Early stage (stage one) lung cancer is a curable disease. The standard treatment for early stage lung cancer is surgery. However, lung cancer surgery is a very invasive procedure and often carries a significant risk of serious complications, including long-term pain, chronic oxygen use and even death. Lung cancer surgery is particularly problematic for the elderly and for those with multiple medical problems such as emphysema and heart disease.
Stereotactic body radiosurgery, an alternative to lung cancer surgery, has yielded very high cure rates. It offers elderly patients, patients with severe lung and heart disease, and others with poor health a viable alternative to lung cancer surgery. Stereotactic body radiosurgery is also used to treat metastasis, which is cancer that has spread from one site to another, such as to the lung and liver.
Conventional radiation treatments (fractionated radiotherapy) have shown much less success than stereotactic body radiosurgery and are known to be more harmful to surrounding lung tissue. The problem with standard external beam radiotherapy is that too much normal lung is exposed to high doses of radiation. Exposing large amounts of lung to radiation places patients at risk for radiation lung damage.
Stereotactic body radiosurgery treats the cancer with multiple beams of radiation, all directed very precisely at the cancer. The precision delivery reduces the amount of radiation to the surrounding tissue, and it allows the cancer to be treated with a very high dose of radiation, thereby reducing the number of treatments needed. With stereotactic body radiosurgery, patients are treated in a matter of days, as opposed to the eight weeks of therapy required with conventional fractionated radiotherapy. Moreover, the results of stereotactic body radiosurgery have been similar to surgical resection
Chemotherapy for the treatment of stage one non-small cell lung cancer is controversial. Until recently, chemotherapy has had no role in the treatment of stage one non-small cell lung cancer. Some studies have demonstrated a possible small benefit in overall survival for patients who receive the treatment. However, it is not completely clear if the toxicity from the chemotherapy treatment justifies the small possible benefit.