What are the factors that will help determine my treatment plan for advanced non-small cell lung cancer?
Answers from Timothy J. Moynihan, M.D.
Treatment for advanced non-small cell lung cancer isn't one-size-fits-all. To create a treatment plan that addresses your unique needs, your doctor will consider:
- Test results. Results from any tests you've had, such as imaging or lab tests, will help guide your doctor's recommendations. For example, cancer that has spread to your brain doesn't usually respond well to chemotherapy. In these cases, radiation therapy and surgery are often more effective.
- Your treatment history. If you've already had treatment, your doctor will look at what worked and what didn't. If you had chemotherapy and your cancer slowed or stopped for a period of time, you might be a good candidate for more chemotherapy.
- Abnormalities in your cancer cells. If testing determines you have certain abnormalities in your cancer cells, your doctor might recommend using targeted therapy drugs. These medications target the specific ways that cancer cells grow.
- Your age and overall health. These factors might affect your treatment plan, though healthy older people tend to have the same response to chemotherapy treatment as do younger people. If you have a health problem, such as nerve damage from diabetes (diabetic neuropathy), you might need to avoid certain medications that can worsen the damage. Having multiple other medical conditions might restrict your treatment options.
- Your ability to do daily activities without help (performance status). Your doctor might consider your ability to get dressed, eat, clean your home and work when determining your treatment plan. Some treatments might be more harmful than helpful, for example, if you are bed- or chairbound.
- Your eligibility for a clinical trial. Your doctor might suggest enrolling in a clinical trial. Discuss the pros, such as the opportunity to try a potentially effective treatment, and the cons, such as travel required to participate in the trial.
Your doctor will also take into account your personal preferences and goals when determining your treatment plan. Talk to him or her about what's most important to you, what you hope the treatments will achieve and what side effects you are willing to face in return for the benefits.
March 01, 2017
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- NCCN guidelines for patients. National Comprehensive Cancer Network. https://www.nccn.org/patients/guidelines/lung-nsclc/index.html#6. Accessed Feb. 1, 2017.
- Lilenbaum RC. Advanced non-small cell lung cancer: Subsequent systemic therapies for previously treated patients. http://www.uptodate.com/home. Accessed Feb. 1, 2017.
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- NCCN quick guide for non-small cell lung cancer — Treatment planning. National Comprehensive Cancer Network. https://www.nccn.org/patients/guidelines/quick_guides/lung-nsclc/treatment_planning/index.html. Accessed Feb. 1, 2017.
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