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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: November 2, 2016.</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 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 detect (find), diagnose, and stage non-small cell lung cancer.</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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956292" co-legend-rid="figlgndCDR0000062956292"><a href="/books/NBK65917.3/figure/CDR0000062956__292/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956292" rid-ob="figobCDR0000062956292"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466533.gif" src-large="/books/NBK65917.3/bin/CDR0000466533.jpg" alt="Anatomy of the respiratory system, showing the trachea and both lungs and their lobes and airways" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956292"><h4 id="CDR0000062956__292"><a href="/books/NBK65917.3/figure/CDR0000062956__292/?report=objectonly" target="object" rid-ob="figobCDR0000062956292">Figure</a></h4><p class="float-caption no_bottom_margin">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 <a href="/books/NBK65917.3/figure/CDR0000062956__292/?report=objectonly" target="object" rid-ob="figobCDR0000062956292">(more...)</a></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/CDR0000062878/#CDR0000062878__924">Unusual Cancers of Childhood 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><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062861/">Smoking in Cancer Care</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 begins in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046056/" class="def">squamous cells</a>, which are thin,
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flat cells that look like fish scales. 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_CDR0000044342/" class="def">pleomorphic</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044233/" class="def">carcinoid</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446528/" class="def">salivary gland carcinoma</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_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> Being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046528/" class="def">asbestos</a>, chromium, nickel, beryllium, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044303/" class="def">arsenic</a>, soot, or tar in the workplace.</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 detect (find), 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_CDR0000689078/" class="def">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>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, <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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956293" co-legend-rid="figlgndCDR0000062956293"><a href="/books/NBK65917.3/figure/CDR0000062956__293/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956293" rid-ob="figobCDR0000062956293"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000428438.gif" src-large="/books/NBK65917.3/bin/CDR0000428438.jpg" alt="X-ray of the chest" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956293"><h4 id="CDR0000062956__293"><a href="/books/NBK65917.3/figure/CDR0000062956__293/?report=objectonly" target="object" rid-ob="figobCDR0000062956293">Figure</a></h4><p class="float-caption no_bottom_margin">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_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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956309" co-legend-rid="figlgndCDR0000062956309"><a href="/books/NBK65917.3/figure/CDR0000062956__309/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956309" rid-ob="figobCDR0000062956309"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000531057.gif" src-large="/books/NBK65917.3/bin/CDR0000531057.jpg" alt="Fine-needle aspiration biopsy of the lung" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956309"><h4 id="CDR0000062956__309"><a href="/books/NBK65917.3/figure/CDR0000062956__309/?report=objectonly" target="object" rid-ob="figobCDR0000062956309">Figure</a></h4><p class="float-caption no_bottom_margin">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 <a href="/books/NBK65917.3/figure/CDR0000062956__309/?report=objectonly" target="object" rid-ob="figobCDR0000062956309">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956295" co-legend-rid="figlgndCDR0000062956295"><a href="/books/NBK65917.3/figure/CDR0000062956__295/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956295" rid-ob="figobCDR0000062956295"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000435997.gif" src-large="/books/NBK65917.3/bin/CDR0000435997.jpg" alt="Bronchoscopy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956295"><h4 id="CDR0000062956__295"><a href="/books/NBK65917.3/figure/CDR0000062956__295/?report=objectonly" target="object" rid-ob="figobCDR0000062956295">Figure</a></h4><p class="float-caption no_bottom_margin">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 <a href="/books/NBK65917.3/figure/CDR0000062956__295/?report=objectonly" target="object" rid-ob="figobCDR0000062956295">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a> 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><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><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044052/" class="def">Light</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044025/" class="def">electron microscopy</a></b>: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653117/" class="def">Immunohistochemistry</a></b>: A 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> in a sample of tissue. The antibody is usually linked to a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types 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> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on the following:</p><ul id="CDR0000062956__243"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> 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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a>, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045680/" class="def">epidermal growth factor receptor</a> (EGFR) gene 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="http://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 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></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 and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, 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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956294" co-legend-rid="figlgndCDR0000062956294"><a href="/books/NBK65917.3/figure/CDR0000062956__294/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956294" rid-ob="figobCDR0000062956294"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466545.gif" src-large="/books/NBK65917.3/bin/CDR0000466545.jpg" alt="PET (positron emission tomography) scan" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956294"><h4 id="CDR0000062956__294"><a href="/books/NBK65917.3/figure/CDR0000062956__294/?report=objectonly" target="object" rid-ob="figobCDR0000062956294">Figure</a></h4><p class="float-caption no_bottom_margin">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 href="/books/NBK65917.3/figure/CDR0000062956__294/?report=objectonly" target="object" rid-ob="figobCDR0000062956294">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046552/" class="def">Radionuclide 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 and is detected by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a>.
