li class="half_rhythm"><div>There are one or more separate tumors in the same <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> of the lung as the primary tumor. </div></li><li class="half_rhythm"><div>Cancer has spread to any of the following: <ul id="CDR0000062956__509"><li class="half_rhythm"><div>The membrane that lines the inside of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">chest wall</a>.</div></li><li class="half_rhythm"><div>Chest wall.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> that controls the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">diaphragm</a>.</div></li><li class="half_rhythm"><div>Outer layer of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> of the sac around the heart.</div></li></ul></div></li></ul></div><div class="half_rhythm"><b><i>or</i></b><div id="CDR0000062956__541" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIA%20lung%20cancer%20(3)&p=BOOKS&id=569441_CDR0000682121.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000682121.jpg" alt="Stage IIIA lung cancer (3); drawing shows (a) a primary tumor (larger than 7 cm) in the left lung and (b) separate tumors in a different lobe of the lung with the primary tumor. Also shown is cancer that has spread to the (c) trachea, (d) carina, (e) esophagus, (f) breastbone, (g) diaphragm, (h) heart, and (i) the aorta and vena cava." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIA lung cancer (3). Cancer may have spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found: (a) the primary tumor is larger than 7 centimeters; and/or (b) there are one or more separate tumors in a different lobe of the lung with the primary tumor; and/or the tumor is any size and cancer has spread to any of the following: (c) trachea, (d) carina, (e) esophagus, (f) breastbone or backbone, (g) diaphragm, (h) heart, (i) major blood vessels that lead to or from the heart (aorta or vena cava), or the nerve that controls the larynx (not shown).</p></div></div></div><div class="half_rhythm">Cancer may have spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:<ul id="CDR0000062956__512"><li class="half_rhythm"><div>The tumor is larger than 7 centimeters. </div></li><li class="half_rhythm"><div>There are one or more separate tumors in a different lobe of the lung with the primary tumor. </div></li><li class="half_rhythm"><div>The tumor is any size and cancer has spread to any of the following: <ul id="CDR0000062956__513"><li class="half_rhythm"><div>Trachea.</div></li><li class="half_rhythm"><div>Carina.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">Esophagus</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000549425/" class="def">Breastbone</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415915/" class="def">backbone</a>.</div></li><li class="half_rhythm"><div>Diaphragm.</div></li><li class="half_rhythm"><div>Heart.</div></li><li class="half_rhythm"><div>Major <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that lead to or from the heart (aorta or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000792054/" class="def">vena cava</a>).</div></li><li class="half_rhythm"><div>Nerve that controls the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a> (voice box). </div></li></ul></div></li></ul></div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682421/" class="def">Stage IIIB</a>: <div id="CDR0000062956__542" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIB%20lung%20cancer%20(1)&p=BOOKS&id=569441_CDR0000521915.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000521915.jpg" alt="Stage IIIB lung cancer (1); drawing shows a primary tumor (5 cm or smaller) in the left lung and cancer in lymph nodes above the collarbone on the same side of the chest as the primary tumor and in lymph nodes on the opposite side of the chest as the primary tumor. Also shown is cancer that has spread to (a) the left main bronchus and (b) the membrane covering the lung. Also shown is (c) part or all of the lung has collapsed or has pneumonitis (inflammation). The carina, pleura, and a rib (inset) are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIB lung cancer (1). The primary tumor is 5 centimeters or smaller and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following may be found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).</p></div></div></div><div class="half_rhythm">The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes above the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000639993/" class="def">collarbone</a> on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following may be found: <ul id="CDR0000062956__515"><li class="half_rhythm"><div>Cancer has spread to the main bronchus, but has not spread to the carina.</div></li><li class="half_rhythm"><div>Cancer has spread to the innermost layer of the membrane that covers the lung.</div></li><li class="half_rhythm"><div>Part of the lung or the whole lung has collapsed or has developed pneumonitis. </div></li></ul></div><div class="half_rhythm"><b><i>or</i></b><div id="CDR0000062956__543" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIB%20lung%20cancer%20(2)&p=BOOKS&id=569441_CDR0000682124.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000682124.jpg" alt="Stage IIIB lung cancer (2); drawing shows a primary tumor in the left lung and (a) a separate tumor in a different lobe of the lung with the primary tumor. Also shown is cancer in lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or where the trachea divides into the bronchi. Also shown is (b) cancer that has spread to the following: the chest wall and the lining of the chest wall and lung, the nerve that controls the voice box, the trachea, the carina, the esophagus, the breastbone, the diaphragm, the nerve that controls the diaphragm, the aorta and vena cava, the heart, and the sac around the heart." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIB lung cancer (2). The tumor may be any size and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta (not shown), or where the trachea divides into the bronchi. Also, one or more of the following is found: (a) there are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor; and/or (b) cancer has spread to any of the following: the chest wall or the membrane that lines the inside of the chest wall, the nerve that controls the voice box, the trachea, the carina, the esophagus, the breastbone or backbone (not shown), the diaphragm, the nerve that controls the diaphragm, the heart, the major blood vessels that lead to or from the heart (aorta or vena cava), or the outer layer of tissue of the sac around the heart.</p></div></div></div><div class="half_rhythm">The tumor may be any size and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta, or where the trachea divides into the bronchi. Also, one or more of the following is found:<ul id="CDR0000062956__518"><li class="half_rhythm"><div>There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor. </div></li><li class="half_rhythm"><div>Cancer has spread to any of the following: <ul id="CDR0000062956__519"><li class="half_rhythm"><div>The membrane that lines the inside of the chest wall. </div></li><li class="half_rhythm"><div>Chest wall.</div></li><li class="half_rhythm"><div>The nerve that controls the diaphragm.</div></li><li class="half_rhythm"><div>Outer layer of tissue of the sac around the heart.