Non-Small-Cell Lung Cancer (cont.)

The 3 major therapies used in NSCLC are surgery, chemotherapy, and radiation therapy. A newer fourth therapy, laser therapy, is becoming more widely used.  

• Surgery: The tumor is removed through an incision in the skin and muscle.



• Chemotherapy: Strong chemicals and drugs are taken internally, either by mouth or through a vein into the bloodstream, to kill tumor cells.



• Radiation therapy: A powerful radiation beam is pointed at the tumor (external beam) or a radiation source is placed within the body next to the tumor (internal beam). The radiation kills the tumor cells.



• Laser therapy: A narrow beam of intense light called a laser is used to kill tumor cells.

Each person with NSCLC should be offered a customized treatment regimen, which should consist of some combination of these therapies depending on disease stage and location.
 
After the staging evaluation, a decision is made whether the tumor is operable. Operable (or resectable) tumors are those that can be removed completely or almost completely by surgery. Generally, only stage I and some stage II and III tumors can be removed by surgery. Sometimes, people with stage III or IV inoperable disease undergo surgery, but this is usually performed to remove enough of the tumor to relieve symptoms such as breathing problems or severe pain. Surgery does not cure people with stage IV or most stage III diseases. For more information see Surgery. 
 
Chemotherapy
 
NSCLC is only moderately sensitive to chemotherapy. Chemotherapy alone does not have the potential to cure people with NSCLC. When the goal is cure, chemotherapy is given in combination with surgery or radiation therapy. Chemotherapy alone is given only to people who cannot undergo surgery or radiation therapy or, in some cases, people whose disease has relapsed after surgery. When given in combination with surgery, the chemotherapy is usually given after surgery (adjuvant chemotherapy). Adjuvant chemotherapy is recommended to treat cancer in stages I-III after surgery has been performed to remove the cancer.

Before beginning treatment, the patient undergoes testing to determine the extent of her disease. In general, chemotherapy is given in cycles. Treatment usually lasts a few days and is then followed by a recovery period of a few weeks. When side effects have subsided and blood cell counts have started to return to normal, the next cycle begins. Usually, chemotherapy is given in regimens of 2 or 4 cycles. After these cycles are over, the patient undergoes repeat CT scans and other tests to see what effect the chemotherapy has had on the tumor.
 
Radiation therapy
 
Radiation therapy may be given in combination with surgery or chemotherapy or alone. Generally, radiation therapy is given alone only for persons who are not candidates for surgery.