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</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_CDR0000046602/" class="def">Endoscopic ultrasound</a> (EUS)</b>: 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 (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">ultrasound</a>) 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>. This procedure is also called endosonography. EUS may be used to guide <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045691/" class="def">fine needle aspiration (FNA) biopsy</a> of the lung, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>, or other areas. <div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956315" co-legend-rid="figlgndCDR0000062956315"><a href="/books/NBK65917.3/figure/CDR0000062956__315/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956315" rid-ob="figobCDR0000062956315"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466552.gif" src-large="/books/NBK65917.3/bin/CDR0000466552.jpg" alt="Endoscopic ultrasound-guided fine-needle aspiration biopsy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956315"><h4 id="CDR0000062956__315"><a href="/books/NBK65917.3/figure/CDR0000062956__315/?report=objectonly" target="object" rid-ob="figobCDR0000062956315">Figure</a></h4><p class="float-caption no_bottom_margin">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 <a href="/books/NBK65917.3/figure/CDR0000062956__315/?report=objectonly" target="object" rid-ob="figobCDR0000062956315">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046287/" class="def">Mediastinoscopy</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgical</a> procedure to look at the organs, tissues, and lymph nodes between the lungs for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas. An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> (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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> of cancer.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956296" co-legend-rid="figlgndCDR0000062956296"><a href="/books/NBK65917.3/figure/CDR0000062956__296/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956296" rid-ob="figobCDR0000062956296"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466554.gif" src-large="/books/NBK65917.3/bin/CDR0000466554.jpg" alt="Mediastinoscopy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956296"><h4 id="CDR0000062956__296"><a href="/books/NBK65917.3/figure/CDR0000062956__296/?report=objectonly" target="object" rid-ob="figobCDR0000062956296">Figure</a></h4><p class="float-caption no_bottom_margin">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 href="/books/NBK65917.3/figure/CDR0000062956__296/?report=objectonly" target="object" rid-ob="figobCDR0000062956296">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><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><b>Lymph node
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a></b>: The
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removal of all or part of a lymph node. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a microscope to look for cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. </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 breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs 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><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__144">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> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046274/" class="def">mucus</a> coughed up from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000661172/" class="def">bronchial washing</a> (a sample of cells taken from inside the airways that lead to the lung). Cancer may have spread to other parts of the body.</p></div><div id="CDR0000062956__145"><h4>Stage 0 (carcinoma in situ)</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 is also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a>.
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</p></div><div id="CDR0000062956__148"><h4>Stage I</h4><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956417" co-legend-rid="figlgndCDR0000062956417"><a href="/books/NBK65917.3/figure/CDR0000062956__417/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956417" rid-ob="figobCDR0000062956417"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000520459.gif" src-large="/books/NBK65917.3/bin/CDR0000520459.jpg" alt="Stage I non-small cell lung cancer" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956417"><h4 id="CDR0000062956__417"><a href="/books/NBK65917.3/figure/CDR0000062956__417/?report=objectonly" target="object" rid-ob="figobCDR0000062956417">Figure</a></h4><p class="float-caption no_bottom_margin">Stage I non-small cell lung cancer. In stage IA, cancer is in the lung only and is 3 cm or smaller. In stage IB, the cancer is (a) larger than 3 cm but not larger than 5 cm, (b) has spread to the main bronchus, and/or (c) has spread to the innermost layer <a href="/books/NBK65917.3/figure/CDR0000062956__417/?report=objectonly" target="object" rid-ob="figobCDR0000062956417">(more...)</a></p></div></div><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__250"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045349/" class="def">Stage IA</a>: 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.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682415/" class="def">Stage IB</a>: Cancer 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 is true:<dl id="CDR0000062956__375" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is larger than 3 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> but not larger than 5 centimeters.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a> and is at least 2 centimeters below where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> joins the bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin">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>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Part of the lung has collapsed or developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the lung) in the area where the trachea joins the bronchus.</p></dd></dl>