</div></li><li class="half_rhythm"><div>Trachea.</div></li><li class="half_rhythm"><div>Carina.</div></li><li class="half_rhythm"><div>Esophagus.</div></li><li class="half_rhythm"><div>Breastbone or backbone.</div></li><li class="half_rhythm"><div>Diaphragm.</div></li><li class="half_rhythm"><div>Heart.</div></li><li class="half_rhythm"><div>Major blood vessels that lead to or from the heart (aorta or vena cava).</div></li><li class="half_rhythm"><div>Nerve that controls the larynx (voice box). </div></li></ul></div></li></ul></div></li><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000793422/" class="def">Stage IIIC</a>: <div id="CDR0000062956__544" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIC%20lung%20cancer&p=BOOKS&id=569441_CDR0000796021.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000796021.jpg" alt="Stage IIIC lung cancer; drawing shows a primary tumor in the left lung and (a) separate tumors in the same lobe of the lung with the primary tumor. Also shown is cancer in lymph nodes above the collarbone on the same side and opposite side of the chest as the primary tumor. Also shown is (b) cancer that has spread to the following: the chest wall and the lining of the chest wall and lung, the nerve that controls the voice box, the trachea, the carina, the esophagus, the breastbone, the diaphragm, the nerve that controls the diaphragm, the heart, the aorta and vena cava, and the sac around the heart." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIC lung cancer. The tumor may be any size and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following is found: (a) there are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor; and/or (b) cancer has spread to any of the following: the chest wall or the membrane that lines the inside of the chest wall, the nerve that controls the voice box, the trachea, the carina, the esophagus, the breastbone or backbone (not shown), the diaphragm, the nerve that controls the diaphragm, the heart, the major blood vessels that lead to or from the heart (aorta or vena cava), or the outer layer of tissue of the sac around the heart.</p></div></div></div><div class="half_rhythm">The tumor may be any size and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following is found: <ul id="CDR0000062956__521"><li class="half_rhythm"><div>There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor. </div></li><li class="half_rhythm"><div>Cancer has spread to any of the following: <ul id="CDR0000062956__522"><li class="half_rhythm"><div>The membrane that lines the inside of the chest wall.</div></li><li class="half_rhythm"><div>Chest wall.</div></li><li class="half_rhythm"><div>The nerve that controls the diaphragm. </div></li><li class="half_rhythm"><div>Outer layer of tissue of the sac around the heart.</div></li><li class="half_rhythm"><div>Trachea.</div></li><li class="half_rhythm"><div>Carina.</div></li><li class="half_rhythm"><div>Esophagus.</div></li><li class="half_rhythm"><div>Breastbone or backbone.</div></li><li class="half_rhythm"><div>Diaphragm.</div></li><li class="half_rhythm"><div>Heart.</div></li><li class="half_rhythm"><div>Major blood vessels that lead to or from the heart (aorta or vena cava). </div></li><li class="half_rhythm"><div>Nerve that controls the larynx (voice box). </div></li></ul></div></li></ul></div></li></ul></div><div id="CDR0000062956__159"><h4>Stage IV</h4><p id="CDR0000062956__523"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045144/" class="def">Stage IV</a> is divided into stages IVA and IVB. </p><ul id="CDR0000062956__524"><li class="half_rhythm"><div class="half_rhythm">Stage IVA:<div id="CDR0000062956__545" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVA%20lung%20cancer&p=BOOKS&id=569441_CDR0000794785.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000794785.jpg" alt="Stage IVA lung cancer; drawing shows a primary tumor in the right lung and (a) a tumor in the left lung. Also shown is (b) fluid or cancer nodules around the lungs or heart (inset), and (c) other organs or tissues where lung cancer may spread, including the brain, adrenal gland, kidney, liver, bone, and distant lymph nodes." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVA lung cancer. The tumor may be any size and cancer may have spread to the lymph nodes. One or more of the following is found: (a) there are one or more tumors in the lung that does not have the primary tumor; and/or (b) cancer is found in fluid around the lungs or heart or there are cancer nodules in the lining around the lungs or the sac around the heart; and/or (c) cancer has spread to one place in an organ or tissue not near the lung, such as the brain, adrenal gland, kidney, liver, or bone, or to a lymph node that is not near the lung.</p></div></div>
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</div><div class="half_rhythm">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> may be any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> may have spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. One or more of the following is found: <ul id="CDR0000062956__525"><li class="half_rhythm"><div>There are one or more tumors in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a> that does not have the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>.</div></li><li class="half_rhythm"><div>Cancer is found in the lining around the lungs or the sac around the heart.</div></li><li class="half_rhythm"><div>Cancer is found in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> around the lungs or the heart.</div></li><li class="half_rhythm"><div>Cancer has spread to one place in an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> not near the lung, such as the brain, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046678/" class="def">adrenal gland</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a>, bone, or to a lymph node that is not near the lung.</div></li></ul></div></li><li class="half_rhythm"><div class="half_rhythm">Stage IVB:<div id="CDR0000062956__546" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20lung%20cancer&p=BOOKS&id=569441_CDR0000521926.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000521926.jpg" alt="Stage IVB lung cancer; drawing shows a primary cancer in the right lung and other parts of the body where lung cancer may spread, including the brain, adrenal gland, kidney, liver, distant lymph nodes, and bone. An inset shows cancer cells spreading from the lung, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB lung cancer. The cancer has spread to multiple places in one or more organs that are not near the lung, such as the brain, adrenal gland, kidney, liver, distant lymph nodes, or bone.</p></div></div></div><div class="half_rhythm">Cancer has spread to multiple places in one or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> that are not near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>.</div></li></ul></div></div><div id="CDR0000062956__592"><h3>Non-small cell
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lung cancer can recur
