July 5, 2024

Understanding Non-Small Cell Lung Cancer: Types, Stages, Symptoms, and Treatment Options


What is Non-Small Cell Lung Cancer?

Non-small cell lung cancer (NSCLC) refers to any type of epithelial lung cancer other than small cell lung cancer. NSCLC accounts for about 85% of all lung cancers. There are three main types of NSCLC:

Adenocarcinoma

Adenocarcinoma starts in the mucus-producing cells found in the outer parts of the lung. It is the most common type of lung cancer and is often linked to a history of smoking. However, adenocarcinoma is seen more often in non-smokers than other types of NSCLC. Early stage (stage I or II) adenocarcinoma grows slowly and is usually asymptomatic for long time.

Squamous Cell Carcinoma

Like adenocarcinoma, cigarette smoking increases the chance of developing squamous cell carcinoma. It grows faster but is still usually asymptomatic in early stages due to limited spread.

Large Cell Carcinoma

Large cell carcinoma refers to several subtypes of lung cancers characterized by large, abnormal cells seen under a microscope. It can grow very rapidly and therefore shows up in advanced stages more often than the other Non-Small Cell Lung Cancer  types. Large cell carcinoma is seen both in smokers and non-smokers.

Staging of Non-Small Cell Lung Cancer

Staging is an important part of assessing NSCLC as it helps determine prognosis and treatment options. The extent of cancer spread is described using the TNM system:

– T describes the size of the main tumor and whether it has invaded nearby tissues
– N describes if the cancer has reached nearby lymph nodes
– M indicates whether the cancer has metastasized (spread) to other parts of the body

Once T, N and M are determined, a stage of 0, I, II, III or IV is assigned. Lower stages indicate less cancer spread. Stage IV means the cancer has spread to distant organs.

Symptoms of Non-Small Cell Lung Cancer

Early stage NSCLC often has no symptoms. Advanced NSCLC symptoms typically include:

– Persistent cough (that doesn’t go away)
– Chest pain
– Hemoptysis (coughing up blood)
– Breathlessness, wheezing or fatigue
– Weight loss and loss of appetite
– Recurrent pneumonia or bronchitis

Rarer symptoms may include shoulder pain, headache, voice changes due to tumor spread to other organs. Seeking medical help for any persisting lung-related symptoms is crucial for early detection and treatment of NSCLC.

Treatment Options for Non-Small Cell Lung Cancer

Treatment depends on the type, stage, and genetic makeup of the cancer as well as a person’s overall health. Common treatment options include:

Surgery: Surgical removal of part of the lung (lobectomy), the entire lung (pneumonectomy), or lymph nodes is often the primary treatment for early stage NSCLC. Surgery may cure or prolong survival.

Radiation Therapy: High-energy rays are used to kill cancer cells and shrink tumors. It may be used alongside chemotherapy or by itself for older patients who cannot tolerate surgery.

Chemotherapy: Anti-cancer drugs are given to shrink the tumor before surgery or control cancer spread during advanced stages. Combination chemotherapy provides slightly better outcomes for stage III/IV NSCLC.

Targeted Therapy: Drugs target specific gene mutations or proteins linked to NSCLC growth. These include tyrosine kinase inhibitors like gefitinib and erlotinib which block tumor cell growth pathways seen in some forms of NSCLC.

Immunotherapy: Drugs like nivolumab and pembrolizumab boost the body’s immune defenses against cancer cells. Immunotherapy improves survival and is now standard of care for some advanced disease cases.

Palliative Care: Aims to reduce symptoms and improve quality of life for metastatic or advanced NSCLC when cure is not possible. Pain relief and prevention of complications are key goals.

With treatment, the overall five-year survival for all NSCLC stages combined is around 26%. But discovering NSCLC early and providing prompt, multidisciplinary care offer the best chances of survival and quality of life outcomes. Seeking medical evaluation is key to diagnosis and treatment decisions.

Prognosis and Prevention of Non-Small Cell Lung Cancer

Prognosis depends on the NSCLC stage at diagnosis as well as other factors like tumor biology, patient age and overall health. Five-year survival rates range from about 50-70% for stage IA NSCLC down to less than 5% for stage IV NSCLC. However, advances in combined modality therapy continue to improve outcomes even in advanced disease.

Not smoking and avoiding secondhand smoke exposure remain the primary actions for preventing NSCLC. Those who quit smoking cut their lung cancer risk significantly over time. Other protective lifestyle factors include a balanced diet, exercise, limiting alcohol intake and sun protection. Early detection also boosts cure rates so seeing a doctor promptly for any persistent lung symptoms is crucial.

Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it