Non-Small Cell Lung Cancer (NSCLC)

Overview

Non-small cell lung cancer is a disease in which malignant cancer cells form in the tissues of the lung. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It usually grows and spreads more slowly than small cell lung cancer. There are three primary types of non-small cell lung cancer:

• Squamous cell carcinoma: Cancer that begins in squamous cells is also called epidermoid carcinoma. Squamous cell carcinoma is usually found in the center of the lung by an air tube (bronchus).
• Large cell carcinoma: Cancer that can occur in any part of the lung. Large cell carcinomas tend to grow and spread faster than the other two types.
• Adenocarcinoma: Cancer that begins in the cells that line the alveoli, often found in an outer area of the lung.

The kinds of cells found in each cancer and how the cells look when viewed under a microscope determine the name for the carcinoma.

Symptoms
Possible early symptoms of non-small cell lung cancer include chest pain, coughing and shortness of breath.

Other persistent conditions which are associated with lung cancer include:

• Wheezing
• Coughing up blood (hemoptysis)
• Hoarseness
• Loss of appetite
• Weight loss for no known reason
• Unusual tiredness

A doctor should be consulted if any of the above problems occur. The doctor will conduct tests and procedures that examine the lungs to detect, diagnose, and stage non-small cell lung cancer.

Stages of Non-Small Cell Lung Cancer:

The following are stage designations for non-small cell lung cancer:
• Stage 0 - the cancer is limited to the inner lining of the lung.
• Stage I - the cancer is small and has not yet spread to any lymph nodes.
• Stage II - the cancer has spread to some lymph nodes near the original tumor site.
• Stage III - the cancer has spread to nearby tissue or spread to lymph nodes far away from the tumor site.
• Stage IV - the cancer has spread to other organs such as the other lung, brain, or liver.

Treatment
The following options are available for treatment of non-small cell lung cancer, with the stage of the cancer, and general health of the patient determining the prognosis.

• Surgery - Surgery may be used to remove the tumor, and some or all of a lung. Unlike small cell lung cancer, surgery given at early stages of non-small cell lung cancer can cure the cancer. Surgery is often the first line of treatment for most patients with stage I and II non-small cell lung cancer, and some patients with stage III tumors. Surgery can potentially cure the disease at this point.
• Chemotherapy - Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
• Radiation therapy - Treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing.
• Laser therapy - Treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.
• Photodynamic therapy (PDT) - Treatment that uses a certain type of laser light to activate a drug injected into the body to kill cancer cells.
• Watchful waiting – The medical profession advocates in some rare cases to closely monitor a patient’s condition without giving any treatment until symptoms appear or change.

The treatment selected depends upon the stage of the cancer. A combination of treatments may be used, with research suggesting that chemotherapy or a combination of chemotherapy and radiation therapy prior to surgery is often the best treatment for patients.

Chemotherapy by itself is often used when the cancer has metastasized and is in stage IV. Chemotherapy has been shown to prolong the life and improve the quality of life in some stage IV patients.

In addition, patients may consider taking part in a clinical trial. Patients can enter clinical trials at any time during the cancer treatment. Discuss the options with your medical team to determine if there is one to fit your needs.