Surgery is the primary therapy for early to mid-stage non-small cell lung cancer (NSCLC).
According to US and Chinese guidelines, surgery is generally preferred if the clinical stage is stage I and II; some patients with stage III may also be offered surgery after neoadjuvant therapy (appropriate tumor shrinkage and disease downgrading through chemotherapy and radiation therapy).
In other words, surgery is usually considered first if the tumor is judged by the physician to be relatively limited, without extensive lymph node and bloodstream metastases, without invasion of vital blood vessels and organs, and if the patient is physically able to tolerate surgery. Some patients with early-stage disease (usually stages I and IIA) may be “cured” with surgery alone; others (such as stages IIB and IIIA) require other treatments before and after surgery, such as chemotherapy and radiation therapy.
It is important to note that lung cancer is complex and varies from person to person. The most appropriate surgical plan will be chosen by your doctor based on your specific situation. As a patient, you don’t have to “eat up” the professional guidelines written for your doctor, just work with him or her to complete your treatment.
Co-author: Dr. Wang Xing, Peking University Cancer Hospital