Book a Consultation
Hearing "non-small cell lung cancer" can leave you with a stack of new questions. Non-small cell lung cancer (NSCLC) is the most common type, accounting for around 80 to 85 percent of cases. At Advanced Cancer Treatment Centers (ACTC), our medical oncology program and radiation team coordinate care close to home.
When the pathology report comes back, you will usually see one of three NSCLC subtypes. The subtype tells your team where the cancer started in the lung. That helps shape which drugs and biomarker tests are most relevant.
•Adenocarcinoma: The most common subtype. It often forms in the outer parts of the lung and is the type most likely to carry a targetable mutation.
•Squamous cell carcinoma: Tends to start in the central airways and is more closely tied to a smoking history.
•Large cell carcinoma: Less common, and it can grow in any part of the lung.
NSCLC behaves differently from small cell lung cancer . Small cell tends to grow and spread faster and follows a different treatment path.
Stage answers a practical question: how far has the cancer traveled, and what does that change about treatment? Your team uses imaging and biopsy findings to assign a stage. That stage points to a treatment pathway, not a single fixed answer.
•Stage I: A small tumor still limited to the lung, with no lymph node involvement. Surgery is the usual first choice when you are healthy enough for it. When surgery is not safe, stereotactic body radiation therapy (SBRT) is a strong alternative.
•Stage II: A larger tumor or limited spread to nearby lymph nodes. Surgery is still common, often followed by chemotherapy or immunotherapy to lower the chance the cancer returns.
•Stage III: Locally advanced disease, often involving lymph nodes in the middle of the chest. Most patients receive a combination of chemotherapy and radiation, sometimes followed by immunotherapy.
•Stage IV: The cancer has reached distant sites. Treatment focuses on systemic therapy, and the choice of drugs depends heavily on biomarker results.
Staging is a team decision, not a number you have to figure out alone. We will walk you through what your stage means before we ask you to make any treatment choices. If staging shifts after surgery or new imaging, your plan can shift with it.
.If your cancer is locally advanced or metastatic, biomarker testing is one of the most important steps before treatment starts. Biomarkers are signals in the cancer cells that can shape how it grows and which drugs may work. Finding them changes which treatments are most likely to help and which ones to skip.
Biomarker testing examines tumor tissue, or sometimes a blood sample, for gene changes and other markers that can influence treatment choices. In NSCLC, that may include EGFR and KRAS G12C mutations, ALK, ROS1, RET, or NTRK fusions, BRAF V600E, MET exon 14 skipping, and HER2 alterations. Different results can point to different drug options.
Your team also tests PD-L1, an immune checkpoint protein on cancer cells. The PD-L1 result helps decide whether immunotherapy is a good fit.
Your team will arrange biomarker testing through a certified laboratory when it is part of your plan. Result timing varies by test, and we will explain what to expect and whether treatment can begin while you are waiting.
If a treatment stops working later, repeat biomarker testing is common. Resistance can change the molecular picture. A new test can point to a next-line targeted therapy you would not have qualified for before.
We will explain each result in plain language and what it means for your next decision.
Most NSCLC plans use more than one treatment, and the order matters. Here is how each piece tends to fit, and which parts ACTC delivers directly versus coordinates with outside specialists. The right combination for you depends on your stage, your biomarker results, and your overall health.
Surgery is the foundation for early-stage NSCLC when you are healthy enough for it. A thoracic surgeon performs the operation at a hospital, not at our center. Common procedures include lobectomy (removing one lobe of the lung), segmentectomy, and wedge resection.
We coordinate with your surgeon and handle radiation or systemic therapy before or after the operation as your plan calls for.
For early-stage NSCLC where surgery is not the right choice, SBRT is often the answer. Stereotactic body radiation therapy (SBRT) delivers a short course of focused, high-dose radiation, usually in three to five sessions over a week or two.
For locally advanced disease, intensity-modulated radiation therapy (IMRT) or image-guided radiation therapy (IGRT) is paired with chemotherapy.
Lung treatment has one tricky problem: your tumor moves every time you breathe. We plan treatment with a four-dimensional computed tomography (4D CT) scan that captures that motion. Radiation is then delivered on a Varian VitalBeam linear accelerator with respiratory gating, part of our radiation oncology program.
Platinum-based chemotherapy doublets remain a backbone of NSCLC treatment. We give chemotherapy as intravenous (IV) infusions in our infusion room.
The timing depends on your stage. Chemotherapy may run before surgery (neoadjuvant) or after surgery (adjuvant). It may also run at the same time as radiation when disease is locally advanced.
For metastatic disease, chemotherapy is sometimes paired with another drug class.
If biomarker testing finds a driver mutation, targeted therapy often becomes the first treatment to try. Drug classes include EGFR inhibitors, ALK and ROS1 inhibitors, KRAS G12C inhibitors, and others matched to BRAF, MET, RET, HER2, or NTRK changes.
Many of these drugs are oral pills you take at home. If your plan includes an oral targeted therapy, our team will help coordinate the next steps for getting the medication.
Immunotherapy has changed the outlook for many NSCLC patients. Checkpoint inhibitors help your immune system recognize and attack cancer cells. They work by blocking immune checkpoint proteins like PD-1, PD-L1, and CTLA-4.
We give these drugs as intravenous (IV) infusions every two to six weeks. They may be used alone, paired with chemotherapy, or given after chemoradiation, depending on your PD-L1 result and stage. Planned courses often run up to about two years.