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(come back) after it has been treated. </h3><p id="CDR0000062956__594">The cancer may come back in the brain, lung, or other parts of the body.</p></div></div><div id="CDR0000062956__164"><h2 id="_CDR0000062956__164_">Treatment Option Overview</h2><div id="CDR0000062956__164.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062956__284">There are different types of treatment for patients with non-small cell lung cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__177">Ten types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062956__179">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__186">Radiation therapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__183">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__452">Targeted therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__527">Immunotherapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__194">Laser therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__191">Photodynamic therapy (PDT)</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__327">Cryosurgery</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__330">Electrocautery</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__288">Watchful waiting</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062956__189">New types of treatment are being tested in
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clinical trials. </a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062956__197">Chemoprevention</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__444">Radiosensitizers</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__200">New combinations</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062956__466">Treatment for non-small cell lung cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__319">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__321">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062956__323">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062956__284"><h3>There are different types of treatment for patients with non-small cell lung cancer.</h3><p id="CDR0000062956__286">Different types of treatments are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000062956__177"><h3>Ten types of standard treatment are used:</h3><div id="CDR0000062956__179"><h4>Surgery </h4><p id="CDR0000062956__181">Four types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> are used to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a> cancer:</p><ul id="CDR0000062956__182"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322895/" class="def">Wedge resection</a>:
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Surgery to remove a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> and some of the normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around it. When a slightly larger amount of tissue is taken, it is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476847/" class="def">segmental resection</a>.<div id="CDR0000062956__297" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Wedge%20resection%20of%20the%20lung&p=BOOKS&id=569441_CDR0000466555.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466555.jpg" alt="Wedge resection of the lung; shows trachea and lungs with cancer in a lung lobe. The removed lung tissue with the cancer and small amount of healthy tissue around it is shown next to the lung lobe it was removed from." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Wedge resection of the lung. Part of the lung lobe containing the cancer and a small amount of healthy tissue around it is removed.</p></div></div></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046314/" class="def">Lobectomy</a>:
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Surgery to remove a whole <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> (section) of the lung.<div id="CDR0000062956__298" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Lobectomy&p=BOOKS&id=569441_CDR0000466538.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466538.jpg" alt="Lobectomy; drawing shows lobes of both lungs, trachea, bronchi, bronchioles, and lymph nodes. Cancer is shown in one lobe. The removed lobe is shown next to the lung from which it was removed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Lobectomy. A lobe of the lung is removed.</p></div></div></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046224/" class="def">Pneumonectomy</a>:
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Surgery to remove one whole lung.<div id="CDR0000062956__299" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Pneumonectomy&p=BOOKS&id=569441_CDR0000466556.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000466556.jpg" alt="Pneumonectomy; drawing shows the trachea, lymph nodes, and lungs, with cancer in one lung. The removed lung with the cancer is shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Pneumonectomy. The whole lung is removed.</p></div></div></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482346/" class="def">Sleeve resection</a>: Surgery to remove part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a>.</div></li></ul><p id="CDR0000062956__347">After the doctor removes all the cancer that can be seen
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at the time of the surgery, some patients may be given
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> after surgery to kill any
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cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are left. Treatment given after the surgery,
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to lower the risk that the cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant
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therapy</a>.</p></div><div id="CDR0000062956__186"><h4>Radiation therapy </h4><p id="CDR0000062956__240">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy: </p><ul id="CDR0000062956__449"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the area of the body with cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer. </div></li></ul><p id="CDR0000062956__443"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386233/" class="def">Stereotactic body radiation therapy</a> is a type of external radiation therapy. Special equipment is used to place the patient in the same position for each radiation treatment. Once a day for several days, a radiation machine aims a larger than usual <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation directly at the tumor. By having the patient in the same position for each treatment, there is less damage to nearby healthy tissue. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.</p><p id="CDR0000062956__242"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046701/" class="def">Stereotactic radiosurgery</a> is a type of external radiation therapy used to treat lung cancer that has spread to the brain. A rigid head frame is attached to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> to keep the head still during the radiation treatment. A machine aims a single large dose of radiation directly at the tumor in the brain. This procedure does not involve surgery. It is also called stereotaxic radiosurgery, radiosurgery, and radiation surgery.</p><p id="CDR0000062956__450">For tumors in the airways, radiation is given directly to the tumor through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046428/" class="def">endoscope</a>.</p><p id="CDR0000062956__245"> The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated.
