Occult Non-Small Cell Lung Cancer
Stage 0 (Carcinoma in Situ)
Stage I Non-Small Cell Lung Cancer
Stage II Non-Small Cell Lung Cancer
Stage IIIA and Stage IIIB Non-Small Cell Lung Cancer
Stage IV Non-Small Cell Lung Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of occult non-small cell lung cancer depends on where the cancer has spread. It can usually be cured by surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with occult non-small cell lung cancer ¹.

Treatment of stage 0 may include the following:

• Surgery (wedge resection or segmental resection).
• Photodynamic therapy using an endoscope.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 non-small cell lung cancer ².

Treatment of stage I non-small cell lung cancer may include the following:

• Surgery (wedge resection, segmental resection, or lobectomy).
• External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
• Surgery followed by chemotherapy.
• A clinical trial of photodynamic therapy using an endoscope.
• A clinical trial of surgery followed by chemoprevention.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I non-small cell lung cancer ³.

Treatment of stage II non-small cell lung cancer may include the following:

• Surgery (wedge resection, segmental resection, lobectomy, or pneumonectomy).
• External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
• Surgery followed by chemotherapy, with or without other treatments.
• A clinical trial of external radiation therapy following surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II non-small cell lung cancer ⁴.

Treatment of stage IIIA non-small cell lung cancer may include the following:

• Surgery with or without radiation therapy.
• External radiation therapy alone.
• Chemotherapy combined with other treatments.
• A clinical trial of new ways of giving radiation therapy and chemotherapy.
• A clinical trial of new combinations of treatments.

Treatment of stage IIIB non-small cell lung cancer may include the following:

• External radiation therapy alone.
• Chemotherapy combined with external radiation therapy.
• Chemotherapy combined with external radiation therapy, followed by surgery.
• Chemotherapy alone.
• A clinical trial of new ways of giving radiation therapy.
• A clinical trial of new combinations of treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III non-small cell lung cancer ⁵.

Treatment of stage IV non-small cell lung cancer may include the following:

• Watchful waiting.
• External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
• Chemotherapy.
• Laser therapy and/or internal radiation therapy.
• A clinical trial of chemotherapy with or without biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV non-small cell lung cancer ⁶.

Glossary Terms

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called immunotherapy, biotherapy, biological response modifier therapy, and BRM therapy.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

To heal or restore health; a treatment to restore health.

A thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may have a tool to remove tissue.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, radiation brachytherapy, and implant radiation therapy.

The use of an intensely powerful beam of light to kill cancer cells.

Surgery to remove a whole lobe (section) of an organ (such as the lungs, liver, brain, or thyroid gland).

Cancer cells are found in sputum (mucus coughed up from the lungs), but no tumor can be found in the lung by imaging or bronchoscopy, or the primary tumor is too small to be assessed.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

Treatment with drugs that become active when exposed to light. These activated drugs may kill cancer cells.

Surgery to remove all of one lung. In a partial pneumonectomy, one or more lobes of a lung are removed.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

A surgical procedure to remove part of an organ or gland. It may also be used to remove a tumor and normal tissue around it. In lung cancer surgery, segmental resection refers to removing a section of a lobe of the lung. Also called segmentectomy.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Abnormal cells are found in the innermost lining of the lung. These abnormal cells may become cancer and spread into nearby normal tissue.

Stage I is divided into stages IA and IB. In stage IA, the tumor is in the lung only and is 3 centimeters or smaller. In stage IB, one or more of the following is true: (1) the tumor is larger than 3 centimeters; (2) cancer has spread to the main bronchus of the lung, and is at least 2 centimeters from the carina (where the trachea joins the bronchi); (3) cancer has spread to the innermost layer of the membrane that covers the lungs; and/or (4) the tumor partly blocks the bronchus or bronchioles and part of the lung has collapsed or developed pneumonitis (inflammation of the lung).

Stage II is divided into stages IIA and IIB. In stage IIA, the tumor is 3 centimeters or smaller and cancer has spread to nearby lymph nodes on the same side of the chest as the tumor. In stage IIB, cancer has spread to nearby lymph nodes on the same side of the chest as the tumor and one or more of the following is true: (1) the tumor is larger than 3 centimeters; (2) cancer has spread to the main bronchus of the lung and is 2 centimeters or more from the carina (where the trachea joins the bronchi); (3) cancer has spread to the innermost layer of the membrane that covers the lungs; and/or (4) the tumor partly blocks the bronchus or bronchioles and part of the lung has collapsed or developed pneumonitis (inflammation of the lung). OR in stage IIB, cancer has NOT spread to lymph nodes and one or more of the following is true: (1) the tumor may be any size and cancer has spread to the chest wall, or the diaphragm, or the pleura between the lungs, or membranes surrounding the heart; (2) cancer has spread to the main bronchus of the lung and is no more than 2 centimeters from the carina (where the trachea meets the bronchi), but has not spread to the trachea; and/or (3) cancer blocks the bronchus or bronchioles and the whole lung has collapsed or developed pneumonitis (inflammation of the lung).

Stage III is divided into stages IIIA and IIIB. In stage IIIA, cancer has spread to lymph nodes on the same side of the chest as the tumor; the tumor may be any size and cancer may have spread to the main bronchus, the chest wall, the diaphragm, the pleura around the lungs, or the membrane around the heart, but cancer has not spread to the trachea; and part or all of the lung may have collapsed or developed pneumonitis (inflammation of the lung). In stage IIIB, the tumor may be any size and has spread to lymph nodes above the collarbone or in the opposite side of the chest from the tumor; AND/OR to any of the following places: the heart, major blood vessels that lead to or from the heart, the chest wall, the diaphragm, the trachea, the esophagus, the sternum (chest bone) or backbone, to more than one place in the same lobe of the lung, and/or into the fluid of the pleural cavity surrounding the lung.

Cancer that may have spread to lymph nodes and has spread to another lobe of the lungs or to other parts of the body, such as the brain, liver, adrenal glands, kidneys, or bone.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.

A surgical procedure to remove a triangle-shaped slice of tissue. It may be used to remove a tumor and a small amount of normal tissue around it.