Surgery is an option for many people with early stage non-small cell lung cancer (NSCLC). Early stage means cancer hasn’t spread outside of the lungs to other organs.
Yet surgery alone may not be enough to get rid of a tumor completely and keep it away. Radiation, chemotherapy, or other treatments before or after surgery can help ensure that you stay cancer-free for longer.
Surgery for NSCLC aims to remove as much of the cancer as possible. The ultimate goal is to prevent it from returning.
Depending on where your tumor is and how large it is, as well as your overall health, the surgeon can decide on the surgical procedure that is best for you. These procedures include:
- removing the tumor and part of the airway to save as much of the lung as possible (sleeve resection)
- removing part of one of the five lobes (wedge resection or segmentectomy)
- removing the whole lobe that contains the tumor (lobectomy)
- removing an entire lung (pneumonectomy)
The surgeon will also remove an area, called a margin, of healthy tissue around the tumor. Having clear margins means there are no cancer cells in the tissue around your tumor.
Surgery might also be an option if cancer has spread to only one part of your body. For example, if you have a tumor in your brain, your surgeon may be able to remove it through a procedure called a craniotomy.
Although surgery is the best way to improve survival in many people with NSCLC, cancer can come back. Having other treatments before or after your surgery will lower the chance that your cancer will return.
The treatments you get depend on the size of your tumor and how far it has spread.
Radiation uses high-energy X-rays to kill cancer cells. Usually, the type of radiation doctors administer to treat NSCLC, called external beam radiation. is delivered from a machine.
You may get radiation before surgery to shrink the tumor. Your doctor will call this “neoadjuvant” or “induction” therapy. A smaller tumor is easier for your surgeon to remove.
You can also get radiation after surgery to remove any cancer cells that have been left behind. Doctors call this “adjuvant” therapy. Research finds that adjuvant radiation therapy improves the 5-year survival rate and lowers the chance that the cancer will return.
Chemotherapy uses strong medication to destroy cancer cells throughout the body. You can have neoadjuvant chemotherapy before surgery to shrink the tumor or adjuvant chemotherapy afterward to kill any remaining cancer cells.
Getting chemotherapy before or after surgery may lower the risk that your cancer will come back, and improve your prognosis. You may get chemotherapy and radiation together to make these treatments more effective.
Your doctor may also recommend targeted therapy or immunotherapy as postsurgical treatment options.
Any NSCLC treatment can cause side effects. Some side effects are temporary and will eventually go away. Others are permanent.
Palliative care is a type of treatment to manage side effects and improve your quality of life. It can also help you cope with the stress of living with lung cancer.
Here are a few other tips to help you manage NSCLC treatment side effects.
- To prevent nausea and diarrhea, eat smaller meals throughout the day and avoid greasy or fatty foods.
- Drink extra fluids to prevent constipation and dehydration.
- Walk or do other exercises every day to keep up your strength and fight fatigue.
- Take naps or rest breaks whenever you need them.
- Take a warm bath or listen to soft music before bed to relax you and help you fall asleep easier.
- If you’re in pain, ask your doctor which pain relievers are safe for you. You might also try alternative pain relieving techniques such as acupuncture or massage.
NSCLC can come back if some cancer cells remain in your body after surgery. Cancer that returns after treatment is called a recurrence. Between 30 percent and 77 percent of people with NSCLC will have a recurrence.
Having chemotherapy and radiation after surgery can lower the chance that your cancer will come back.
You’ll see your doctor for follow-ups about once every 6 months to check for a recurrence. During these visits, you’ll have exams, blood tests, and imaging tests such as CT scans, PET scans, or MRI. If your cancer does return, your doctor can start you on treatment again.
Treatment for NSCLC usually involves a combination of therapies. Surgery is an option for early stage lung cancer that hasn’t spread to other parts of your body. It offers you the best chance for long-term survival.
Along with surgery, you may need chemotherapy, radiation, target therapy, immunotherapy, or some combination of these treatments to prevent a recurrence.
Your doctor will explain how these treatments could help you and what side effects they can cause. Your doctor can also give you tips to help you manage any treatment side effects you do have.