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It also depends on where the cancer is found. External and internal radiation therapy are used to treat non-small cell lung cancer.</p></div><div id="CDR0000062956__183"><h4>Chemotherapy </h4><p id="CDR0000062956__239">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). </p><p id="CDR0000062956__451">The way the chemotherapy is given depends on the type and stage of the cancer being treated.</p><p id="CDR0000062956__428">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/lung" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Small Cell Lung Cancer</a> for more information.</p></div><div id="CDR0000062956__452"><h4>Targeted therapy</h4><p id="CDR0000062956__454"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibodies</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitors</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mammalian target of rapamycin (mTOR) inhibitors</a> are three types of targeted therapy being used to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> non-small cell lung cancer.</p><p id="CDR0000062956__436"><b>Monoclonal antibodies</b></p><p id="CDR0000062956__455">Monoclonal antibodies are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells.</p><p id="CDR0000062956__456">There are different types of monoclonal antibody <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>:</p><ul id="CDR0000062956__457"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044222/" class="def">Vascular endothelial growth factor</a> (VEGF) inhibitor therapy: Cancer cells make a substance called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044474/" class="def">VEGF</a>, which causes new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to form (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046529/" class="def">angiogenesis</a>) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">Bevacizumab</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000648687/" class="def">ramucirumab</a> are VEGF inhibitors and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046739/" class="def">angiogenesis inhibitors</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491507/" class="def">Epidermal growth factor receptor (EGFR) inhibitor</a> therapy: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044397/" class="def">EGFRs</a> are proteins found on the surface of certain cells, including cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653114/" class="def">Epidermal growth factor</a> attaches to the EGFR on the surface of the cell and causes the cells to grow and divide. EGFR inhibitors block the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044958/" class="def">receptor</a> and stop the epidermal growth factor from attaching to the cancer cell. This stops the cancer cell from growing and dividing. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045467/" class="def">Cetuximab</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777080/" class="def">necitumumab</a> are EGFR inhibitors.</div></li></ul><div id="CDR0000062956__597" class="box"><h3><span class="title">monoclonal antibodies: how monoclonal antibodies treat cancer</span></h3><div class="caption"><p>How do monoclonal antibodies work to treat cancer? This video shows how monoclonal antibodies, such as trastuzumab, pembrolizumab, and rituximab, block molecules cancer cells need to grow, flag cancer cells for destruction by the body’s immune system, or deliver harmful substances to cancer cells. </p></div><p><a href="https://www.youtube.com/watch?v=dxnjAc-rqz8" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div><p id="CDR0000062956__458"><b>Tyrosine kinase inhibitors</b></p><p id="CDR0000062956__459">Tyrosine kinase inhibitors are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653146/" class="def">small-molecule drugs</a> that go through the cell <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membrane</a> and work inside cancer cells to block signals that cancer cells need to grow and divide. Some tyrosine kinase inhibitors also have angiogenesis inhibitor effects.</p><p id="CDR0000062956__460">There are different types of tyrosine kinase inhibitors:</p><ul id="CDR0000062956__461"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491538/" class="def">Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors</a>: EGFRs are proteins found on the surface and inside certain cells, including cancer cells. Epidermal growth factor attaches to the EGFR inside the cell and sends signals to the tyrosine kinase area of the cell, which tells the cell to grow and divide. EGFR tyrosine kinase inhibitors stop these signals and stop the cancer cell from growing and dividing. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000508929/" class="def">Erlotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000258356/" class="def">gefitinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000751176/" class="def">afatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000776961/" class="def">osimertinib</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795025/" class="def">dacomitinib</a> are types of EGFR tyrosine kinase inhibitors. Some of these drugs work better when there is also a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutation</a> (change) in the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000796876/" class="def">EGFR gene</a></i>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750798/" class="def">Kinase inhibitors</a> that affect cells with certain gene changes:<ul id="CDR0000062956__595"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">Dabrafenib</a> is used to stop proteins being made by the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000561325/" class="def">BRAF</a></i> gene.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750072/" class="def">Trametinib</a> is used to stop proteins being made by the <i>MEK</i> gene.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">Crizotinib</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000784260/" class="def">entrectinib</a> are used to stop proteins from being made by the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000721252/" class="def">ALK</a></i> and <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000779660/" class="def">ROS1</a></i> genes. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000760747/" class="def">Ceritinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777448/" class="def">alectinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000788756/" class="def">brigatinib</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795540/" class="def">lorlatinib</a> are used to stop proteins from being made by the <i>ALK</i> gene.