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</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. Stage IIA and IIB are each divided into two sections depending on the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>, where the tumor is found, and whether there is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</p><ul id="CDR0000062956__414"><li class="half_rhythm"><div class="half_rhythm"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045357/" class="def">Stage IIA</a>: <div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956418" co-legend-rid="figlgndCDR0000062956418"><a href="/books/NBK65917.3/figure/CDR0000062956__418/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956418" rid-ob="figobCDR0000062956418"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000520465.gif" src-large="/books/NBK65917.3/bin/CDR0000520465.jpg" alt="Stage IIA non-small cell lung cancer" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956418"><h4 id="CDR0000062956__418"><a href="/books/NBK65917.3/figure/CDR0000062956__418/?report=objectonly" target="object" rid-ob="figobCDR0000062956418">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIA non-small cell lung cancer. Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor; the cancer is (a) 5 cm or smaller, (b) has spread to the main bronchus, and/or (c) has spread to the innermost layer of <a href="/books/NBK65917.3/figure/CDR0000062956__418/?report=objectonly" target="object" rid-ob="figobCDR0000062956418">(more...)</a></p></div></div></div><div class="half_rhythm">(1) <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_CDR0000046634/" class="def">tumor</a>. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:<dl id="CDR0000062956__360" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The tumor is not larger than 5 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"> Cancer has spread to the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a> and is at least 2 centimeters below where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> joins the bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin">
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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>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Part of the lung has collapsed or developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the lung) in the area where the trachea joins the bronchus.</p></dd></dl></div><div class="half_rhythm"><b><i>or</i></b></div><div class="half_rhythm"> (2) Cancer has not spread to lymph nodes and one or more of the following is true:<dl id="CDR0000062956__377" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The tumor is larger than 5 centimeters but not larger than 7 centimeters.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to the innermost layer of the membrane that covers the lung.</p></dd><dt>-</dt><dd><p class="no_top_margin">Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.</p></dd></dl></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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956419" co-legend-rid="figlgndCDR0000062956419"><a href="/books/NBK65917.3/figure/CDR0000062956__419/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956419" rid-ob="figobCDR0000062956419"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000682110.gif" src-large="/books/NBK65917.3/bin/CDR0000682110.jpg" alt="Stage IIB non-small cell lung cancer" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956419"><h4 id="CDR0000062956__419"><a href="/books/NBK65917.3/figure/CDR0000062956__419/?report=objectonly" target="object" rid-ob="figobCDR0000062956419">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIB non-small cell lung cancer. Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor; the cancer is (a) larger than 5 cm but not larger than 7 cm, (b) has spread to the main bronchus, and/or (c) has spread <a href="/books/NBK65917.3/figure/CDR0000062956__419/?report=objectonly" target="object" rid-ob="figobCDR0000062956419">(more...)</a></p></div></div></div><div class="half_rhythm"> (1) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> has spread to nearby <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_CDR0000046634/" class="def">tumor</a>. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:<dl id="CDR0000062956__379" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The tumor is larger than 5 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> but not larger than 7 centimeters.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to the main <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a> and is at least 2 centimeters below where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> joins the bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin">
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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>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Part of the lung has collapsed or developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the lung) in the area where the trachea joins the bronchus.</p></dd></dl>
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</div><div class="half_rhythm"><b><i>or</i></b></div><div class="half_rhythm">(2) Cancer has not spread to lymph nodes and one or more of the following is true:<dl id="CDR0000062956__363" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The tumor is larger than 7 centimeters.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to the main bronchus (and is less than 2 centimeters below where the trachea joins the bronchus), the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">chest wall</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">diaphragm</a>, or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> that controls the diaphragm. </p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to the membrane around the heart or lining the chest wall.</p></dd><dt>-</dt><dd><p class="no_top_margin">The whole lung has collapsed or developed pneumonitis (inflammation of the lung).</p></dd><dt>-</dt><dd><p class="no_top_margin">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.</p></dd></dl></div></li></ul></div><div id="CDR0000062956__365"><h4>Stage IIIA</h4><p id="CDR0000062956__415"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045367/" class="def">Stage IIIA</a> is divided into three sections depending on the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>, where the tumor is found, and which <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> (if any).