Cancer – lung – non-small cell; Non-small cell lung cancer; NSCLC; Adenocarcinoma – lung; Squamous cell carcinoma – lung
Non-small cell lung cancer (NSCLC) is the most common type of
There are three common types of NSCLC:
- Adenocarcinomas are often found in an outer area of the lung.
- Squamous cell carcinomas are usually found in the center of the lung next to an air tube (bronchus).
- Large cell carcinomas can occur in any part of the lung. They tend to grow and spread faster than the other two types.
Causes, incidence, and risk factors
Smoking causes most cases of lung cancer. The risk depends on the number of cigarettes you smoke every day and for how long you have smoked. Being around the smoke from other people (secondhand smoke) also raises your risk of lung cancer. But some people who do not smoke and have never smoked develop lung cancer.
Research shows that smoking marijuana may help cancer cells grow. But there is no direct link between smoking marijuana and developing lung cancer.
Constant exposure to high levels of air pollution and drinking water that has a high level of arsenic can increase your risk of lung cancer. A history of radiation therapy to the lungs can also increase risk.
Working with or near cancer-causing chemicals or materials can also increase risk. Such chemicals include:
- Chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust
- Certain alloys, paints, pigments, and preservatives
- Products using chloride and formaldehyde
Early lung cancer may not cause any symptoms. Symptoms you should watch for include:
Chest pain Coughthat does not go away Coughing up blood
Loss of appetite Losing weight without trying Shortness of breath Wheezing
Other symptoms that may be due to NSCLC, often in the late stages:
Bone pain or tenderness Eyelid drooping Hoarseness or changing voice Joint pain Nail problems
- Swallowing difficulty
Swelling of the face Weakness
- Shoulder pain or weakness
These symptoms can be due to other, less serious conditions. It is important to talk to your health care provider.
Signs and tests
The doctor will perform a physical exam and ask about your medical history. You will be asked if you smoke, and if so, how much and for how long. You will also be asked about other things that may have put you at risk of lung cancer, such as exposure to certain chemicals.
When listening to the chest with a stethoscope, the doctor may hear fluid around the lungs.
This may suggest cancer.Tests that may be performed to diagnose lung cancer or see if it has spread include:
Bone scan Chest x-ray
- Complete blood count (
CBC) CT scan of the chest MRI of the chest
- Positron emission tomography (
PET) scan Sputum testto look for cancer cells Thoracentesis(sampling of fluid build-up around the lung)
In some cases, a piece of tissue is removed from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:
Bronchoscopycombined with biopsy CT-scan-directed needle biopsy
- Endoscopic esophageal ultrasound (EUS) with biopsy
Mediastinoscopy with biopsy Open lung biopsy Pleural biopsy
If the biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. Stage means how big the tumor is and how far it has spread. NSCLC is divided into five stages:
- Stage 0 – the cancer has not spread beyond the inner lining of the lung
- Stage I – the cancer is small and has not spread to the lymph nodes
- Stage II – the cancer has spread to some lymph nodes near the original tumor
- Stage III – the cancer has spread to nearby tissue or to far away lymph nodes
- Stage IV – the cancer has spread to other organs of the body, such as the other lung, brain, or liver
There are many different types of treatment for NSCLC. Treatment depends on the stage of the cancer.
Surgery is the common treatment for NSCLC that has not spread beyond nearby lymph nodes. The surgeon may remove:
- One of the lobes of the lung (lobectomy)
- Only a small part of the lung (wedge or segment removal)
- The entire lung (pneumonectomy)
Some patients need
- Chemotherapy alone is often used when the cancer has spread outside the lung (stage IV).
- It may also be given before surgery or radiation to make those treatments more effective. This is called neoadjuvant therapy.
- It may be given after surgery to kill any remaining cancer. This is called adjuvant therapy.
Controlling symptoms and preventing complications
- Treat the cancer, along with chemotherapy, if surgery is not possible
- Help relieve symptoms caused by the cancer, such as breathing problems and swelling
- Help relieve cancer pain when the cancer has spread to the bones
The following treatments are mostly used to relieve symptoms caused by NSCLC:
Laser therapy – a small beam of light burns and kills cancer cells
Photodynamic therapy – uses a light to activate a drug in the body, which kills cancer cells
You can ease the stress of illness by joining a
Outlook varies. Most often, NSCLC grows slowly. In some cases, it can be very aggressive and cause rapid death. The cancer may spread to other parts of the body, including the bone, liver, small intestine, and brain.
Chemotherapy has been shown to prolong the life and improve the quality of life in some patients with stage IV.
Cure rates are related to the stage of disease and whether you are able to have surgery.
- Stages I and II cancers have the highest survival and cure rates.
- Stage III cancer can be cured in some cases.
- Stage IV cancer that has returned is almost never cured. The goals of therapy are to extend and improve quality of life.
Calling your health care provider
Call your health care provider if you have symptoms of lung cancer, particularly if you smoke.
If you smoke, now is the time to quit. Also, try to avoid secondhand smoke,.
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