Side effects depend on which treatments you receive, and they rarely all come at once. Knowing what to watch for makes it easier to call us early instead of waiting it out.
•Chest radiation: Fatigue is the most common effect. You may also notice skin irritation in the treated area and a sore throat or painful swallowing (esophagitis) toward the end of treatment. Practical tips on eating well during treatment and skin care during radiation cover most of what helps.
•Chemotherapy: Common effects include fatigue, low blood counts, nausea, and numbness or tingling in the hands and feet (neuropathy). We monitor blood work between cycles and adjust as needed.
•Targeted therapy: Side effects vary by class. EGFR inhibitors often cause an acne-like rash and diarrhea. ALK and ROS1 inhibitors can cause muscle aches, joint stiffness, vision changes, or fatigue.
•Immunotherapy: Most people tolerate it well, but the immune system can occasionally attack healthy organs. These immune-related adverse events can affect the lungs, thyroid, liver, skin, or bowels. Report new symptoms early so we can step in before they get worse.
Reach out to us early if something feels wrong, even between visits. Call us promptly for fever or chills, new or worsening shortness of breath, severe or persistent diarrhea or vomiting, painful or spreading rash, or dizziness. Our radiation oncologist handles radiation side effects, while our medical oncologists handle side effects from drug-based treatments.
For severe symptoms such as chest pain, sudden trouble breathing, fainting, or any emergency, call 911 or go to the nearest emergency room first, then notify our team.
Catching NSCLC early changes what treatment looks like. The U.S. Preventive Services Task Force recommends annual low-dose computed tomography (LDCT) screening for adults aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years.
LDCT screening is ordered through your primary care doctor, not through an oncology center like ACTC. Cancers found through screening are often small enough to be treated with stereotactic body radiation therapy (SBRT) or surgery alone.
Your care at ACTC is delivered by a coordinated team that handles medical oncology, radiation oncology, symptom support, and follow-up close to home.
•Radiation oncology: A board-certified radiation oncologist plans and delivers SBRT and other radiation treatments.
•Medical and hematology oncology: Medical oncologists manage chemotherapy, targeted therapy, and immunotherapy through our medical oncology program.
•Day-to-day support: Nurse practitioners and clinical nursing staff are part of the care team between physician visits.
ACTC is located at 15211 Cortez Boulevard in Brooksville, just east of the Suncoast Parkway. We see patients from Spring Hill, Weeki Wachee, Ridge Manor, Masaryktown, and Timber Pines, along with neighbors in Pasco, Citrus, and Sumter counties.
For many patients, radiation, infusions, and follow-up labs can happen at ACTC in Brooksville. Call 352-345-4565 with questions about getting started.
The cancer specialists at ACTC in Florida offer outstanding patient care by prescribing personalized and evidence-based treatment plans tailored to individual patients' needs.
We provide a supportive environment focused on the physical and emotional well-being of patients throughout their cancer journey.
Our expert providers at ACTC include:
Dr. Aaron Denson – MD, Hematology & Oncology
Dr. D. Alan Kerr II – MD, Ph.D., Hematology/Medical Oncology
Dr. Peter Zavitsanos – MD, Radiation Oncologist
A new lung cancer diagnosis brings many decisions at once, and you do not have to sort through them alone. Bring your imaging, pathology report, and any questions you have, and we will map out a plan that fits your stage and your life. Call 352-345-4565 or book a consultation to get started.
Schedule a consultation by calling
352-345-4565
It depends on the cell type your biopsy shows. NSCLC tends to grow more slowly and includes three subtypes: adenocarcinoma, squamous cell, and large cell carcinoma. NSCLC makes up about 80 to 85 percent of lung cancers and uses a different mix of treatments.
Yes, for most patients with advanced or metastatic NSCLC. Biomarker results help your team decide if drug treatment should start with targeted therapy or immunotherapy. Your team will arrange testing through a certified laboratory, and timing varies by test.
Early-stage disease often does not require the same broad panel.
It varies in how the dose is delivered. SBRT gives high-dose radiation in three to five precise sessions, while traditional radiation runs over six or seven weeks of daily treatments. The focused approach means nearby healthy tissue receives much less exposure.
At ACTC we plan SBRT with four-dimensional computed tomography (4D CT) imaging and deliver it on a Varian VitalBeam linear accelerator with respiratory gating.
Yes. SBRT is designed for early-stage NSCLC patients who cannot have surgery because of lung function, heart issues, or other health concerns.
For carefully selected patients, outcomes with SBRT are similar to surgical outcomes. We coordinate with your pulmonologist to confirm SBRT is the right path.
It varies by stage and treatment type. SBRT for early-stage disease may finish in one to two weeks, while chemotherapy runs in cycles over several months. Immunotherapy is often planned for up to about two years, and targeted therapy is taken as long as it keeps working.
It depends on what is driving the resistance. We typically order repeat biomarker testing, sometimes from a fresh biopsy, sometimes from a blood-based test. The result may point to a next-generation drug in the same family or to a different approach.
Not directly. Annual LDCT screening is ordered through primary care for adults who meet the criteria. Once a nodule or cancer is found, that is when an oncology team like ours steps in for diagnosis confirmation, staging, and treatment planning
Schedule a consultation by calling
352-345-4565
Subscribe to our newsletter
Social Links
15211 Cortez Boulevard, Brooksville, Florida 34613