Treatment of metastatic Non small cell lung cancer (NSCLC)

How is metastatic non-small cell lung cancer treated?

Stage 4 NSCLC is also known as metastatic lung cancer, wherein the cancer has spread to other lung or beyond the chest and reached areas like the bones, brain etc. cancer at this stage cannot be cured and the main intention of treatment is to relieve the patient of the symptoms which is also known as palliative treatment. Treatment options for these patients include targeted therapy, chemotherapy and the management of the metastatic site.

Picture of a doctor evaluating a patient's lung cancer screening

Read more on staging of non-small cell lung cancer

  • Targeted therapy

There are special drugs that have been developed to target cancer cells and the changes made by it. This kind of treatment is known as targeted therapy. Targeted therapy depends on the type of mutation in tumor cell e.g. EGFR, ALK, ROS 1, BRAF etc. This assessment can be done by liquid biopsy also and as per the mutation patient receives oral tablet for the same.

  • Chemotherapy

Chemotherapy might be used as a palliative treatment method to relieve the patient’s symptoms. Chemotherapy can be offered only in patients with good performance status.
Drugs used in chemo can be through the bloodstream or the patient can take it orally too. The treatment of chemotherapy is usually conducted through the system of cycles and 4 to 6 cycles is common.

  • Thoracentesis and Pleurodesis

Thoracentesis is done in patients who have a malignant pleural effusion which is fluid collecting around the chest area that makes breathing difficult for the patient. Thoracentesis is the procedure of draining the collected fluid from the chest area.
In Pleurodesis, a sclerosing agent (Talc, Bleomycin) is injected into the pleural cavity for further development of pleural effusion.

  • Other treatment options

For patients with bone metastasis, where the cancer has spread to the bone, the treatment given is radiotherapy, chemotherapy and bisphosphonates. For patients with brain metastasis, where the cancer has spread to the brain, surgery, radiosurgery or radiation are available treatment options.

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