Non small Cell Lung Cancer: Treatment, Procedure, Cost and Side Effects

It is also known as Non-small Cell lung Carcinoma, or simply NSCLC . There are two main types of lung cancer, about 80%-85% of lung cancers are non-small cell lung cancer (NSCLC), about 10% to 15% are small cell lung cancer (SCLC) There are various sub-types of NSCLC, the most common among being Adenocarcinoma, constituting about 40% of lung cancers, another form is Squamous cell carcinoma which constitutes 25% to 30% of all lung cancers, then there is Large cell carcinoma, it accounts for 10% to 15% of all lung cancers. There are also other types of lung tumors like Lung carcinoid tumor, other cancers that spread to the lungs etc. Depending on the stage of cancer and other factors the main treatment options for people having NSCLC are

Surgery

Radiofrequency ablation (RFA)

Radiation therapy

Chemotherapy

Targeted therapies

Immunotherapy

Palliative treatments can also be used to help with the symptoms to the disease.

Usually more than one type of treatment is used, for the analysis of progression of the disease and for treatment, an individual has to visit a series of doctors, including A thoracic surgeon, A radiation oncologist, A medical oncologist, A pulmonologist etc.

Surgery to remove cancer can be an option for treatment of early stage NSCLC, since the surgery involves a lot of risks, the surgeon should be highly experienced. Different operations are used to possibly cure NSCLC:

Pneumonectomy: This removes an entire lung.

Lobectomy: An entire lobe with tumor(s) is removed.

Sleeve resection: It is used to treat the cancer of the airways in the lungs

Segmentectomy: A part of lobe is removed.

People having small lung tumors can undergo Radioactive Ablation especially if they can’t tolerate surgery.

Depending on the stage of NSCLC, radiation therapy might be used. It is used as the main treatment along with chemotherapy, if the lung tumor can’t be removed due to its size. It can also be used after surgery to try to kill any small areas of cancer that the surgery might have missed. It can also be used before surgery to shrink the tumor.

Radiation therapies are of two main types:

External beam radiation therapy: It focusses radiation from outside the body on the cancer

Brachytherapy: It is used to shrink tumors in the airway and to relieve symptoms.

Chemotherapy: It is treatment with anti-cancer drugs that are injected into the vein or taken orally, these drugs enter the bloodstream and go throughout the body, making it useful for cancer anywhere in the body.

For tumors to grow they need new blood vessels to nourish them, this process is known as angiogenesis, some targeted drugs known as angiogenesis inhibitors, block this new blood vessel growth. Examples of targeted drugs are Bevacizumab, Ramucirumab.

Immunotherapy is also very beneficial for NSCLC, it is the use of medicines to stimulate a person’s own immune system. As it activates the immune system, it helps the system to recognize and destroy cancer cells. These drugs are given to people whose cancer starts growing again after chemotherapy.

Palliative treatment is aimed at relieving the symptoms of cancer, sometimes fluid can build up in the chest, to remove this Thoracentesis can be done which is a procedure done to remove the fluid by numbing an area of the chest and using a needle to drain out the fluid. Another method is Pleurodesis, it is also done to remove the fluid and keep it from coming back. To treat the buildup around the heart Pericardiocentesis can be done.

There can be some serious side-effects due to surgery including excess bleeding, blood clots in the legs or lungs, wound infections, and pneumonia.

Possible side effects of radiation therapy can be fatigue, nausea and vomiting, loss of appetite and weight loss, hair loss

Side effects of chemotherapy are diarrhea or constipation, increased chance of infections, easy bruising or bleeding, mouth sores etc.

If cure is the ultimate goal then it takes about 4-6 months for the treatment to finish and a person to recover

The price of the treatment ranges from Rs2.5lakhs-Rs20 lakhs

For some people, treatment may remove or completely destroy the lung cancer, but there are always chances for the cancer to reappear, survivors can often get any type of second cancer, chances of relapse are higher in survivors who smoke.