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956420" co-legend-rid="figlgndCDR0000062956420"><a href="/books/NBK65917.3/figure/CDR0000062956__420/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956420" rid-ob="figobCDR0000062956420"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000521911.gif" src-large="/books/NBK65917.3/bin/CDR0000521911.jpg" alt="Stage IIIA non-small cell lung cancer (1)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956420"><h4 id="CDR0000062956__420"><a href="/books/NBK65917.3/figure/CDR0000062956__420/?report=objectonly" target="object" rid-ob="figobCDR0000062956420">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIIA non-small cell lung cancer (1). Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor. The cancer may have spread to (a) the main bronchus; (b) lung lining, chest wall lining, or chest wall; (c) diaphragm; <a href="/books/NBK65917.3/figure/CDR0000062956__420/?report=objectonly" target="object" rid-ob="figobCDR0000062956420">(more...)</a></p></div></div><p id="CDR0000062956__395">(1) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482347/" class="def">sternum</a> (chest bone) or where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a> enters the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>. Also:</p><ul id="CDR0000062956__386"><li class="half_rhythm"><div>The tumor may be any size.</div></li><li class="half_rhythm"><div>Part of the lung (where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> joins the bronchus) or the whole lung may have collapsed or developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the lung).</div></li><li class="half_rhythm"><div>There may be 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.</div></li><li class="half_rhythm"><div>Cancer may have spread to any of the following:<dl id="CDR0000062956__407" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Main bronchus, but not the area where the trachea joins the bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">Chest wall</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">Diaphragm</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> that controls it.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">Membrane</a> around the lung or lining the chest wall.</p></dd><dt>-</dt><dd><p class="no_top_margin">Membrane around the heart.</p></dd></dl></div></li></ul><p id="CDR0000062956__389"><b><i>or</i></b></p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956421" co-legend-rid="figlgndCDR0000062956421"><a href="/books/NBK65917.3/figure/CDR0000062956__421/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956421" rid-ob="figobCDR0000062956421"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000682116.gif" src-large="/books/NBK65917.3/bin/CDR0000682116.jpg" alt="Stage IIIA lung cancer (2)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956421"><h4 id="CDR0000062956__421"><a href="/books/NBK65917.3/figure/CDR0000062956__421/?report=objectonly" target="object" rid-ob="figobCDR0000062956421">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIIA lung cancer (2). Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor. The cancer may have spread to (a) the main bronchus; (b) the lung lining, chest wall lining, or chest wall; (c) diaphragm; (d) heart <a href="/books/NBK65917.3/figure/CDR0000062956__421/?report=objectonly" target="object" rid-ob="figobCDR0000062956421">(more...)</a></p></div></div><p id="CDR0000062956__387">(2) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also:</p><ul id="CDR0000062956__388"><li class="half_rhythm"><div>The tumor may be any size.</div></li><li class="half_rhythm"><div>The whole lung may have collapsed or developed pneumonitis (inflammation of the lung).</div></li><li class="half_rhythm"><div>There may be one or more separate tumors in any of the lobes of the lung with cancer.</div></li><li class="half_rhythm"><div>Cancer may have spread to any of the following:<dl id="CDR0000062956__408" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Main bronchus, but not the area where the trachea joins the bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin">Chest wall.</p></dd><dt>-</dt><dd><p class="no_top_margin">Diaphragm and the nerve that controls it.</p></dd><dt>-</dt><dd><p class="no_top_margin">Membrane around the lung or lining the chest wall.</p></dd><dt>-</dt><dd><p class="no_top_margin">Heart or the membrane around it.</p></dd><dt>-</dt><dd><p class="no_top_margin">Major <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that lead to or from the heart.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Trachea.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">Esophagus</a>.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Nerve that controls the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a> (voice box).</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482347/" class="def">Sternum</a> (chest bone) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415915/" class="def">backbone</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482344/" class="def">Carina</a> (where the trachea joins the bronchi).</p></dd></dl></div></li></ul><p id="CDR0000062956__409"><b><i>or</i></b></p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956422" co-legend-rid="figlgndCDR0000062956422"><a href="/books/NBK65917.3/figure/CDR0000062956__422/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956422" rid-ob="figobCDR0000062956422"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000682121.gif" src-large="/books/NBK65917.3/bin/CDR0000682121.jpg" alt="Stage IIIA non-small cell lung cancer (3)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956422"><h4 id="CDR0000062956__422"><a href="/books/NBK65917.3/figure/CDR0000062956__422/?report=objectonly" target="object" rid-ob="figobCDR0000062956422">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIIA non-small cell lung cancer (3). Cancer has spread to (a) the heart; (b) major blood vessels that lead to or from the heart; (c) trachea; (d) esophagus; (e) sternum; and/or (f) carina. Cancer may have spread to the nerve that controls the larynx <a href="/books/NBK65917.3/figure/CDR0000062956__422/?report=objectonly" target="object" rid-ob="figobCDR0000062956422">(more...)</a></p></div></div><p id="CDR0000062956__392">(3) Cancer has not spread to the lymph nodes and the tumor may be any size. Cancer has spread to any of the following:</p><ul id="CDR0000062956__410"><li class="half_rhythm"><div>Heart.