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795811/" class="def">Larotrectinib</a> and entrectinib are used to stop proteins being made by <i>NTRK1</i>, <i>NTRK2</i>, and <i>NTRK3</i> gene fusions.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801614/" class="def">Selpercatinib</a> is used to stop proteins being made by the <i>RET</i> fusion gene or the mutated <i>RET</i> gene.</div></li></ul></div></li></ul><p id="CDR0000062956__598"><b>Mammalian target of rapamycin (mTOR) inhibitors</b></p><p id="CDR0000062956__599"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mTOR inhibitors</a> block a protein called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653126/" class="def">mTOR</a>, which may keep cancer cells from growing and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">prevent</a> the growth of new blood vessels that tumors need to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">Everolimus</a> is a type of mTOR inhibitor.</p><p id="CDR0000062956__463">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/lung" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Small Cell Lung Cancer</a> for more information.</p></div><div id="CDR0000062956__527"><h4>Immunotherapy</h4><p id="CDR0000062956__529"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a>.</p><p id="CDR0000062956__530"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">Immune checkpoint inhibitor</a> therapy is a type of immunotherapy used to treat some patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a> non-small-cell lung cancer.</p><p id="CDR0000062956__596">Types of immune checkpoint inhibitor therapy include:</p><ul id="CDR0000062956__531"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777027/" class="def">PD-1</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797389/" class="def">PD-L1</a> inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">Pembrolizumab</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a> are types of PD-1 inhibitors. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000781154/" class="def">Atezolizumab</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000788775/" class="def">durvalumab</a> are types of PD-L1 inhibitors.</div></li></ul><div id="CDR0000062956__464" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=569441_CDR0000774646.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65917.23/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of proteins PD-L1 (on the tumor cell) to PD-1 (on the T cell), which keeps T cells from killing tumor cells in the body. Also shown are a tumor cell antigen and T cell receptor. The panel on the right shows immune checkpoint inhibitors (anti-PD-L1 and anti-PD-1) blocking the binding of PD-L1 to PD-1, which allows the T cells to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).</p></div></div><div id="CDR0000062956__532" class="box"><h3><span class="title">immune checkpoint inhibitors</span></h3><div class="caption"><p>Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.</p></div><p><a href="https://www.youtube.com/watch?v=GIUu239FWMg" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div><p id="CDR0000062956__533">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/lung" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Small Cell Lung Cancer</a> for more information.</p></div><div id="CDR0000062956__194"><h4>Laser therapy</h4><p id="CDR0000062956__196"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045154/" class="def">Laser therapy</a> is a
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cancer treatment that uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045748/" class="def">laser beam</a> (a narrow beam of intense light) to kill cancer cells.</p></div><div id="CDR0000062956__191"><h4>Photodynamic therapy (PDT)</h4><p id="CDR0000062956__193"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045238/" class="def">Photodynamic therapy</a>
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(PDT) is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476949/" class="def">Fiberoptic</a> tubes are then used to carry the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue. It is used mainly to treat tumors on or just under the skin or in the lining of internal organs. When the tumor is in the airways, PDT is given directly to the tumor through an endoscope.</p></div><div id="CDR0000062956__327"><h4>Cryosurgery</h4><p id="CDR0000062956__329"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045985/" class="def">Cryosurgery</a> is a treatment that uses an instrument to freeze and destroy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a>. This type of treatment is also called cryotherapy. For tumors in the airways, cryosurgery is done through an endoscope.</p></div><div id="CDR0000062956__330"><h4>Electrocautery</h4><p id="CDR0000062956__332">Electrocautery is a treatment that uses a probe or needle heated by an electric current to destroy abnormal tissue. For tumors in the airways, electrocautery is done through an endoscope.</p></div><div id="CDR0000062956__288"><h4>Watchful waiting</h4><p id="CDR0000062956__290"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a> is closely <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitoring</a> a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> without giving any treatment until <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> appear or change. This may be done in certain rare cases of non-small cell lung cancer.</p></div></div><div id="CDR0000062956__189"><h3>New types of treatment are being tested in
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clinical trials. </h3><p id="CDR0000062956__316">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000062956__197"><h4>Chemoprevention</h4><p id="CDR0000062956__199"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045487/" class="def">Chemoprevention</a> is the
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use of drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a>, or other substances to reduce the risk of cancer or to reduce the risk cancer will <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recur</a> (come back). For lung cancer, chemoprevention is used to lessen the chance that a new tumor will form in the lung.</p></div><div id="CDR0000062956__444"><h4>Radiosensitizers</h4><p id="CDR0000062956__446"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046553/" class="def">Radiosensitizers</a> are substances that make tumor cells easier to kill with radiation therapy. The combination of chemotherapy and radiation therapy given with a radiosensitizer is being studied in the treatment of non-small cell lung cancer.</p></div><div id="CDR0000062956__200"><h4>New combinations</h4><p id="CDR0000062956__202">New combinations of treatments are being studied in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical
