Getting an Advanced Non-Small Cell Lung Cancer Diagnosis: What You Need to Know

Most lung cancers are found when they’re harder to treat, but breakthrough therapies are prolonging and improving patients’ quality of life.

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If you’ve been diagnosed with advanced lung cancer, you’re probably feeling overwhelmed, scared, and have many questions regarding your condition. Can my lung cancer be treated? Can it be cured? What will my life be like from now on?

“Many patients don’t have a lot of information about lung cancer,” says Jorge Gomez, MD, a lung oncologist at Mount Sinai Hospital in New York City. “Some of them haven’t heard about the newer therapies that can prolong life, can improve quality of life, and have had a significant impact in the treatment of lung cancer.”

What Is Advanced Lung Cancer?

Lung cancer is divided into three different categories: localized lung cancer, locally advanced lung cancer, and advanced or metastatic cancer.

  • Localized lung cancer is when patients have a small tumor and no lymph nodes in the center of the chest.
  • Locally advanced lung cancer is when patients have lymph nodes in the center of the chest.
  • Advanced or metastatic cancer is when the cancer has escaped the lungs.

When doctors use the term “advanced lung cancer” they’re often talking about stage III or stage IV lung cancer. Because lung cancer is often difficult to find in its early stages, most people are diagnosed after the disease has become advanced.

“About half of the patients who are diagnosed with lung cancer are diagnosed with metastatic or advanced disease. The other half are diagnosed with either localized or locally advanced disease,” says Dr. Gomez.

A stage III diagnosis means the cancer might be large, and/or it may have spread to lymph nodes in the middle of the chest, between the left and right lungs. There are two kinds of stage III lung cancers:

  • Stage IIIA means the cancer has spread to lymph nodes on the same side of the chest as the tumor.
  • Stage IIIB means the cancer has spread to lymph nodes above the collarbone or in the opposite side of the chest as the tumor

A stage IV diagnosis means the cancer is at the most advanced stage, and has spread to the other lung or to other parts of the body, such as the brain or bones, or it’s caused fluid to collect around the outside of the lungs.


How Advanced Lung Cancer Is Treated

There are many effective therapies for treating lung cancer. Choosing the right treatment depends on the stage of your cancer and what course of treatment works best for your lifestyle.

Stage IIIA and stage IIIB cancer are treated differently. “They’re both treated with the intent of curing the cancer, but in different ways,” says Dr. Gomez. “Patients with stage IIIA can have surgery, and patients with stage IIIB can have chemotherapy and radiation in an attempt again to cure the cancer, but the majority of those patients will not be cured.”

Stage IV lung cancer is widespread when it is diagnosed. There is no treatment that will cure stage IV lung cancer, but different treatments can reduce symptoms and help people with metastatic lung cancer live longer.

People with stage IV lung cancer can have one or more of the following treatments:

  • Chemotherapy
  • Radiation therapy
  • Targeted therapy. “Targeted therapies are oral therapies that treat very specific types of lung cancer,” says Dr. Gomez. “These drugs go to a specific site in the cancer to turn that cancer cell off; they’re extremely effective. They’re actually more effective than chemotherapy and they cost significantly less side effects than chemotherapy.”
  • Immunotherapy. “Immunotherapies are newer therapies, that aren’t toxic like chemotherapy or don’t attack the cancer directly like chemotherapies. They activate the body’s immune system, so those immune cells can then attack the cancer cells and kill them,” says Dr. Gomez.
  • Surgery to remove a cancer growth that is outside of the lungs.
  • Palliative care, or treatment for symptoms caused by the cancer.

“Treatment that is being given [at stage IV] has the goal of prolonging the [patient’s] survival, meaning allowing the patient to live longer than they would if they did not have any therapy at all,” says Kevin Sullivan, MD, a lung oncologist at Monter Cancer Center, Northwell Health in New Hyde Park, New York.

“It also has the goal of palliation of their symptoms. They may be having symptoms related to their disease, and by palliating those symptoms or easing those symptoms, that can improve their quality of life,” says Dr. Sullivan.