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</div></li><li class="half_rhythm"><div>Major blood vessels that lead to or from the heart.
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</div></li><li class="half_rhythm"><div>Trachea.
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</div></li><li class="half_rhythm"><div>Esophagus.
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</div></li><li class="half_rhythm"><div>Nerve that controls the larynx (voice box).</div></li><li class="half_rhythm"><div>Sternum (chest bone) or backbone.
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</div></li><li class="half_rhythm"><div>Carina (where the trachea joins the bronchi).</div></li></ul></div><div id="CDR0000062956__405"><h4>Stage IIIB</h4><p id="CDR0000062956__416"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000682421/" class="def">Stage IIIB</a> is divided into two sections depending on the size of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>, where the tumor is found, and which <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956423" co-legend-rid="figlgndCDR0000062956423"><a href="/books/NBK65917.3/figure/CDR0000062956__423/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956423" rid-ob="figobCDR0000062956423"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000521915.gif" src-large="/books/NBK65917.3/bin/CDR0000521915.jpg" alt="Stage IIIB non-small cell lung cancer (1)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956423"><h4 id="CDR0000062956__423"><a href="/books/NBK65917.3/figure/CDR0000062956__423/?report=objectonly" target="object" rid-ob="figobCDR0000062956423">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIIB non-small cell lung cancer (1). Cancer has spread to lymph nodes above the collarbone or on the opposite side of the chest as the primary tumor. The cancer may have spread to (a) the main bronchus; (b) lung lining, chest wall lining, or chest <a href="/books/NBK65917.3/figure/CDR0000062956__423/?report=objectonly" target="object" rid-ob="figobCDR0000062956423">(more...)</a></p></div></div><p id="CDR0000062956__397">(1) Cancer has spread to lymph nodes above the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000639993/" class="def">collarbone</a> or to lymph nodes on the opposite side of the chest as the tumor. Also:</p><ul id="CDR0000062956__398"><li class="half_rhythm"><div>The tumor may be any size.</div></li><li class="half_rhythm"><div>Part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a> (where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> joins the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045629/" class="def">bronchus</a>) or the whole lung may have collapsed or developed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482345/" class="def">pneumonitis</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflammation</a> of the lung).</div></li><li class="half_rhythm"><div>There may be one or more separate tumors in any of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobes</a> of the lung with cancer.</div></li><li class="half_rhythm"><div>Cancer may have spread to any of the following:<dl id="CDR0000062956__411" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Main bronchus.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">Chest wall</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">Diaphragm</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> that controls it.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">Membrane</a> around the lung or lining the chest wall.</p></dd><dt>-</dt><dd><p class="no_top_margin">Heart or the membrane around it.</p></dd><dt>-</dt><dd><p class="no_top_margin">Major <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that lead to or from the heart.</p></dd><dt>-</dt><dd><p class="no_top_margin">Trachea.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">Esophagus</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Nerve that controls the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a> (voice box).</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482347/" class="def">Sternum</a> (chest bone) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415915/" class="def">backbone</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482344/" class="def">Carina</a> (where the trachea joins the bronchi).</p></dd></dl>
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</div></li></ul><p id="CDR0000062956__401"><b><i>or</i></b></p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956424" co-legend-rid="figlgndCDR0000062956424"><a href="/books/NBK65917.3/figure/CDR0000062956__424/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956424" rid-ob="figobCDR0000062956424"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000682124.gif" src-large="/books/NBK65917.3/bin/CDR0000682124.jpg" alt="Stage IIIB non-small cell lung cancer (2)" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956424"><h4 id="CDR0000062956__424"><a href="/books/NBK65917.3/figure/CDR0000062956__424/?report=objectonly" target="object" rid-ob="figobCDR0000062956424">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IIIB non-small cell lung cancer (2). Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor and to (a) the heart; (b) major blood vessels that lead to or from the heart; (c) trachea; (d) esophagus; (e) sternum; <a href="/books/NBK65917.3/figure/CDR0000062956__424/?report=objectonly" target="object" rid-ob="figobCDR0000062956424">(more...)</a></p></div></div><p id="CDR0000062956__402">(2) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are near the sternum (chest bone) or where the bronchus enters the lung. Also:</p><ul id="CDR0000062956__412"><li class="half_rhythm"><div>The tumor may be any size.</div></li><li class="half_rhythm"><div>There may be separate tumors in different lobes of the same lung.</div></li><li class="half_rhythm"><div>Cancer has spread to any of the following:<dl id="CDR0000062956__403" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Heart.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Major blood vessels that lead to or from the heart.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Trachea.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Esophagus.</p></dd><dt>-</dt><dd><p class="no_top_margin">Nerve that controls the larynx (voice box).</p></dd><dt>-</dt><dd><p class="no_top_margin">Sternum (chest bone) or backbone.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Carina (where the trachea joins the bronchi).