Lung cancer

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Treatments for stage 1 non–small cell lung cancer

The following are treatment options for stage 1 non–small cell lung cancer. Your healthcare team will suggest treatments based on your needs and work with you to create a treatment plan.

Surgery

Surgery is a standard treatment for stage 1 non–small cell lung cancer for people who are well enough to have surgery.

Lobectomy to remove the lobe of the lung is the main type of surgery for stage 1 non–small cell lung cancer. It offers the best chance that the cancer will be completely removed.

Wedge or segmental resection is used to remove the tumour along with a margin of healthy lung tissue. This type of surgery may be offered for stage 1 non–small cell lung cancer in people who do not have very good lung function.

Sleeve resection is used to remove a tumour in the large airway of the lung (bronchus).

During surgery for non–small cell lung cancer, the lymph nodes in the chest and around the lungs are removed. The surgery may be stopped if there is cancer in more lymph nodes than was shown with diagnostic tests. This is done because the cancer has spread too far for surgery to be helpful as a treatment.

Surgery may be done again if the lab reports that there was cancer in the margins (positive margins) of the tissue that was removed.

Radiation therapy

Radiation therapy is offered for stage 1 non–small cell lung cancer in people who are not well enough to have surgery or who choose not to have surgery.

Stereotactic body radiotherapy (SBRT) may be offered to people with lung cancer that hasn’t spread outside of the lung.

Hypofractionated radiation therapy may be offered to people who are not able to have SBRT.

3-D conformal radiation therapy (3-D CRT) or intensity-modulated radiation therapy (IMRT) may be offered to people who cannot tolerate the dose of radiation given during SBRT or hypofractionated treatments.

Radiation therapy may be given after surgery if cancer is found in the margins of the tissue that was removed and surgery can’t be done again. It is not given after surgery for stage 1 non–small cell lung cancer if the entire tumour has been removed and there is no cancer found in the tissue margins. Research has shown that giving radiation therapy lowers survival in this group of people.

Chemotherapy

Chemotherapy may be offered after surgery to people with stage 1 non–small cell lung cancer with a tumour that is 4 cm or larger who are healthy enough to have chemotherapy. Your healthcare team will discuss the benefits and risks of chemotherapy with you.

The most common chemotherapy drug combination used is cisplatin and vinorelbine (Navelbine). If a person cannot be given cisplatin because of poor health, carboplatin (Paraplatin, Paraplatin AQ) may be given instead.

Clinical trials

You may be asked if you want to join a clinical trial for non–small cell lung cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

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