NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 70

NCCN Guidelines for Patients
: Non-Small Cell Lung Cancer
Version 1.2014
Part 7: Treatment by cancer stage
7.5 Stage IV treatments
You may have stage IV lung cancer based on tests given
before treatment. Or you may have been upstaged to
stage IV after surgery. If you have stage IV cancer, talk
with your treatment team about starting supportive care
early since it has been shown to extend and enhance life.
For M1a disease, the cancer has spread from one lung to
the other, into the pleura, or into the fluid around the lung
or heart. Some of these cancers may be able to be treated
with surgery, radiation therapy, or both. For M1b disease,
the lung cancer has spread to sites beyond the chest area.
Very rarely, lung cancer spreads to only one site beyond
the chest. Examples of such sites are the adrenal gland or
brain. In these cases, it may be possible to treat the lung
tumor and the distant metastasis with surgery, radiation
therapy, or both. However, these treatments aren’t
suggested if there is N2 or N3 disease.
Part 7.5 covers stage IV cancers that can’t be treated with
surgery or radiation therapy. This includes lung cancer
that has spread to more than one site beyond the chest. In
these cases, treatment depends on the histologic subtype
and results of molecular testing as described in Part 5.4 on
page 38.
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