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Non-small cell lung cancer is the most common type of lung cancer, which accounts for around eighty-five to ninety percent of all lung cancer cases. It can be further divided into three types, which include -

• Squamous cell (epidermoid) carcinoma, which starts in the cells lining the lung's inner airways. Around 25% of all lung cancers fall into this category.
• Adenocarcinoma, which starts in those cells which produce mucus. It is the most common type of cancer in non-smokers and it progresses more slowly, as compared to other types. Around 40% of all lung cancers fall into this category.
• Large cell (undifferentiated) carcinoma, which can affect any part of the lung. It spreads more rapidly as compared to other lung cancers and it tougher to treat. Around 10% to 15% of all lung cancers fall into this category.

The most common cause of lung cancer is smoking. Your risk of getting lung cancer is directly proportional to the number of cigarettes you smoke each day. Being exposed to secondhand smoke on a regular basis could also increase your risks of non-small cell lung cancer considerably. In many instances though, people develop lung cancer even though they have never smoked. Some of the other possible causes of lung cancer include -

• A family history of lung cancer
• High levels of air pollution
• Undergoing radiation therapy
• Drinking water with high arsenic levels
• Exposure to chemicals like uranium or beryllium & material like asbestos

Many individuals do not even realize that they are suffering from non-small cell lung cancer, until the condition progresses to a more advanced stage. This is because the symptoms only occur in the later stages, when the disease becomes difficult to cure. Given below are some of the prominent symptoms of non-small cell lung cancer -

• Cough that is persistent and worsens with time
• Shoulder pain
• Shortness of breath and difficulty in breathing
• Swelling
• Discomfort and pain in the chest area
• Swallowing problems
• Hoarseness and changes in the voice
• Joint pain
• Bloody sputum or phlegm
• Drooping eyelids
• Recurring infections like pneumonia or bronchitis
• Weakness and fatigue
• Unexplained weight loss

Unfortunately, these symptoms are not exclusive to lung cancer and can occur due to other health problems. However, it is important to visit a doctor as soon as you notice any of these symptoms. In addition to a physical exam, your health care provider will probably ask you to undergo a series of tests for an accurate diagnosis. These include -

• Complete blood count (CBC)
• Bone scan
• CT Scan
• MRI
• Chest x-ray
• PET scan
• Thoracentesis
• Sputum test
• Biopsy

Once the presence of cancerous cells is confirmed, further imaging tests are required to determine the stage of the disease.

The treatment depends on the type and stage as well as your overall health. Some of the possible treatment options include -

• Surgery (lobectomy, pneumonectomy or segment) for removal of the cancer cells
• Radiation therapy
• Chemotherapy
• Targeted therapy

If surgery is not an option, patients are usually asked to undergo chemotherapy along with radiation therapy. However, controlling the symptoms after the course of these therapies is a very important part of the treatment of lung cancer.

The prognosis for non-small cell lung cancer is highly varied. This disease grows slowly in most patients. In some instances, it could also spread to other parts of the body, like the bone, brain, liver and small intestines. In rare instances, non-small cell lung cancer can be aggressive and may lead to rapid death.

Of course, the survival rate is higher for those who start undergoing treatment when the condition is in the first or second stage. Tumors that have progressed to the third stage can be cured in some instances. Unfortunately, patients in the 4th stage of lung cancer are rarely cured. However, therapy is recommended for extending and improving the overall quality of their lives.

References

• Jett JR, Schild SE, Keith RL, Kesler KA. Treatment of non-small cell lung cancer, stage IIIB: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:266S-276S.
• Johnson DH, Blot WJ, Carbone DP, et al. Cancer of the lung: non-small cell lung cancer and small cell lung cancer. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 76.
• Tassinari D, Scarpi E, Sartori S, Tamburini E, Santelmo C, Tombesi P, Lazzari-Agli L. Second-line treatments in non-small cell lung cancer. A systematic review of literature and metaanalysis of randomized clinical trials.Chest. 2009;135:1596-1609

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