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Stage 4 NSCLC Action Plan

Resource

Cancer Care

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Making a plan for what’s next can help you be confident about your journey with lung cancer.

No one can predict the course that cancer will take. That’s why it’s important to learn as much as you can now, so you can be prepared for what may come next in your treatment journey.

As you move forward during this time, it is important to understand that there are steps you can take to get started.

Step 1: Learn about the type and stage of your lung cancer

The first thing to do after receiving a diagnosis is to find out what kind of lung cancer you have. Your doctor can tell you the type and stage of cancer you have during your initial diagnosis. After that, it’s important to get a full diagnosis, which includes working with different doctors, having different types of tests done, and testing for biomarkers if you have Stage 4 lung cancer. A full diagnosis can help determine a complete picture of your specific cancer, which allows you and your doctor to choose the right treatment plan for you.

Step 2: Test for biomarkers in Stage 4 lung cancer

Testing for biomarkers in Stage 4 of lung cancer diagnosis can be very helpful in understanding more about the type of cancer treatments that may work best for you. Biomarker tests are usually given to people with Stage 4 lung cancer, and they may have a big impact on your treatment decisions. So, if you have Stage 4 lung cancer, it's important to ask your doctor about biomarker testing. Some common biomarkers your tumors may be tested for are PD-L1, EGFR, KRAS, BRAF, ALK, MET, RET, NTRK and ROS1. The National Comprehensive Cancer Network® (NCCN®) is an alliance of 30 leading cancer centers devoted to patient care, research, and education. NCCN recommends (Category 1) that eligible patients with metastatic non-squamous NSCLC get tested for PD-L1, EGFR, and ALK biomarkers before starting their first treatment, if clinically possible.*†

Step 3: Follow up after your test

After biomarker testing, it’s important to follow up with your doctor. It may take over 2 weeks to get the results of all your tests. The results of biomarker testing can help identify the treatment options to match your specific needs. If you test positive for an EGFR mutation and have Stage 4 lung cancer, 

there is a treatment that may be right for you

. Write down any questions you may have for your healthcare team regarding testing and your treatment options.

Step 4: Set up treatment goals

Write down any questions, expectations, or aspirations to share with your healthcare team. Together, you and your team can set a realistic goal of what you’d like to achieve through treatment. This can help you and your team understand your options and select the appropriate treatment plan for you.

Step 5: Do your best to stick to your treatment plan

Once you have received all your test results, and you and your doctor have chosen the right treatment for you, make sure to follow your doctor’s instructions and ask any questions you may have about side effects and next steps. If you begin to experience any concerning side effects, it’s important to talk to your healthcare team as soon as possible. Listening to your body and being aware of side effects can make you feel more confident about your treatment.

Step 6: Fit your treatment goals into your life goals

A lung cancer diagnosis may impact different aspects of your life. Telling your family and friends about your diagnosis can be difficult, but it may give you a sense of relief to share the news. You should also consider how your finances may be affected and if you’re going to continue to work.

Don’t Be Afraid to Ask Questions

If you have questions or concerns about your treatment, talk to your doctors, nurses, and healthcare team. Partnering closely with your healthcare team can help you understand your treatment plan and feel more comfortable opening up about what’s on your mind. If you need help from friends or family—for instance, if you’d like them to go with you to doctor appointments—let them know. Keeping in mind what’s important to you is a good way to make sure your treatment goals are being met.

Listen to Your Body

It’s also important to pay attention to your body and how you are feeling. Tell your doctor right away about any changes you notice in your health. And be on the lookout for possible symptoms of cancer progression, which may include:

  • Chest pain
  • Headache
  • Difficulty breathing
  • Continuous coughing, including coughing up blood
  • Difficulty or pain in swallowing
  • Swelling of the neck and face
  • Hoarseness
  • High-pitched wheezing when taking a breath

The approach you and your doctor have decided on may have to change depending on your cancer and how it is responding to treatment. That’s why it is important to work closely with your doctor to know what your next steps will be if your cancer changes. That way, you will have a plan in place and be ready to make decisions when needed.

*Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.8.2020. ©National Comprehensive Cancer Network, Inc. 2020. All rights reserved. Accessed May 26, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org.

†The NCCN Guidelines® for NSCLC provide recommendations for individual biomarkers that should be tested and recommend testing techniques but do not endorse any specific commercially available biomarker assays.

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

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