</p></dd></dl></div></li></ul></div><div id="CDR0000062956__159"><h4>Stage IV</h4><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956425" co-legend-rid="figlgndCDR0000062956425"><a href="/books/NBK65917.3/figure/CDR0000062956__425/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956425" rid-ob="figobCDR0000062956425"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000521926.gif" src-large="/books/NBK65917.3/bin/CDR0000521926.jpg" alt="Stage IV non-small cell lung cancer" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956425"><h4 id="CDR0000062956__425"><a href="/books/NBK65917.3/figure/CDR0000062956__425/?report=objectonly" target="object" rid-ob="figobCDR0000062956425">Figure</a></h4><p class="float-caption no_bottom_margin">Stage IV non-small cell lung cancer. The cancer has spread to the other lung, and/or to lymph nodes, fluid around the lungs or heart, and/or other parts of the body, such as the brain, liver, adrenal gland, kidney, or bone. </p></div></div><p id="CDR0000062956__382">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045144/" class="def">stage IV</a>, 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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. One or more of the following is true:</p><ul id="CDR0000062956__383"><li class="half_rhythm"><div>There are one or more tumors in both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>.</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 other parts of the body, 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 glands</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidneys</a>, or bone.</div></li></ul></div></div></div><div id="CDR0000062956__162"><h2 id="_CDR0000062956__162_">Recurrent Non-Small Cell Lung Cancer</h2><p id="CDR0000062956__163"><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
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lung cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has recurred (come back) after it has been treated.
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The cancer may come back in the brain, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, or other parts of the body.</p></div><div id="CDR0000062956__164"><h2 id="_CDR0000062956__164_">Treatment Option Overview</h2><div 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">Nine types of standard treatment are used:</a></div></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></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>Nine 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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956297" co-legend-rid="figlgndCDR0000062956297"><a href="/books/NBK65917.3/figure/CDR0000062956__297/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956297" rid-ob="figobCDR0000062956297"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466555.gif" src-large="/books/NBK65917.3/bin/CDR0000466555.jpg" alt="Wedge resection of the lung" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956297"><h4 id="CDR0000062956__297"><a href="/books/NBK65917.3/figure/CDR0000062956__297/?report=objectonly" target="object" rid-ob="figobCDR0000062956297">Figure</a></h4><p class="float-caption no_bottom_margin">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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956298" co-legend-rid="figlgndCDR0000062956298"><a href="/books/NBK65917.3/figure/CDR0000062956__298/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956298" rid-ob="figobCDR0000062956298"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466538.gif" src-large="/books/NBK65917.3/bin/CDR0000466538.jpg" alt="Lobectomy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956298"><h4 id="CDR0000062956__298"><a href="/books/NBK65917.3/figure/CDR0000062956__298/?report=objectonly" target="object" rid-ob="figobCDR0000062956298">Figure</a></h4><p class="float-caption no_bottom_margin">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 class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956299" co-legend-rid="figlgndCDR0000062956299"><a href="/books/NBK65917.3/figure/CDR0000062956__299/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956299" rid-ob="figobCDR0000062956299"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000466556.gif" src-large="/books/NBK65917.3/bin/CDR0000466556.jpg" alt="Pneumonectomy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956299"><h4 id="CDR0000062956__299"><a href="/books/NBK65917.3/figure/CDR0000062956__299/?report=objectonly" target="object" rid-ob="figobCDR0000062956299">Figure</a></h4><p class="float-caption no_bottom_margin">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">Even if 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 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="http://www.cancer.gov/about-cancer/treatment/drugs/lung#1" 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 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> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitors</a> are the two main 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 antibody <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory from a single type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> cell. These antibodies can identify substances on cancer cells or normal substances in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> or tissues that may help cancer cells grow. The antibodies attach to the substances and 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 therapy:</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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> 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 necitumumab are EGFR inhibitors.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">Immune checkpoint inhibitor</a> therapy: PD-1 is a protein on the surface of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a> that helps keep the body’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045722/" class="def">immune responses</a> in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">Nivolumab</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a> are types of immune checkpoint inhibitors.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062956464" co-legend-rid="figlgndCDR0000062956464"><a href="/books/NBK65917.3/figure/CDR0000062956__464/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062956464" rid-ob="figobCDR0000062956464"><img class="small-thumb" src="/books/NBK65917.3/bin/CDR0000774646.gif" src-large="/books/NBK65917.3/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062956464"><h4 id="CDR0000062956__464"><a href="/books/NBK65917.3/figure/CDR0000062956__464/?report=objectonly" target="object" rid-ob="figobCDR0000062956464">Figure</a></h4><p class="float-caption no_bottom_margin">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 <a href="/books/NBK65917.3/figure/CDR0000062956__464/?report=objectonly" target="object" rid-ob="figobCDR0000062956464">(more...)</a></p></div></div></div></li></ul><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>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000751176/" class="def">afatinib</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>EGFR</i>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a>.</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: Certain changes in the <i>ALK </i> and <i>ROS1</i> genes cause too much protein to be made. Blocking these proteins may stop the cancer from growing and spreading. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">Crizotinib</a> is used to stop proteins from being made by the <i>ALK</i> and <i>ROS1</i> gene. