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Non-Small Cell Lung Cancer Diagnosis and Treatment in NJ, CT, MD, and the Washington, D.C., Area

Lung cancer develops when the cells that line the lungs are repeatedly damaged (often because of smoking). Over time, these damaged cells begin to act abnormally, and malignant tumors can develop. The two major types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is much more common than SCLC, accounting for about 80 percent to 85 percent of lung cancer cases.

Located in New Jersey, Connecticut, Maryland, and the Washington, D.C., area, Regional Cancer Care Associates (RCCA) has extensive experience treating all types of lung cancer, including NSCLC. Learn more about NSCLC, risk factors, and treatment options.

What Is Non-Small Cell Lung Cancer?

Non-small cell lung cancer (NSCLC) is an umbrella term for several types of lung cancer. Typically, NSCLC grows and spreads more slowly than SCLC. Most cases of NSCLC are caused by smoking. 

Seated patient talking with provider who is holding scan of lungs

Types and Subtypes of NSCLC

The three primary types of NSCLC are:

  • Adenocarcinoma: This type of NSCLC starts in the cells that line the lungs’ small air sacs, known as alveoli. It is usually slow-growing and can develop in both smokers and nonsmokers.
  • Squamous cell carcinoma: Squamous cells are thin, flat cells found in the lining of the bronchi, which carry air from the windpipe to the lungs. This type of NSCLC is likely to spread.
  • Large cell carcinoma: This less common form of NSCLC can develop anywhere in the lungs.

There are also other rare subtypes of NSCLC, such as sarcomatoid carcinoma.

Causes and Risk Factors for NSCLC

Risk factors for NSCLC include:

  • Smoking: People who smoke tobacco in any form, especially cigarettes, are at increased risk of lung cancer.
  • Secondhand smoke: People who live or work in an environment where other people smoke can also be at elevated risk.
  • Occupational hazards: Jobs that involve repeated exposure to substances like asbestos, radon, chromium, formaldehyde, and nickel can increase risk for NSCLC.
  • Environmental factors: Exposure to heavy air pollution or water with high arsenic levels can also increase the risk of developing lung cancer.
  • Medical history: Some medical conditions, like pulmonary fibrosis and HIV/AIDS, increase risk for NSCLC.
  • Radiation exposure: Prior cancer treatment that involves radiation therapy in the chest area can raise lung cancer risk.

Signs and Symptoms of NSCLC

Early stages of NSCLC may not cause any noticeable symptoms. As NSCLC progresses, common signs and symptoms can include:

  • Persistent cough
  • Shortness of breath
  • Chest pain
  • Loss of appetite
  • Unexplained weight loss
  • Fatigue
  • Coughing up blood
  • Wheezing or hoarseness
  • Difficulty swallowing
  • Swelling in the face or veins of the neck
  • Bone pain

Diagnosing NSCLC

If lung cancer is suspected, several different tests may be needed to rule out other conditions. In addition to reviewing a patient’s medical history and completing a physical examination, a provider may order:

  • Imaging tests: X-rays can show abnormal growths in the lungs, while a CT scan or MRI can reveal smaller lesions that cannot be detected on an X-ray.
  • Sputum cytology: This test analyzes a sample of a patient’s mucus under a microscope to check for cancerous cells.
  • Biopsy and tissue sampling: A lung biopsy requires a small incision in the chest. Using a needle, a doctor will remove a sample of tissue from the patient’s lung for analysis.
  • Bronchoscopy: This procedure uses a thin, lighted tube to visualize the inside of the airways.

Additional tests, such as blood work and urinalysis, may also help confirm a diagnosis of NSCLC.

Staging and Grading NSCLC

Once a patient has been diagnosed with NSCLC, a physician will determine the stage, which indicates how far the cancer has advanced and informs a treatment plan. Lung cancer stages are indicated with Roman numerals running from 0 to IV:

  • Occult stage: In this stage, the location of the cancer cannot be determined, but cancer cells may be present in a sputum cytology or lung fluid biopsy sample.
  • Stage 0: In this stage, also known as carcinoma in situ, abnormal cells are found on the surface of the lung tissue but have not spread any further.
  • Stage I: In this stage, cancer cells are small and found only inside the lung.
  • Stage II: In this stage, a larger lung tumor is present, but cancer has not spread to lymph nodes or is limited to lymph nodes within the lung.
  • Stage III: In this stage, tumors or growths are large and may have spread to surrounding lymph nodes or tissues.
  • Stage IV: In this most advanced stage, cancer has spread to other parts of the body through the bloodstream or lymphatic system. Early detection usually improves treatment outcomes.

The five-year survival rate for patients with early-stage NSCLC is 63 percent.

Treatment Options for NSCLC

A patient’s treatment plan will depend on several factors, including the cancer stage and the person’s overall health. Common treatment options include:

Surgery

Surgery is often the preferred treatment option for early-stage NSCLC. Depending on the location and size of the tumor, surgery may involve the removal of an entire lobe of the lung (lobectomy) or a larger part of the lung (known as lung resection).