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trials</a>.</p></div></div><div id="CDR0000062956__466"><h3>Treatment for non-small cell lung cancer may cause side effects.</h3><p id="CDR0000062956__466_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, see our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000062956__319"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062956__319_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062956__319_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062956__319_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062956__321"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062956__321_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062956__321_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000062956__323"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062956__323_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062956__323_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p></div></div><div id="CDR0000062956__552"><h2 id="_CDR0000062956__552_">Treatment of Occult Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__559">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__553">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000363610/" class="def">occult non-small cell lung cancer</a> depends on the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. Occult <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> are often found at an early stage (the tumor is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a> only) and sometimes can be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cured</a> by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</p><p id="CDR0000062956__TrialSearch_552_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__554"><h2 id="_CDR0000062956__554_">Treatment of Stage 0 (Carcinoma in Situ)</h2><p id="CDR0000062956__560">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__555">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000363611/" class="def">stage 0</a> may include the
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following:</p><ul id="CDR0000062956__556"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322895/" class="def">wedge resection</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476847/" class="def">segmental resection</a>). </div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045238/" class="def">Photodynamic
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therapy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748973/" class="def">electrocautery</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045407/" class="def">cryosurgery</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322858/" class="def">laser surgery</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> in or near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a>. </div></li></ul><p id="CDR0000062956__TrialSearch_554_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__557"><h2 id="_CDR0000062956__557_">Treatment of Stage I Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__561">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__558">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045349/" class="def">stage IA non-small cell lung cancer</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682415/" class="def">stage IB non-small cell lung cancer</a> may include the following:</p><ul id="CDR0000062956__562"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322895/" class="def">wedge resection</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476847/" class="def">segmental resection</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482346/" class="def">sleeve resection</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046314/" class="def">lobectomy</a>).</div></li><li class="half_rhythm"><div>Surgery followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491538/" class="def">EGFR tyrosine kinase inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000776961/" class="def">osimertinib</a>.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a>, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386233/" class="def">stereotactic body radiation therapy</a> for patients who cannot have surgery or choose not to have surgery.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a> for patients who cannot have surgery or choose not to have surgery.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> following surgery.
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</div></li><li class="half_rhythm"><div>A clinical trial of treatment given through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046428/" class="def">endoscope</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045238/" class="def">photodynamic therapy</a> (PDT).
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</div></li><li class="half_rhythm"><div>A clinical trial of surgery followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045487/" class="def">chemoprevention</a>.</div></li></ul><p id="CDR0000062956__TrialSearch_557_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__563"><h2 id="_CDR0000062956__563_">Treatment of Stage II Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__564">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__565">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045357/" class="def">stage IIA non-small cell lung cancer</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682419/" class="def">stage IIB non-small cell lung cancer</a> may include the following:</p><ul id="CDR0000062956__566"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322895/" class="def">wedge resection</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476847/" class="def">segmental resection</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482346/" class="def">sleeve resection</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046314/" class="def">lobectomy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046224/" class="def">pneumonectomy</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> followed by surgery.</div></li><li class="half_rhythm"><div>Surgery followed by chemotherapy.</div></li><li class="half_rhythm"><div>Surgery followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491538/" class="def">EGFR tyrosine kinase inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000776961/" class="def">osimertinib</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> for patients who cannot have surgery. </div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> following surgery.
