Non-Small Cell Lung Cancer

Non-small cell lung cancer is a dreadful form of lung cancer which affects 90% of lung cancer patients. Non-small cell lung cancer is an aggregate of three distinct histologies of lung cancer, including large cell carcinoma (cancer that may begin in several types of large cells), adenocarcinoma (cancer that begins in the cells that line the alveoli and produce substances such as mucus), and squamous or epidermoid carcinoma (cancer that begins in squamous cells, which are thin, flat cells that resemble fish scales). Less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumor, and salivary gland carcinoma.

There are a variety of tests that are used to detect, diagnose, and stage non-small cell lung cancer. These include: a physical exam and history, a chest x-ray, a CT scan (often referred to as a CAT scan), PET scan (positron emission tomography scan which makes a picture of where glucose is being used in the body because malignant tumor cells use more glucose than normal cells do), a sputum cytology (the examination of mucus coughed up from the lungs), fine-needle aspiration biopsy of the lung, a bronchoscopy (the examination of the trachea and large airways in the lung for abnormal signs), a thoracoscopy (the examination of the organs inside the chest to check for abnormal signs), and a thoracentesis (the extraction and examination of the fluid from the space between the lining of the chest and the lung).

At diagnosis, patients with non-small cell lung cancer can be divided into 3 groups that reflect both the extent of the disease and the treatment approach. The first group has the best prognosis and are candidates for surgery. The second group includes patients with locally advanced tumors and will usually face a combination of treatments, such as chemotherapy and radionation therapy. The third group consists of patients with non-small cell lung cancer that has metastasized away from the initial area of the cancer. In these cases, the cancer requires a combination of treatment approaches and has a poor prognosis.

Primarily depending upon the extent of the cancer and the prognosis, there are several different treatment approaches for those diagnosed with non-small cell lung cancer. From traditional treaments to new, radical treatments that are still in clinical trails, patients have greater choices than ever before.

Standard treatments for non-small cell lung cancer include:

Wedge Resection Surgery: removes a triangle-shaped slice of tissue, including the tumor and a small area of normal tissue around it.

Segmental Resection Surgery: removes a slightly larger amount of tissue than Wedge Resection Surgery.

Lobectomy Surgery: removes an entire lobe (section) of the lung.

Pneumonectomy Surgery: removes one entire lung.

Sleeve Resection Surgery: removes part of the bronchus.

Radiation Therapy: uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation at the cancer. This second form of radiation treatment is often referred to as brachytherapy or internal radiation therapy. It implants a radioactive substance directly into or in the area of the cancer.

Chemotherapy: uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Taken by mouth or injected, the drugs enter the bloodstream and can reach cancer cells throughout the body. When placed directly into the area of the cancer, the drugs primarily affect cancer cells in that area.

Laser Therapy: uses an intense laser beam to kill cancer cells.

Photodynamic Therapy: is a form of laser therapy that involves the use of a photosensitizing agent injected into the patient's bloodstream, then absorbed by the cells of the body, remaining in the cancer cells longer than it does in normal cells. One to three days after the injection, after the photosensitizing agent has left the normal cells, the tumor is exposed to light, which produces a form of oxygen that destroys the cancer cells. Photodynamic Therapy can be used to treat very small tumors in those patients for whom the usual treatments for lung cancer are not appropriate.

Biologic Therapy (Immunotherapy): uses the patient's immune system to fight the cancer. Substances made by the body or made in a laboratory help boost the body's natural defenses.

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