NON-SMALL CELL LUNG CANCER

Non-small cell lung cancer (NSCLC): This type of lung cancer, though less notorious than its small cell counterpart, carries significant implications for those affected. Lung cancer is predominantly found in individuals with non-small cell lung cancer (NSCLC), which, although serious, can often be managed effectively with treatment. Moreover, there are steps you can take to improve your well-being while dealing with it.

NSCLC is most commonly observed among smokers or individuals exposed to significant amounts of secondhand smoke, particularly those aged over 65.

Causes

As for the causes of NSCLC, doctors haven’t pinpointed a definitive cause. However, smoking or exposure to smoke is a common factor among many patients. Other factors contributing to an increased risk of lung cancer include exposure to radon, a radioactive gas found naturally in soil and rocks, as well as asbestos, mineral and metal dust, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, air pollution, radiation therapy to the chest or breast, and HIV/AIDS. Moreover, there is evidence suggesting a genetic predisposition to the disease, with instances of it running in families.

Types of Non-small cell lung cancer

NSCLC tumors are categorized into four types:

Adenocarcinoma: Originating in the cells of the air sacs that produce mucus and other substances, often in the outer regions of the lungs. It’s the most prevalent form of lung cancer, affecting both smokers and nonsmokers, with a higher incidence among those under 45. This type typically progresses more slowly than others.
Squamous cell (epidermoid) carcinoma: Arising in the cells lining the inner airways of the lungs, constituting about a quarter of lung cancer cases.
Large cell (undifferentiated) carcinoma: Exhibiting rapid growth and spread, making it more challenging to treat. This type accounts for approximately 10% of lung cancers.
Adenosquamous carcinoma: A relatively uncommon form typically developing in the outer lung areas, with smoking elevating the risk of its occurrence.

The treatment approach recommended by your healthcare provider will hinge on the extent to which the lung cancer has spread.

Prevalence

NSCLC is the most prevalent form of lung cancer, accounting for approximately 85% of all lung cancer cases worldwide. Its incidence is closely linked to smoking rates, with smokers being at significantly higher risk compared to non-smokers. However, it’s crucial to note that NSCLC can also affect individuals who have never smoked.

Symptoms

Early stages of NSCLC may not exhibit noticeable symptoms, or they might be mistaken for other ailments such as pneumonia or a collapsed lung.

Similar to other forms of lung cancer, NSCLC symptoms can include:

Persistent or worsening cough
Chest pain, particularly aggravated during coughing, laughing, or deep breaths
Hoarseness or changes in voice tone
Harsh, raspy breathing sounds
Wheezing
Unexplained weight loss and decreased appetite
Coughing up blood or mucus
Shortness of breath
Fatigue or weakness
Lingering lung issues like bronchitis or pneumonia

If the cancer metastasizes to other parts of the body, additional symptoms may arise, such as:

Bone pain
Headaches
Dizziness or balance disturbances
Numbness or weakness in an arm or leg
Yellowing of the skin or eyes (jaundice)

Risk Factors

Several factors increase the risk of developing NSCLC, including:

Smoking: The primary risk factor, accounting for the majority of NSCLC cases.
Environmental exposure: Prolonged exposure to carcinogens such as asbestos, radon, and air pollution heightens the risk.
Genetics: Family history and inherited genetic mutations can predispose individuals to NSCLC.
Age: Risk increases with advancing age, with the majority of cases diagnosed in individuals over 65.

Diagnosis

Upon initial consultation, your doctor will engage in a discussion with you, inquiring about various aspects such as when you first noticed symptoms, your overall well-being, any coughing or wheezing episodes, factors influencing symptom severity, your occupation, smoking history, and any family history of lung cancer. Additionally, a physical examination will be conducted, followed by a series of diagnostic tests.

Imaging tests play a crucial role in identifying tumors within the lungs and assessing the extent of cancer spread:

X-rays utilize low levels of radiation to produce images of internal structures.
MRI (magnetic resonance imaging) offers detailed views of blood flow, organs, and tissues.
Ultrasound generates images by reflecting sound waves off internal tissues.
PET (positron emission tomography) scans employ a radioactive tracer to detect areas of heightened cellular activity.
CT (computed tomography) scans provide detailed images of lung tissue and blood vessels.

Sputum cytology involves laboratory analysis of coughed-up mucus to detect cancer cells.

In cases where abnormal growths or fluid accumulation in the lungs are identified, a fine-needle aspiration biopsy may be performed to extract tissue samples for further examination.

To visually inspect the lungs and chest cavity, your doctor may utilize a thin, flexible tube equipped with a light and camera. Tissue samples, including those from nearby lymph nodes, may also be obtained through various methods:

Bronchoscopy involves inserting a tube through the nose or mouth into the lungs.
Endobronchial ultrasound combines bronchoscopy with ultrasound to examine lymph nodes and other structures.
Endoscopic ultrasound employs an endoscope inserted through the throat into the esophagus.
Thoracoscopy utilizes small incisions along the side to examine the outer lung surface and surrounding tissue.
Mediastinoscopy involves a small incision above the breastbone, allowing access to the space between the lungs.