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</div></li></ul><p id="CDR0000062956__TrialSearch_563_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__567"><h2 id="_CDR0000062956__567_">Treatment of Stage IIIA Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__568">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__569">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045367/" class="def">stage IIIA non-small cell
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lung cancer</a> that can be removed with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> may include the following:</p><ul id="CDR0000062956__570"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> followed by surgery.</div></li><li class="half_rhythm"><div>Chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> followed by surgery.</div></li><li class="half_rhythm"><div>Surgery followed by chemotherapy.</div></li><li class="half_rhythm"><div>Surgery followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491538/" class="def">EGFR tyrosine kinase inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000776961/" class="def">osimertinib</a>.</div></li><li class="half_rhythm"><div>Surgery followed by chemotherapy combined with radiation therapy. </div></li><li class="half_rhythm"><div>Surgery followed by radiation therapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new combinations of treatments.</div></li></ul><p id="CDR0000062956__571">Treatment of stage IIIA non-small cell lung cancer that cannot be removed with surgery may include the following:</p><ul id="CDR0000062956__572"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> alone.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322858/" class="def">laser surgery</a>, as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative treatment</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>. </div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">immunotherapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">immune checkpoint inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000788775/" class="def">durvalumab</a>.</div></li><li class="half_rhythm"><div>A clinical trial of new combinations of treatments.</div></li></ul><p id="CDR0000062956__573">For more information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046609/" class="def">supportive care</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and symptoms including cough, shortness of breath, and chest pain, see the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000352193/">Cardiopulmonary Syndromes</a>.</p><p id="CDR0000062956__574"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">Non-small cell lung cancer</a> of the superior sulcus, often called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045817/" class="def">Pancoast tumor</a>, begins in the upper part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a> and spreads to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">chest wall</a>, large <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a>. Treatment of Pancoast tumors may include the following:</p><ul id="CDR0000062956__575"><li class="half_rhythm"><div>Surgery.</div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy followed by surgery.</div></li><li class="half_rhythm"><div>Radiation therapy alone.</div></li><li class="half_rhythm"><div>A clinical trial of new combinations of treatments.</div></li></ul><p id="CDR0000062956__576">Some stage IIIA non-small cell lung tumors that have grown into the chest wall may be completely removed. Treatment of chest wall tumors may include the following:</p><ul id="CDR0000062956__577"><li class="half_rhythm"><div>Surgery.</div></li><li class="half_rhythm"><div>Surgery and radiation therapy.</div></li><li class="half_rhythm"><div>Radiation therapy alone.</div></li><li class="half_rhythm"><div>Chemotherapy combined with radiation therapy and/or surgery.</div></li><li class="half_rhythm"><div>A clinical trial of new combinations of treatments.</div></li></ul><p id="CDR0000062956__TrialSearch_567_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__578"><h2 id="_CDR0000062956__578_">Treatment of Stage IIIB and Stage IIIC Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__579">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__580">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682421/" class="def">stage IIIB non-small cell
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lung cancer</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000793422/" class="def">stage IIIC non-small cell lung cancer</a> may include the following:</p><ul id="CDR0000062956__581"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">external radiation therapy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> given as separate treatments over the same period of time.</div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy given as separate treatments over the same period of time, with the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation therapy increasing with time.</div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy given as separate treatments over the same period of time. Chemotherapy alone is given before or after these treatments.</div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">immunotherapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">immune checkpoint inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000788775/" class="def">durvalumab</a>.</div></li><li class="half_rhythm"><div>External radiation therapy alone for patients who cannot be treated with chemotherapy.</div></li><li class="half_rhythm"><div>External radiation therapy as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a>, to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045154/" class="def">Laser therapy</a>
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and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">internal radiation
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therapy</a> to relieve symptoms and improve the quality of life.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">Clinical trials</a> of new external radiation therapy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346524/" class="def">schedules</a> and new types of treatment.</div></li><li class="half_rhythm"><div>A clinical trial of chemotherapy and radiation therapy combined with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046553/" class="def">radiosensitizer</a>. </div></li><li class="half_rhythm"><div>Clinical trials of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> combined with chemotherapy and radiation therapy.</div></li></ul><p id="CDR0000062956__582">For more information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046609/" class="def">supportive care</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and symptoms such as cough, shortness of breath, and chest pain, see the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries:</p><ul id="CDR0000062956__583"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000352193/">Cardiopulmonary Syndromes</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062845/">Cancer Pain</a></div></li></ul><p id="CDR0000062956__TrialSearch_578_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__584"><h2 id="_CDR0000062956__584_">Treatment of Newly Diagnosed Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__585">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__586">Treatment of
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newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045144/" class="def">stage IV</a>,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045866/" class="def">relapsed</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung cancer</a> may include the following:</p><ul id="CDR0000062956__587"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a>.</div></li><li class="half_rhythm"><div>Combination chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">monoclonal antibody</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">bevacizumab</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045467/" class="def">cetuximab</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777080/" class="def">necitumumab</a>.</div></li><li class="half_rhythm"><div>Combination chemotherapy followed by more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045768/" class="def">maintenance therapy</a> to help keep cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045850/" class="def">progressing</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491538/" class="def">EGFR tyrosine kinase inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000776961/" class="def">osimertinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795025/" class="def">dacomitinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000258356/" class="def">gefitinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000508929/" class="def">erlotinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000751176/" class="def">afatinib</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795665/" class="def">ALK inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777448/" class="def">alectinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">crizotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000760747/" class="def">ceritinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000788756/" class="def">brigatinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795540/" class="def">lorlatinib</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750801/" class="def">BRAF inhibitor</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798762/" class="def">MEK inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">dabrafenib</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750072/" class="def">trametinib</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">crizotinib</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000784260/" class="def">entrectinib</a> to stop proteins from being made by the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000721252/" class="def">ALK</a></i> and <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000779660/" class="def">ROS1</a></i> genes.</div></li><li class="half_rhythm"><div>Targeted therapy with a NTRK inhibitor, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795811/" class="def">larotrectinib</a> or entrectinib.</div></li><li class="half_rhythm"><div>Targeted therapy with a RET inhibitor, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801614/" class="def">selpercatinib</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">immune checkpoint inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>, with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mTOR inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">everolimus</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045154/" class="def">Laser therapy</a>
