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Early Stage Non-Small Cell Lung Cancer Treatment

Lung cancer is a very serious—and sometimes, scary—topic. It’s the second most common cancer in both males and females with about 228,150 new cases of lung cancer diagnosed each year. According to The Chest Foundation, about 14% of all new cancers in the U.S. annually are lung cancer. 

Lung cancer is divided into two types: small cell lung cancer (SCLC), and non-small cell lung cancer (NSCLC). Symptoms, diagnosis, and prognosis vary depending on which type of lung cancer a person has. Click each link above to learn more about the two types of lung cancers.

What both SCLC and NSCLC have in common is that early detection is vital to the successful treatment and survival of both types of lung cancer. There are treatment options available for early stages of both small cell lung cancer and non-small cell lung cancer. Below, you will learn what constitutes “early stage lung cancer” and the treatment options that are available for NSCLC.

Early Stage Non-Small Cell Lung Cancer Treatment 

Non-small cell lung cancer accounts for about 85% of diagnosed lung cancers. NSCLC is further broken down into subtypes: squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. For more information on these subtypes of NSCLC, click here.

Below are the stages of Non-Small Cell Lung Cancer that are considered “early stages” and treatment options for each. 

Treatment for Stage 0 NSCLC

Stage 0 non-small cell lung cancer is also known as carcinoma in situ—this means that the cancer is found only in cells in which it started and has not spread. This is the earliest stage at which NSCLC can be detected. Since this type of cancer typically presents with no symptoms, it’s often found incidentally, as part of another type of testing. 

Theoretically speaking, Stage 0 NSCLC should be completely treatable since it’s found so early; it is considered noninvasive and incapable of spreading to other areas of the body. However, some people do have or develop secondary cancers, which can makes a full recovery difficult.  

The preferred treatment for this stage of cancer is surgery. There are different types of surgeries performed for Stage 0 NSCLC, including:

  • Lobectomy: Removal of the entire lobe on which the tumor is located (the lungs have 5 lobes; 3 on the right and 2 on the left). This is the preferred surgery for treating this stage of NSCLC.
  • Segmentectomy or wedge resection: Partial removal of the affected lobe.
  • Sleeve resection: During this operation, the areas of the airway directly above and below the tumor are cut and the tumor/affected area is removed. The airway is then sewn back together.
  • Pneumonectomy: Full removal of the lung.

The kind of surgery depends on various factors such as the location of the tumor in relation to vital organs and how well a person is expected to tolerate surgery.  

For people who don’t make good surgery candidates, a specialized type of radiation treatment known as stereotactic body radiotherapy (SBRT) may be used. SBRT is performed by delivering precise doses of radiation to cancer cells in an effort to minimize damage to healthy tissue and cells. 

Treatment for Stage I NSCLC

About 30% of early-stage non-small cell lung cancer is diagnosed in Stage I and Stage II. Stage I NSCLC is the stage at which long-term survival is longest and most likely. This stage of lung cancer is further broken down as follows:

  • Stage IA: The tumor is less than 3 cm
  • Stage IB: The tumor is between 3 cm and 7 cm

When receiving a lung cancer diagnosis, an oncologist might use what’s called the TNM system. TNM stands for “tumor,” “nodes,” and “metastasis.” (Metastasis refers to the spread of cancer.) A Stage I lung cancer might read as follows using this staging system: Stage IA (T1N0M0). This means the tumor is in stage 1, with no nodes or metastasis.

There are a few treatment options available for Stage I non-small cell lung cancer, with surgery again being the preferred treatment. (See above for types of lung cancer surgeries.) In some cases where a patient is not expected to tolerate surgery well, a technique known as video-assisted thoracoscopic surgery (VATS) is performed. This surgery is less invasive than other surgeries typically performed to treat early-stage NSCLC. You can read more about a VATS procedure here.

If surgery is not a viable option, there are other treatments available. These include:

  • SBRT (see above for explanation)
  • Proton beam therapy: A technique which delivers energy in the form of protons (positively charged particles) to the tissue area being affected by cancer.
  • Chemotherapy
  • Radiation therapy

Chemotherapy and radiation therapy aren’t typically used for treating this early stage of lung cancer, but will sometimes be performed if the patient is at high-risk for recurrence. 

Treatment for Stage II NSCLC

Stage II NSCLC is defined as “localized cancer.” This means there is a tumor in the lung that may have spread to lymph nodes, but no further metastasis has been noted.

Like with Stage I NSCLC, Stage II is broken into subtypes. For more information on how Stage II NSCLC is further broken down, click here

Treatment for Stage II NSCLC is similar to Stage I: surgery is the preferred treatment method. Unlike Stage I, however, Stage II is often treated with a combination of therapies that include chemotherapy or radiation after surgery has been performed. The reason is that Stage II tumors are more likely to recur with surgery alone. 

Treatment for Stage IIIA NSCLC

Stage IIIA NSCLC is considered a “locally advanced” cancer. This means has spread to lymph nodes on the same side of the body that the tumor is located but has not spread to any other areas. Approximately 10% of NSCLC is diagnosed at this stage. 

Oncologists typically use the TNM system to further stage type IIIA NSCLC. For more information about the various types of this stage, click here

Because of the amount of variables in this stage of non-small cell lung cancer, treatment options are difficult to pinpoint. Stage IIIA lung cancer has an overall poor survival rate.

Treatment options for Stage IIIA NSCLC include surgery, followed by adjuvant (post-surgical) chemotherapy.  In some studies, chemotherapy performed before surgery (known as preoperative chemotherapy) has been proven to increase survival rates. If a Stage IIIA cancer is considered inoperable, a combination of chemotherapy and radiation is sometimes used. 

For people unable to tolerate chemotherapy and surgery, radiation therapy alone is often a treatment option. 

Dr. Michael Czarnecki: Treatment for Early Stage Non-Small Cell Lung Cancer

Dr. Michael Czarnecki—”The Lung Doc”—is a board-certified pulmonary physician by the American Board of Internal Medicine. He is trained in all areas of pulmonary health, including the diagnosis and treatment of early-stage NSCLC. Whether you suspect you have lung cancer or require treatment, Dr. Mike can help. To book an appointment with Dr. Mike, call 423-710-3864 or request an appointment online.