Non-small cell lung cancer (NSCLC) consists of about 85 percent of lung cancer cases. There are three subtypes of NSCLC — squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. The stages of NSCLC are based on the location of the cancer and whether it has spread from the lungs to the lymph nodes or other organs of the body. The main stages are stage 0, stage I, stage II, stage IIIA and IIIB, and stage IV.

Different stages of NSCLC 

• In stage I, the cancer is located in the lungs and has not spread to any lymph nodes.
• In stage II, cancer spreads to the nearby lymph nodes while still being present in the lungs.
• There are two subtypes of stage III, A and B. In stage IIIA, cancer has spread only to the lymph node that is on the same side of the lung where the cancer was diagnosed. Whereas, in stage IIIB, cancer has spread to the lymph nodes of the opposite lung or even above the collarbone.
• Stage IV is the most advanced stage, where cancer has metastasized and spread to other parts of the body.

Treatment of NSCLC in stage 0 and stage I

• In stage 0, usually, NSCLC is limited only to the lining of the airways and has not attacked the lung tissues or other areas yet. Hence, it can be managed by surgery alone. A patient does not need advanced treatments like chemotherapy or radiation at this stage.
• Similarly, in stage I NSCLC, surgery may be the only treatment needed. The surgery may be conducted by taking out only that part of the lung that contains the tumor or by taking out small pieces of the lung. Also, some lymph nodes could be removed to check if there are any cancer cells present in them.

Common ways to treat stage II, stage IIIA, and IIIB of NSCLC

• People who have NSCLC stage II and are fit for surgery have their cancer cells removed by sleeve resection or lobectomy. Sometimes, removal of the whole lung may be required. Also, there is a high chance that cancer cells could be present in the lymph nodes as well, and doctors may have to remove these too. In some cases, chemotherapy and even radiation may be recommended before surgery to shrink the tumor and make the operation easy.
• Similarly, in stages IIIA and IIIB, usually, a combination of chemotherapy, radiation, and surgery is used for treating cancer. Hence, treatment for these stages requires input from a medical oncologist, a thoracic surgeon, and a radiation oncologist.

Management options for metastatic NSCLC

• Metastatic NSCLC treatment is different from any previous stage as cancer has now become widespread. As the cancer cells have extended to different parts of the body, it is extremely hard to cure. Metastatic NSCLC treatment depends upon factors like where the cancer has spread, the overall health of the patient, and the number of tumors.
• If the person diagnosed is in good health, surgery, targeted therapy, chemotherapy, radiation therapy, and immunotherapy are the preferred treatment options for metastatic NSCLC. These treatments help one cope with their symptoms and live longer.
• Other metastatic NSCLC treatments for relieving symptoms are laser therapy or photodynamic therapy (PDT).

Side effects of NSCLC treatments
The reaction of one’s body to any stage of NSCLC treatment, including metastatic NSCLC treatments, depends upon various factors like the dosage prescribed, a person’s medical history, and the length of the treatment. Usually, the side effects are short-term, but some can last after the treatment is completed as well. The side effects are uncomfortable and painful, but doctors have now come up with new ways to reduce and prevent these side effects. Below are the possible side effects of NSCLC treatments.

• Memory and concentration problems
• Bone issues
• Blood clots
• Hair loss
• Lymphedema
• Pain
• Neuropathy
• Diarrhea
• Vomiting and nausea