Treatments for stage 1 non–small cell lung cancer

The following are treatment options for stage 1 non−small cell lung cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is a standard treatment for stage 1 non–small cell lung cancer for people who are well enough to have surgery.

A lobectomy removes the lobe of the lung where the tumour is. This is the main type of surgery for stage 1 non–small cell lung cancer. It offers the best chance that the cancer will be completely removed.

A wedge or segmental resection removes the tumour along with a margin of healthy lung tissue around the tumour. This type of surgery may be offered for stage 1 non–small cell lung cancer in people who do not have very good lung function.

A sleeve resection removes a tumour from one of the airway tubes of the lung (the bronchi) along with a margin of healthy tissue around the tumour.

During surgery for non–small cell lung cancer, the lymph nodes in the chest and around the lungs are removed and checked for cancer. If there is cancer in more lymph nodes than was shown with diagnostic tests, the surgery may be stopped because the cancer has spread too far for surgery to be helpful as a treatment.

You may have surgery a second time if the lab report shows that there was cancer in the margins (called positive margins) of the tissue that was removed.

Radiation therapy is offered for stage 1 non–small cell lung cancer if you are not well enough to have surgery or if you choose not to have surgery.

If you have stage 1 non–small cell lung cancer that has been completely removed with surgery, you are not offered radiation therapy after surgery. This is because research has shown that it reduces survival instead of improving it.

Stereotactic body radiotherapy (SBRT) may be offered if the cancer hasn't spread outside of the lung.

Hypofractionated radiation therapy may be offered if you are not able to have SBRT.

3D conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) may be offered if you cannot tolerate the dose of radiation given during SBRT or hypofractionated treatments.

You may have radiation therapy after surgery if cancer is found in the margins of the tissue that was removed and you cannot have surgery again.

Chemotherapy may be offered after surgery if you have stage 1B non–small cell lung cancer and are healthy enough to have chemotherapy. Research has shown it might improve survival in some people with early stage lung cancer. Your healthcare team will discuss the benefits and risks of chemotherapy with you.

The most common chemotherapy drug combination used is cisplatin and vinorelbine. If you aren't able to have cisplatin, carboplatin and paclitaxel may be used.

Atezolizumab (Tecentriq) is a type of PD-L1 checkpoint inhibitor. It may be offered by itself for stage 1 non–small cell lung cancer that has been completely removed with surgery, and has not progressed after chemotherapy.

Talk to your doctor about clinical trials open to people with non−small cell lung cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.