Following the diagnostic procedures, your doctor will determine the cancer stage, indicating its location and spread. Understanding each stage is crucial for devising an effective treatment plan:

Occult stage: Cancer cells are present in lung fluid or sputum but are not visually detectable within the lungs.
Stage 0: Cancer cells are confined to the lining of the airways.
Stage I: A small tumor is present in one lung without lymph node involvement.
Stage II: A larger tumor exists in one lung or has spread to nearby lymph nodes.
Stage III: Cancer has spread to distant lymph nodes or adjacent structures within one lung.
Stage IV: Cancer has metastasized to both lungs, fluid surrounding the lungs, or other organs like the brain and liver.

Treatments

Treatment for non-small cell lung cancer (NSCLC) typically involves two approaches: targeting the cancer itself and managing symptoms to improve quality of life.

Depending on the type and stage of cancer, your doctor may recommend a combination of treatments:

Surgery: In early stages, surgical removal of the cancerous tissue may be advised. This can involve partial or complete removal of the affected lung. Other surgical techniques, such as freezing or using heated probes or needles, may also be utilized to destroy cancer cells.
Radiation therapy: This treatment targets remaining cancer cells post-surgery and can also be used for cancers that are inoperable. Radiation may be administered externally using a high-energy beam or internally via a radioactive substance placed near the cancer site.
Chemotherapy: Anti-cancer drugs, delivered orally or intravenously, circulate throughout the body to eliminate cancer cells. Chemotherapy may be administered before or after surgery, or as a standalone treatment.
Targeted therapy: These drugs and antibodies specifically inhibit cancer cell growth and spread with minimal damage to healthy cells compared to radiation and chemotherapy.
Laser and photodynamic therapy (PDT): This method utilizes a special laser light to activate drugs absorbed by cancer cells, effectively killing them while minimizing harm to surrounding healthy tissue.
Clinical trials: Participation in research studies exploring novel cancer treatments may be an option. Patients are encouraged to consult with their doctors and explore opportunities available through organizations like the National Cancer Institute.

Home Care Tips

For individuals undergoing treatment for NSCLC, maintaining overall health and well-being is paramount. Some home care tips include:

Follow prescribed treatment regimens diligently.
Eat a balanced diet rich in fruits, vegetables, and lean proteins to support the immune system.
Stay physically active within the limits of your condition to combat fatigue and maintain strength.
Seek emotional support from loved ones, support groups, or mental health professionals to cope with the challenges of living with cancer.

Prevention

While certain risk factors for NSCLC, such as genetic predispositions, cannot be modified, there are steps individuals can take to reduce their risk:

Avoid tobacco in all forms, including smoking and exposure to secondhand smoke.
Minimize exposure to environmental carcinogens such as asbestos and radon.
Follow workplace safety guidelines if working in environments with potential carcinogen exposure.
Attend regular screenings as recommended by healthcare professionals, especially for individuals with a history of smoking or other risk factors.

When to See a Doctor

If you experience any persistent symptoms associated with NSCLC, such as chronic cough, chest pain, or unexplained weight loss, it’s essential to consult a healthcare provider promptly. Early detection and intervention can significantly improve treatment outcomes and prognosis.

Outlook/Prognosis

The prognosis for NSCLC varies widely depending on factors such as the stage at diagnosis, overall health, and response to treatment. While it remains a serious condition, advances in medical technology and treatment modalities offer hope for improved outcomes and extended survival for many patients.

Note

While undergoing treatment, it’s important to stay vigilant for any physical or emotional changes and communicate them to your doctor promptly.

Maintaining a healthy diet is crucial for sustaining strength and energy, even if appetite fluctuates. Opt for frequent small meals rather than large ones to ensure adequate nutrition.

If breathing difficulties arise, supplemental oxygen therapy may be beneficial. Additionally, practicing relaxation techniques such as meditation, listening to soothing music, or imagining serene environments can help alleviate stress. Complementary therapies like gentle massage and aromatherapy may also promote relaxation. Discuss these options with your doctor to address fatigue, pain, or breathlessness effectively.

Coping with the diagnosis of cancer can evoke a range of emotions including fear, anger, and sadness. It’s normal to experience strong feelings during this time. Consider seeking support from a support group or counselor specializing in cancer care to navigate through these emotions. Your doctor can provide recommendations or refer you to social workers, nurses, clergy, or other professionals who can offer assistance.

Sources:

American Cancer Society. “Key Statistics for Lung Cancer.”
National Cancer Institute. “Non-Small Cell Lung Cancer Treatment (PDQ) – Health Professional Version.”
Mayo Clinic. “Lung Cancer.” mayoclinic.org.
Centers for Disease Control and Prevention. “Lung Cancer.”
College of American Pathologists: “Lung Cancer: Lung Adenocarcinoma.”
Medscape: “Non-Small Cell Lung Cancer Treatment & Management.”
University of Southern California: “A Patient’s Guide to Lung Surgery.”
Johns Hopkins Medicine Health Library: “Mediastinoscopy.”
LungCancer.org: “Types and Staging of Lung Cancer.”
Medline Plus: “Radiation Therapy.”
UpToDate: “Patient information: Non-small cell lung cancer treatment; stage I to III cancer (Beyond the Basics).”