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 Non-Small Cell Lung Cancer
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. 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. General information about clinical trials is available from the NCI Web site ².

Treatment of stage 0 may include the following:

• Surgery (wedge resection or segmental resection).
• Photodynamic therapy using an endoscope.
• Electrocautery, cryosurgery, or laser surgery 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 ³. 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. General information about clinical trials is available from the NCI Web site ².

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

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

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 ⁴. 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. General information about clinical trials is available from the NCI Web site ².

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

• Surgery (wedge resection, segmental resection, sleeve resection, lobectomy, or pneumonectomy).
• External radiation therapy (for patients who cannot have surgery or choose not to have surgery).
• Surgery followed by chemotherapy.
• A clinical trial of 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 ⁵. 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. General information about clinical trials is available from the NCI Web site ².

Treatment of stage IIIA non-small cell lung cancer that can be removed with surgery may include the following:

• Surgery followed by chemotherapy.
• A clinical trial of new combinations of treatments.

Treatment of stage IIIA non-small cell lung cancer that cannot be removed with surgery may include the following:

• Surgery followed by chemotherapy.
• Chemotherapy combined with radiation therapy.
• External radiation therapy alone (for patients who cannot be treated with combined therapy).

For more information about supportive care for symptoms including cough, shortness of breath, and chest pain, see the PDQ summary on Cardiopulmonary Syndromes ⁶.

Non-small cell lung cancer of the superior sulcus, often called Pancoast tumor, begins in the upper part of the lung and spreads to nearby tissues such as the ribs and vertebrae. Treatment of Pancoast tumors may include the following:

• Radiation therapy alone.
• Radiation therapy and surgery.
• Surgery alone.
• Chemotherapy combined with radiation therapy and surgery.
• A clinical trial of new combinations of treatments.

Some stage IIIA non-small cell lung tumors that have grown into the chest wall may be completely removed. Treatment of chest wall tumors may include the following:

• Surgery.
• Surgery and radiation therapy.
• Radiation therapy alone.
• Chemotherapy combined with radiation therapy and/or surgery.

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 ⁷. 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. General information about clinical trials is available from the NCI Web site ².

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

• Chemotherapy combined with external radiation therapy.
• External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
• Clinical trials of new combinations of treatments.

For more information about supportive care for symptoms such as cough, shortness of breath, and chest pain, see the following PDQ summaries:

• Cardiopulmonary Syndromes ⁶
• Pain ⁸

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 ⁷. 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. General information about clinical trials is available from the NCI Web site ².

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

• External radiation therapy as palliative therapy, to relieve pain and other symptoms and improve the quality of life.
• Combination chemotherapy.
• Combination chemotherapy and biologic therapy.
• Laser therapy and/or internal radiation therapy using an endoscope.
• A clinical trial of new combinations of treatments.

For more information about supportive care for symptoms including cough, shortness of breath, and chest pain, see the following PDQ summaries:

• Cardiopulmonary Syndromes ⁶
• Pain ⁸

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 ⁹. 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. General information about clinical trials is available from the NCI Web site ².

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 biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.

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.

The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.

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 clinical study.

Treatment using more than one anticancer drug.

A procedure in which tissue is frozen to destroy abnormal cells. This is usually done with a special instrument that contains liquid nitrogen or liquid carbon dioxide. Also called cryoablation and cryosurgical ablation.

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, implant radiation therapy, and radiation brachytherapy.

A surgical procedure that uses the cutting power of a laser beam to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.

Treatment that uses intense, narrow beams of light to cut and destroy tissue, such as cancer tissue. Laser therapy may also be used to reduce lymphedema (swelling caused by a buildup of lymph fluid in tissue) after breast cancer surgery.

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

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

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.

A type of lung cancer that begins in the upper part of a lung and spreads to nearby tissues such as the ribs and vertebrae. Most Pancoast tumors are non-small cell cancers. Also called pulmonary sulcus tumor.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

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.

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 irradiation and radiotherapy.

Surgery 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.

Surgery to remove a lung tumor in a lobe of the lung and a part of the main bronchus (airway). The ends of the bronchus are rejoined and any remaining lobes are reattached to the bronchus. This surgery is done to save part of the lung. Also called sleeve lobectomy.

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.

Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, palliative care, and symptom management.

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.

Treatment.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The vertebral column encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spinal column, and spine.

Surgery 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.