Radiation Therapy

Radiation therapy uses focused, high-energy X-ray beams to kill cancer cells or slow their growth. Radiation therapy may be used in combination with other treatments, such as chemotherapy or surgery.

Chemotherapy

Chemotherapy is a common cancer treatment that uses drugs to stop cancer cells from growing. Some patients receive chemotherapy intravenously, while others take oral medications. With both forms of treatment, the drugs travel through the bloodstream to act against cancer cells in the lungs or other parts of the body.

Targeted Therapy

Targeted therapy uses drugs that are designed to identify and attack cancer cells that have specific genetic mutations. This helps slow the spread of NSCLC. This is an increasingly utilized form of treatment, and there are many types of targeted therapy drugs.

Immunotherapy

Immunotherapy is a cancer treatment that uses medication to harness the power of a patient’s immune system. Some immunotherapy drugs work by boosting the body’s ability to identify and kill cancer cells. Others block the proteins that prevent T cells from attacking cancer cells.

Multidisciplinary Approach to Care

Cancer treatment plans are personalized for each patient. Often, a multidisciplinary approach to care is used, in which medical oncologists, surgeons, and radiation oncologists work together. For example, a patient may undergo a course of radiation before surgery to help shrink tumors. Other providers, such as counselors or dietitians, may also work with the patient to provide supportive care.

Managing Treatment Side Effects

Cancer treatments such as chemotherapy and radiation can cause side effects. Some common side effects and strategies for mitigating them include:

  • Hair loss: Hair thinning and loss are common side effects of chemotherapy. Some patients choose to wear a cold cap during cancer treatment to reduce these effects.
  • Nausea and vomiting: Medication can help relieve vomiting and nausea. An oncology dietitian can also recommend dietary changes to reduce nausea.
  • Fatigue and weakness: Cancer-related fatigue is common. Strategies to manage fatigue include exercise, physical therapy, massage, yoga, and acupuncture.
  • Skin changes: Patients may experience rashes or dry, itchy skin. Using mild cleansers and lotions without dyes or fragrances can help, as can wearing soft clothing made from natural fibers.
  • Neuropathy: Cancer treatment can cause peripheral neuropathy that leads to nerve pain, numbness, or tingling. Medication can relieve neuropathy pain.

Cancer can also take an emotional and psychological toll. Patients are encouraged to talk with their providers about the types of mental health support and services available to them.

Living With NSCLC

There are plenty of strategies to help patients through the process of NSCLC treatment and survivorship. These include:

  • Lifestyle modifications: Patients with NSCLC should quit smoking immediately. Oxygen therapy can also help improve fatigue and shortness of breath.
  • Dietary considerations: During and after treatment, patients with NSCLC should strive to eat a healthy, balanced diet with plenty of fruits and vegetables, whole grains, and lean proteins.
  • Exercise: Regular physical activity can improve circulation, boost energy levels, and strengthen the immune system.
  • Mental well-being: Patients with cancer, as well as their loved ones, can seek emotional support to help them cope with the uncertainty of cancer.

Prevention and Risk Reduction

Quitting smoking is the best way to reduce one’s risk of lung cancer. Patients who want help stopping smoking should ask their primary care provider for smoking cessation resources. Those who have a history of smoking should also talk with their provider about getting screened for lung cancer. Annual screenings are recommended for certain patients and help with the early detection of lung cancer, which can improve treatment outcomes.

Survivorship and Follow-Up Care

Cancer care continues even after a patient’s scans are clear. Long-term monitoring is required to check for recurrence or secondary cancers. Unfortunately, patients with NSCLC are at higher risk of developing a second lung cancer. A patient’s oncology team will set a schedule for ongoing monitoring.

It is normal to struggle with survivorship. Patients may feel a mixture of relief, guilt that they survived when other people with cancer did not, and anxiety that their cancer will come back. Joining other survivors in an online or in-person support group can help patients navigate these complicated emotions.

Find Expert Lung Cancer Care at RCCA

Fortunately, promising advances in NSCLC research and treatment are offering hope to patients with cancer. Individuals throughout New Jersey, Connecticut, Maryland, and the Washington, D.C., area count on the experienced medical oncologists at Regional Cancer Care Associates. Providing evidence-based care for all cancer types, malignant blood disorders, and benign blood disorders, the RCCA team creates personalized treatment plans for each patient. With over 20 locations, patients can receive advanced care close to home. For more information or to schedule an appointment, contact RCCA today.

Let Us Help You Fight

If you or a loved one is battling non-Hodgkin lymphoma, you aren’t alone. Our experts at Regional Cancer Care Associates are dedicated to delivering accurate diagnoses and effective treatments. To find out more or make an appointment, get in touch with us at one of our locations throughout Connecticut, Maryland, and New Jersey.

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