American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the definition of treatment for metastatic NSCLC (stage IV)?

1. Curative

2. Palliative

3. Experimental

4. Preventative

The correct answer is: Palliative

The definition of treatment for metastatic non-small cell lung cancer (NSCLC) at stage IV primarily focuses on palliation. At this advanced stage, the cancer has spread beyond the lungs to other organs, making curative treatment less feasible. The goal of treatment shifts from trying to cure the cancer to alleviating symptoms, managing pain, and improving quality of life. Palliative care involves a comprehensive approach to support the patient, including symptom relief, psychological support, and assistance with decision-making regarding ongoing care. It does not aim to eradicate the disease but rather to provide comfort and maintain the patient’s quality of life for as long as possible. Other options, such as curative treatment, would imply that the intention is to completely eliminate the cancer, which is rarely attainable in stage IV NSCLC. Experimental treatments may offer some hope for patients, but they are not the standard approach for management at this stage. Preventative treatments would not apply here since the cancer is already metastatic. Thus, the emphasis on palliative care is most appropriate for stage IV metastatic NSCLC.