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Treatment for non small cell lung cancer (NSCLC)

Find out about how your doctor decides which treatment you need, the types of treatment you might have, and treatment by stage.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

Your treatment depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • how abnormal the cells look under a microscope (the grade )
  • your general health and level of fitness

Treatment overview

The main treatments are:

  • surgery
  • chemotherapy
  • radiotherapy
  • chemoradiotherapy – chemotherapy with radiotherapy
  • symptom control treatment

Your MDT will discuss your treatment, its benefits and the possible side effects with you.

You have one or more of these treatments. This depends on the stage of your cancer and also how well the treatment works.

Treatment by stage

Stage 1

Stage 1 means your cancer is small and is contained inside the lung. It hasn’t spread to lymph nodes.

Surgery is the main treatment. Your surgeon might remove:

  • part of your lung (a lobectomy)
  • all of the lung (pneumonectomy)

You might have chemotherapy after your operation to lower the chance of your cancer coming back.

If you aren’t fit enough for surgery you might have:

  • radiotherapy
  • radiofrequency ablation

Stage 2

Stage 2 can mean different things. It is divided into stage 2A and 2B.

Stage 2A means that the cancer is between 4cm and 5cm in size but hasn't spread to any lymph nodes.

Stage 2B can mean:

  • the cancer is up to 5cm in size and has spread into nearby lymph nodes or
  • the cancer is between 5cm and 7cm but hasn't spread into any lymph nodes or
  • there is more than one area of cancer in one lobe of the lung or
  • the cancer has spread into structures close to the lung

Surgery is the main treatment. Your surgeon might remove:

  • part of your lung (a lobectomy)
  • all of the lung (pneumonectomy)

After surgery, you might have chemotherapy to lower the chance of your cancer coming back.

Depending on the results of your surgery, you might have radiotherapy after your operation.

If you aren’t fit enough for surgery you might have:

  • radiotherapy
  • chemoradiotherapy – chemotherapy with radiotherapy

Stage 3

Stage 3 means your cancer is in more than one lobe of the lung, or it has spread to lymph nodes or nearby structures in the chest.

You might have surgery if:

  • the surgeon can remove all of the cancer
  • you are well enough

Your surgeon might need to remove part of the lung or the whole lung.   

After surgery, you might have chemotherapy to lower the chance of your cancer coming back. You might also have radiotherapy.

If you can’t have surgery you might have one or more of these treatments:

  • radiotherapy
  • chemotherapy
  • chemoradiotherapy – chemotherapy and radiotherapy together
  • targeted drugs

Stage 4

Stage 4 means your cancer has spread to your other lung or to a distant part of your body such as the liver or bones.

Treatment aims to control the cancer for as long as possible and help with symptoms.

You might have:

  • chemotherapy
  • targeted drugs
  • radiotherapy
  • symptom control treatment, such as treatment to help you breathe more easily

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Last reviewed: 
07 Aug 2017
  • TNM Classification of Malignant Tumours (8th edition)
    International Union Against Cancer   
    John Wiley and Sons, 2016

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2016

  • Lung cancer: diagnosis and management
    National Institute for Health and Care Excellence (NICE), 2011

  • Management of lung cancer
    Scottish Intercollegiate Guideline Network, February 2014

  • The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer
    Peter Goldstraw and others for the Study of Lung Cancer Staging and Prognostic Factors Committee
    Journal of Thoracic Oncology, 2015, vol.11, No.1:39-51

  • Guidelines on the Radical Management of Patients with lung cancer
    British Thoracic Society guidelines
    Thorax, October 2010 Vol 65 Supplement 3 October

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