Lung Cancer (Non-Small Cell) - NSCLC

Table of Contents H1
Table of Contents H2
Table of Contents H3

Lung Cancer (Non-Small Cell) - NSCLC

Introduction to Lungs

The lungs play a critical role in the respiratory system, absorbing oxygen from the air and supplying it to the bloodstream. At the same time, they expel carbon dioxide, a waste product generated by cells, through exhalation. The lungs contain several types of cells, predominantly epithelial cells that produce mucus, keeping the lungs healthy. Additionally, the lungs have nerve cells, hormone-producing cells, blood cells, and connective tissues.

What is Non-Small Cell Lung Cancer (NSCLC)?

Lung cancer occurs when healthy lung cells grow uncontrollably, forming a tumor. This tumor may be either benign (non-cancerous) or malignant (cancerous). NSCLC refers to one of the two primary types of lung cancer, the other being small cell lung cancer (SCLC).

Types of NSCLC

1. Adenocarcinoma:

• Begins in the epithelial cells lining the outer part of the lungs.

• Represents 40% of NSCLC cases.

2. Squamous Cell Carcinoma:

• Develops in the squamous cells inside the lungs.

• Accounts for 30% of NSCLC cases.

3. Large Cell Carcinoma:

• Characterized by large, abnormal cells.

4. Undifferentiated NSCLC:

• Cells show no clear distinction, making diagnosis and treatment more complex.

Statistics

India reports approximately 72,510 cases of lung cancer annually, ranking 4th among all cancers in terms of both incidence and mortality.

• Around 66,279 deaths occur annually due to lung cancer. Specific NSCLC data is not fully available.

Risk Factors

Smoking:

• The leading cause of lung cancer. Smoking introduces 7,000 chemicals, with 69 known carcinogens.

Secondhand smoke also increases cancer risk for non-smokers.

Asbestos Exposure:

• Increases lung cancer risk, especially when combined with smoking.

• Common in occupations like shipbuilding, insulation work, and mining.

Radon Exposure:

• This radioactive gas increases lung cancer risk.

Air Pollution:

• Living in areas with high pollution increases susceptibility.

Genetics:

• A family history of lung cancer raises risk, even for non-smokers.

Prevention of Lung Cancer

• Avoid smoking to significantly reduce cancer risk.

• Quitting smoking, even after years, lowers the risk over time.

Screening for Lung Cancer

Screening helps detect lung cancer early and can improve survival rates.

Low-dose CT scans are recommended for:

• Individuals aged 55-74 with 30 pack-years of smoking history.

• Those who quit smoking within the past 15 years.

Symptoms of NSCLC

Fatigue

Chronic cough

Shortness of breath

Chest pain

Loss of appetite

Coughing up blood

Weight loss

Hoarseness

Advanced Symptoms:

Bone pain

Back pain

Abdominal pain

Seizures

Difficulty speaking

Diagnosis

CT Scan / MRI / PET-CT Scan: Imaging to detect tumors.

Bone Scan: Detects cancer spread to bones.

Biopsy: Tissue samples examined under a microscope to confirm cancer.

FNAC: Fine needle aspiration to collect lung tissue for analysis.

Bronchoscopy: A camera examines the lung’s interior, with samples collected if necessary.

Thoracoscopy / Thoracotomy: Surgical techniques to access the chest cavity for diagnosis.

Biomarker Testing: Identifies genetic mutations, helping target specific therapies (e.g., EGFR, ALK, ROS1 mutations).

Stages of NSCLC

1. Stage 0:

• Cancer is localized and confined within the lung.

2. Stage IA - IB:

• Tumor size ranges from 3-5 cm.

• No spread to lymph nodes.

3. Stage IIA - IIB:

• Tumor size increases beyond 5 cm, with limited lymph node involvement.

4. Stage III:

• Extensive spread to multiple lymph nodes but not to distant organs.

5. Stage IVA - IVB:

• Cancer has spread to other organs.

6. Recurrent Cancer:

• Cancer returns after treatment.

Treatment Options for NSCLC

1. Surgery

Lobectomy: Removes one affected lobe of the lung.

Wedge Resection: Removes the tumor and surrounding healthy tissue.

Segmentectomy: Removes a larger portion of the lung than a wedge resection.

Pneumonectomy: Removes one entire lung.

2. Radiation Therapy

• Uses high-energy beams to kill cancer cells.

• Methods include IMRT and SBRT.

• Common side effects: Fatigue, skin changes, shortness of breath, and cough.

3. Chemotherapy

• Drugs are used to destroy cancer cells.

Neoadjuvant Chemotherapy: Administered before surgery to shrink the tumor.

Adjuvant Chemotherapy: Given after surgery to eliminate remaining cancer cells.

Common Drugs:

Carboplatin, Cisplatin

Docetaxel, Etoposide

Gemcitabine, Paclitaxel

• Side effects: Fatigue, nausea, infections, hair loss, and appetite loss.

4. Targeted Therapy

• Focuses on specific genes or proteins in cancer cells.

Common Targeted Drugs:

Erlotinib, Osimertinib, Alectinib

Gefitinib, Crizotinib, Dabrafenib

5. Immunotherapy

• Boosts the immune system to fight cancer cells.

Common Immunotherapy Drugs:

Atezolizumab (Tecentriq)

Nivolumab (Opdivo)

Pembrolizumab (Keytruda)

Follow-Up Care

After completing treatment, regular follow-up visits are essential to monitor for recurrence and manage side effects.

Similar types

Further Reading

Similar types of cancer you can read about

related Blogs

Blogs About This Type

No items found.
related Blogs

Blogs About This Type

No items found.
News

News About This Type

No items found.
Media

Media About This Type

No items found.