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000760747/" class="def">Ceritinib</a> is used to stop proteins from being made by the <i>ALK</i> gene.</div></li></ul><p id="CDR0000062956__463">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/lung#1" 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="http://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__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. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </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__205"><h2 id="_CDR0000062956__205_">Treatment Options by Stage</h2><div id="CDR0000062956__206"><h3>Occult Non-Small Cell Lung Cancer</h3><p id="CDR0000062956__207">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_206_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41125&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">occult non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062956__209"><h3>Stage 0 (Carcinoma in Situ)</h3><p id="CDR0000062956__210">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__211"><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> 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><li class="half_rhythm"><div>Electrocautery, <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 tumors in or near the bronchus.</div></li></ul><p id="CDR0000062956__TrialSearch_209_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38941&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage 0 non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062956__212"><h3>Stage I Non-Small Cell Lung Cancer</h3><p id="CDR0000062956__213">Treatment of stage I <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung
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cancer</a> may include the following:</p><ul id="CDR0000062956__214"><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>
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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 <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_212_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41226&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage I non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062956__216"><h3>Stage II Non-Small Cell Lung Cancer</h3><p id="CDR0000062956__217">Treatment of stage II <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045323/" class="def">non-small cell lung
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cancer</a> may include the following:</p><ul id="CDR0000062956__218"><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><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_216_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41327&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage II non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062956__220"><h3>Stage IIIA Non-Small Cell Lung Cancer </h3><p id="CDR0000062956__337">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__338"><li class="half_rhythm"><div>Surgery followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li><li class="half_rhythm"><div>Surgery followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy followed by surgery.</div></li><li class="half_rhythm"><div>Surgery followed by chemotherapy combined with radiation therapy. </div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy followed by 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 combinations of treatments.</div></li></ul><p id="CDR0000062956__339">Treatment of stage IIIA non-small cell lung cancer that cannot be removed with surgery may include the following:</p><ul id="CDR0000062956__340"><li class="half_rhythm"><div>Chemotherapy and radiation therapy given over the same period of time or one followed by the other.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> alone for patients who cannot be treated with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000688810/" class="def">combined therapy</a>, or 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><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 palliative treatment to relieve symptoms and improve the quality of life. </div></li><li class="half_rhythm"><div>A clinical trial of new combinations of treatments.</div></li></ul><p id="CDR0000062956__351">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__335"><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__336"><li class="half_rhythm"><div>Radiation therapy alone.</div></li><li class="half_rhythm"><div>Radiation therapy followed by surgery.</div></li><li class="half_rhythm"><div>Chemotherapy and radiation therapy given as separate treatments over the same period of time. Surgery may also be done after chemotherapy and radiation therapy.</div></li><li class="half_rhythm"><div>Surgery alone.</div></li><li class="half_rhythm"><div>A clinical trial of new combinations of treatments.</div></li></ul><p id="CDR0000062956__341">Some stage IIIA non-small cell lung tumors that have grown into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">chest wall</a> may be completely removed. Treatment of chest wall <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> may include the following:</p><ul id="CDR0000062956__342"><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_220_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41428&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage III non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062956__334"><h3>Stage IIIB Non-Small Cell Lung Cancer</h3><p id="CDR0000062956__224">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> may include the following:</p><ul id="CDR0000062956__225"><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 followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</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 <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_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__343">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__344"><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_334_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41428&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage III non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062956__227"><h3>Stage IV Non-Small Cell Lung Cancer</h3><p id="CDR0000062956__228">Treatment of
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045144/" class="def">stage IV non-small cell lung cancer</a>