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and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">internal radiation
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therapy</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that are blocking the airways.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a>, to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046658/" class="def">second primary tumor</a>.</div></li><li class="half_rhythm"><div>Surgery to remove <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797669/" class="def">brain</a>, followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the whole brain.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044452/" class="def">Stereotactic radiosurgery</a> for tumors that have spread to the brain and cannot be treated with surgery.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> and combinations of treatments.</div></li></ul><p id="CDR0000062956__TrialSearch_584_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__588"><h2 id="_CDR0000062956__588_">Treatment of Progressive Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__589">For information about the treatments listed below, see the <a href="#CDR0000062956__177">Treatment Option Overview</a> section.</p><p id="CDR0000062956__590">Treatment of
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045850/" class="def">progressive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045144/" class="def">stage IV</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045866/" class="def">relapsed</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung cancer</a> may include the following:</p><ul id="CDR0000062956__591"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000491538/" class="def">EGFR tyrosine kinase inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000508929/" class="def">erlotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000258356/" class="def">gefitinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000751176/" class="def">afatinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000776961/" class="def">osimertinib</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795665/" class="def">ALK inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">crizotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000760747/" class="def">ceritinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777448/" class="def">alectinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000788756/" class="def">brigatinib</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750801/" class="def">BRAF inhibitor</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798762/" class="def">MEK inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">dabrafenib</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750072/" class="def">trametinib</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">crizotinib</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000784260/" class="def">entrectinib</a> to stop proteins from being made by the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000721252/" class="def">ALK</a></i> and <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000779660/" class="def">ROS1</a></i> genes. </div></li><li class="half_rhythm"><div>Targeted therapy with a NTRK inhibitor, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795811/" class="def">larotrectinib</a> or entrectinib.</div></li><li class="half_rhythm"><div>Targeted therapy with a RET inhibitor, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801614/" class="def">selpercatinib</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">immune checkpoint inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000781154/" class="def">atezolizumab</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mTOR inhibitor</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">everolimus</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> and combinations of treatments.</div></li></ul><p id="CDR0000062956__TrialSearch_588_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062956__310"><h2 id="_CDR0000062956__310_">To Learn More About Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__311">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about non-small cell lung cancer, see the following: </p><ul id="CDR0000062956__430"><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/lung" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Lung Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062825/">Lung Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258019/">Lung Cancer Screening</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/drugs/lung" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Small Cell Lung Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Immunotherapy to Treat Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/surgery/lasers-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Lasers in Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/surgery/photodynamic-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Photodynamic Therapy for Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/surgery/cryosurgery-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cryosurgery in Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Tobacco</a> (includes help with quitting)</div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/second-hand-smoke-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Secondhand Smoke and Cancer</a></div></li></ul><p id="CDR0000062956__310_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000062956__310_41"><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062956__AboutThis_1"><h2 id="_CDR0000062956__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062956__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062956__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062956__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062956__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062956__AboutThis_6">This PDQ cancer information summary has current information about the treatment of non-small cell lung cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062956__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062956__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000062956__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062956__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062956__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062956__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062956__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062956__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062956__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062956__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Non-Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389355]</p><p id="CDR0000062956__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000062956__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062956__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062956__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062956__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65917.23/?report=reader">PubReader</a></li><li><a href="/books/NBK65917.23/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65917" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65917" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Non-Small Cell Lung Cancer Treatment (PDQ®): Patient Version. 2021 Apr 8. 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xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062956__118" ref="log$=inpage&link_id=inpage">General Information About Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__134" ref="log$=inpage&link_id=inpage">Stages of Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__164" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062956__552" ref="log$=inpage&link_id=inpage">Treatment of Occult Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__554" ref="log$=inpage&link_id=inpage">Treatment of Stage 0 (Carcinoma in Situ)</a></li><li><a href="#CDR0000062956__557" ref="log$=inpage&link_id=inpage">Treatment of Stage I Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__563" ref="log$=inpage&link_id=inpage">Treatment of Stage II Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__567" ref="log$=inpage&link_id=inpage">Treatment of Stage IIIA Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__578" ref="log$=inpage&link_id=inpage">Treatment of Stage IIIB and Stage IIIC Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__584" ref="log$=inpage&link_id=inpage">Treatment of Newly Diagnosed Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__588" ref="log$=inpage&link_id=inpage">Treatment of Progressive Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__310" ref="log$=inpage&link_id=inpage">To Learn More About Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" 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