Treatments for stage 2 non–small cell lung cancer
Surgery is a standard treatment for stage 2 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 2 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 tissue around the tumour. This type of surgery may be offered for stage 2 non–small cell lung cancer if your lung function is not very good.
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.
An extended pulmonary resection or a chest wall resection may be done for stage 2 non–small cell lung cancer that has spread to the chest wall or other tissues around the lung.
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 to have surgery again if the lab report shows that cancer is found in the margins (called positive margins) of the tissue that was removed.
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External radiation therapy is offered for stage 2 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 2 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.
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.
Stereotactic body radiotherapy (SBRT) may be offered if the cancer has not spread outside the lung.
Hypofractionated radiation treatments 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.
Chemotherapy may be offered after surgery for stage 2 non–small cell lung cancer if you 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 can't have cisplatin, carboplatin and paclitaxel may be used.
Chemoradiation may be offered as a treatment if you can't have surgery and the tumour is 5 to 7 cm in size or if you have cancer that has spread to the lymph nodes. Your healthcare team will discuss the benefits and risks of chemoradiation with you.
Atezolizumab (Tecentriq) is a type of PD-L1
Clinical trials @(Model.HeadingTag)>
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.
Stephen Lam, MD, FRCPC
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National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer (Version 3.2020) . 2020 .
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