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may include the following:</p><ul id="CDR0000062956__229"><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>Chemotherapy followed by more chemotherapy 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>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 necitumumab.</div></li><li class="half_rhythm"><div>Targeted therapy with a monoclonal antibody, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">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>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">crizotinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000760747/" class="def">ceritinib</a>.</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_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 <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__345">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 following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries:</p><ul id="CDR0000062956__346"><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><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000577190/">Last Days of Life</a></div></li></ul><p id="CDR0000062956__TrialSearch_227_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38942&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage IV non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://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__231"><h2 id="_CDR0000062956__231_">Treatment Options for Recurrent Non-Small Cell Lung Cancer </h2><p id="CDR0000062956__232">Treatment of <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
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the following:</p><ul id="CDR0000062956__233"><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> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a>, to relieve pain and other <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_CDR0000045214/" class="def">Chemotherapy</a> with or without <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_CDR0000648687/" class="def">ramucirumab</a>. </div></li><li class="half_rhythm"><div>Targeted therapy with a monoclonal antibody, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>.</div></li><li class="half_rhythm"><div>Targeted therapy with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">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>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710948/" class="def">crizotinib</a>, for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> with certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a> changes.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045154/" class="def">Laser therapy</a> or
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">internal radiation 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_CDR0000045570/" class="def">Surgery</a> to remove <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has spread to the brain, 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></ul><p id="CDR0000062956__TrialSearch_231_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=42347&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">recurrent non-small cell lung cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</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="http://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="http://www.cancer.gov/publications/patient-education/wyntk-lung-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What You Need To Know About™ Lung Cancer</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="http://www.cancer.gov/about-cancer/treatment/drugs/lung#1" 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="http://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="http://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="http://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="http://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="http://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="http://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="http://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="http://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="http://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="http://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="http://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="http://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="http://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 ("Date Last Modified") 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="http://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 are listed in PDQ and can be found online at <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 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="http://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://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="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 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="http://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="http://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="http://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 class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65917</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389355" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389355</a></span></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/NBK65917.3/?report=reader">PubReader</a></li><li><a href="/books/NBK65917.3/?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. 2016 Nov 2. 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Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65917.28/">NBK65917.28</a></span> October 11, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65917.27/">NBK65917.27</a></span> October 11, 2023</li><li><span class="bk_col_itm"><a 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2018</li><li><span class="bk_col_itm"><a href="/books/NBK65917.6/">NBK65917.6</a></span> November 9, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65917.5/">NBK65917.5</a></span> April 13, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65917.4/">NBK65917.4</a></span> December 16, 2016</li><li><span class="bk_col_itm">NBK65917.3</span> November 2, 2016 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65917.2/">NBK65917.2</a></span> July 8, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65917.1/">NBK65917.1</a></span> May 12, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" 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="#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__162" ref="log$=inpage&link_id=inpage">Recurrent Non-Small Cell Lung Cancer</a></li><li><a href="#CDR0000062956__164" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062956__205" ref="log$=inpage&link_id=inpage">Treatment Options by Stage</a></li><li><a href="#CDR0000062956__231" ref="log$=inpage&link_id=inpage">Treatment Options for 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" 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/NBK65865/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389388" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" 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class="brieflinkpopperctrl" href="/pubmed/26389461" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Small Intestine Cancer Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Small Intestine Cancer Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li 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<a class="text-white" href="https://www.hhs.gov/">HHS</a>
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<li>
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<a class="text-white" href="https://www.usa.gov/">USA.gov</a>
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