The first 60 days: Lung cancer (all types)
Lung cancer splits into non-small-cell (about 85 percent) and small-cell (about 15 percent) disease, which behave and are treated very differently. The subtype pages carry the detail; this page covers screening, staging and what the types share. Below, week by week, is what OnCo's record of Lung cancer (all types) says about the first two months: the order is typical, the timing is yours to ask about. Sections appear only where the record has something to say. Orientation, not medical advice.
What happens now
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
CT, PET-CT, bronchoscopy or CT-guided biopsy, endobronchial ultrasound of nodes, brain MRI; molecular testing on every non-squamous non-small-cell tumour.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
- PathologistNamed in the standard of care for: Diagnosis and staging.
- RadiologistNamed in the standard of care for: Screening, Diagnosis and staging.
- SurgeonNamed in the standard of care for: Treatment.
- Medical oncologistNamed in the standard of care for: Treatment.
- Clinical oncologist (radiotherapy)Named in the standard of care for: Treatment.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Annual low-dose CT for people aged about 50 to 80 with a heavy smoking history (NLST, NELSON).
By type and stage on the subtype pages: surgery or stereotactic radiotherapy for early disease, chemoradiation with immunotherapy for locally advanced, targeted or immune therapy for metastatic disease.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example EGFR, ALK, ROS1, KRAS G12C, BRAF V600E, MET exon 14, RET, NTRK, HER2 mutations, PD-L1 expression, Stage by TNM and PET-CT, Circulating tumour DNA for minimal residual disease), and what were the results?These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Recognised subtypes for this cancer include Non-small-cell lung cancer, Small-cell lung cancer, Carcinoid and other neuroendocrine tumours of the lung.
- Is germline (inherited) genetic testing recommended for me or my family?Inherited variants can change treatment and matter for relatives.
Screening
- For my situation (screening), which of the standard options do you recommend and why?Guideline options include: Annual low-dose CT for people aged about 50 to 80 with a heavy smoking history (NLST, NELSON).
- How do the results of NLST & NELSON (low-dose CT screening) apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Diagnosis and staging
- For my situation (diagnosis and staging), which of the standard options do you recommend and why?Guideline options include: CT, PET-CT, bronchoscopy or CT-guided biopsy, endobronchial ultrasound of nodes, brain MRI; molecular testing on every non-squamous non-small-cell tumour.
Treatment
- For my situation (treatment), which of the standard options do you recommend and why?Guideline options include: By type and stage on the subtype pages: surgery or stereotactic radiotherapy for early disease, chemoradiation with immunotherapy for locally advanced, targeted or immune therapy for metastatic disease.
Any stage
- Are there clinical trials I could join, for example of Tarlatamab, Datopotamab deruxtecan?Trials are how the next standard of care is set; asking early keeps options open.
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Supportive care improves quality of life and helps patients complete treatment.
- I read that “Most patients still present with advanced disease”. How does that affect my plan?Open problems are where trials and second opinions matter most.
- I read that “Resistance to every targeted drug emerges within one to three years”. How does that affect my plan?Open problems are where trials and second opinions matter most.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
- Lung cancer (all types): the full pageLung cancer splits into non-small-cell (about 85 percent) and small-cell (about 15 percent) disease, which behave and are treated very differently. The subtype pages carry the detail; this page covers screening, staging and what the types share.
- One-page appointment sheetYour questions, the words you may hear, what to bring, and space for the answers. Print it.
- Treatment sequencingWhich treatment tends to follow which, line by line.
- NavigatorStandard of care for your stage, what you have tried, and trials near you.