American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary treatment approach for stage I or II non-small cell lung cancer (NSCLC)?

1. Chemotherapy

2. Radiation therapy

3. Surgery with curative intent

4. Targeted therapy

The correct answer is: Surgery with curative intent

The primary treatment approach for stage I or II non-small cell lung cancer (NSCLC) is surgery with curative intent. In the early stages of NSCLC, surgical resection of the tumor is the most effective method to achieve long-term survival and potentially cure the disease. The rationale behind this approach is that, at these stages, the cancer is typically localized and has not spread extensively beyond the lung, making it amenable to complete surgical removal. When performed properly, surgery can eradicate the cancerous cells and reduce the risk of recurrence, especially when combined with adjuvant therapies, such as chemotherapy or radiation, in select cases. The goal is to ensure that all cancerous tissue is excised, thus maximizing the chances of a favorable outcome for the patient. While other treatments, such as chemotherapy, radiation therapy, or targeted therapy, may play roles in the management of lung cancer, they are generally not the first-line approach for stage I or II NSCLC. Chemotherapy is more often utilized in later stages or as neoadjuvant therapy in cases where the tumor is borderline resectable. Radiation therapy may also be employed either post-operatively or for patients who are not suitable candidates for surgery. Targeted therapy is primarily indicated for specific