American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the treatment for stage III non-small cell lung cancer?

1. Surgery

2. Chemoradiation

3. Systemic chemotherapy

4. Observation

The correct answer is: Chemoradiation

Stage III non-small cell lung cancer (NSCLC) refers to a locally advanced stage where the cancer has spread to nearby lymph nodes but has not yet metastasized to distant sites. The treatment approach for this stage typically involves a combination of therapies to maximize the chances of eradicating the cancer and improving outcomes for the patient. Chemoradiation, which combines chemotherapy with radiation therapy, is considered the standard treatment for many patients with stage III NSCLC. The chemotherapy helps to sensitize the tumor to radiation, making the cancer cells more susceptible to the damaging effects of the radiation therapy. This approach can decrease the risk of recurrence and potentially improve overall survival rates. Surgery may be considered in select patients with specific types of tumors or in cases where the cancer is resectable, but it is often not the primary treatment for stage III disease due to the involvement of lymph nodes. Systemic chemotherapy is typically not used in isolation when treating this stage, as the multimodal approach of chemoradiation is preferred. Observation is not a viable treatment option for stage III NSCLC because it would not address the disease's progression and could lead to poorer outcomes. Thus, the combination of chemotherapy and radiation therapy is crucial for managing stage III NSCLC