There are many options to treat metastatic non-small-cell lung cancer (NSCLC). Your treatment plan will depend on your health, the characteristics of your cancer, and your overall goals. You will work with your doctor and cancer care team to choose options to help you feel as good as possible every day. There is no one-size-fits-all approach.    

Here’s what to keep in mind.

Your Options

There are several different treatments for you and your doctor to choose from:

Surgery. A surgeon removes the tumor and some of the surrounding tissue. Surgery may be possible if the cancer has spread to only one other site like your brain. Sometimes, your doctor will recommend chemotherapy or radiation therapy after your surgery to kill any leftover cancer cells and lower the chances that the cancer will return.

Chemotherapy. This is medicine designed to shrink or kill cancer cells. Usually, you either take pills or  get the medicine directly into your veins.

Targeted therapy. This is a type of medicine that homes in on specific features of cancer cells. For example, tumors need to create new blood vessels to stay nourished. Some targeted therapies block the growth of these new blood vessels. Other targeted therapies pinpoint mutations common to NSCLC cancer cells. This can include changes in specific genes.

Immunotherapy. Cancer cells are good at hiding from your immune system. Immunotherapy boosts your defenses so it can find and fight cancer more effectively. This can be an option if you aren’t a candidate for targeted therapy.

Radiation therapy. This uses high-energy X-rays to kill cancer cells or shrink your tumors. A machine outside your body delivers the radiation. You can get it internally, as well. The radiation goes inside your body in or near the cancer. For people with advanced cancer, radiation can help ease symptoms like bone pain.

You may also want to consider a clinical trial. This is part of the process to discover new treatments. Researchers test new therapies and medicines in people with cancer to see if they are effective and safe.

Talk to your doctor to see if a clinical trial might be right for you.

Making the Right Treatment Decision

Finding the right treatment plan depends on several things:

  • Your overall health
  • How well your lungs work
  • The characteristics of your cancer
  • Where your cancer has spread
  • The number of tumors you have
  • Which treatments you’ve already tried

It can take some time to make a decision. It’s important to weigh each treatment against its risks and possible side effects.  You may want to visit another cancer doctor and get a second opinion. That could help you get more information about your choices.

For metastatic NSCLC, your doctor will usually send your tumor to a lab and have it examined for genetic mutations and biomarkers. If they find either, your first line of treatment will probably be targeted therapy. That could help shrink your tumors and control their growth.  

Your doctor may test your tumor for proteins called PD-1 and PD-L1. If there are high levels of either, it may mean that immunotherapy could work for you.

If neither targeted therapy nor immunotherapy seem right for you, your doctor might recommend that your first line of treatment be chemotherapy, radiation, or both.  

You may also choose not to be treated. In this case, your doctor can help ease your cancer symptoms and improve your quality of life. For example, they can help you manage pain or shortness of breath and make your feel more comfortable.

When it comes to treating metastatic NSCLC, there are many options to fight it. Talk to your doctor and your family about your options and your goals for treatment. That way, you can decide what’s right for you.

WebMD Medical Reference

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