Lung cancer? Let's learn about Non-Small Cell Lung Cancer (NSCLC)!

Are you experiencing shortness of breath or a persistent cough? Maybe someone in your family has heard of lung cancer. Today we are going to talk about one of the most common types of lung cancer. Although this is a somewhat complex topic, we will talk about it simply, in a way that you can understand.

What is Non-Small Cell Lung Cancer (NSCLC)?

Simply put, Non-Small Cell Lung Cancer (NSCLC) is when the cells inside your lungs start to divide and grow abnormally and uncontrollably. Like a weed, these cells try to spread everywhere without control. There are two main types of lung cancer. One is called NSCLC. The other is called Small Cell Lung Cancer (SCLC) . These two names are based on how these cancer cells look under a microscope. The cells in SCLC are small, round, and shaped like a ball. The cells in NSCLC are larger.

SCLC is usually a little more aggressive than NSCLC, meaning it spreads more quickly. However, even though NSCLC cells are larger, they usually grow more slowly. The problem here is that NSCLC can be asymptomatic in its early stages . Therefore, by the time it is detected, the cancer may have already spread (metastasized) to other parts of the body. That's why it's so important to detect and treat it early . In fact, 80% to 85% of lung cancers are NSCLC.

Are there types of NSCLC?

Yes, there are several main types of NSCLC. Doctors identify these by looking at the cancer cells under a microscope and based on their appearance. We are mainly talking about three types:

• Adenocarcinoma: This is the most common type of NSCLC. It most often develops in the outer parts of the lungs.
• Large cell carcinoma: This type of cancer cells appear larger than other types when viewed under a microscope. It can develop anywhere in the lungs.
• Squamous cell carcinoma: This usually starts in the middle of the lungs, near the main airways through which we breathe.

In addition to these three main types, there are other rare types such as sarcomatoid carcinoma and adenosquamous carcinoma , but they are not seen as often.

What are the symptoms of this?

Okay, now you're probably wondering what symptoms NSCLC causes. As mentioned earlier, sometimes there may be no symptoms at all, which is the scariest part. But there are some common symptoms. If you have one or more of these, don't panic, but it's a good idea to see a doctor.

• Chest pain: Like someone is squeezing your chest, or a pain that gets worse when you breathe, laugh, or cough.
• Persistent cough: A cough that lasts for weeks, sometimes getting worse, without a cold.
• Coughing up blood: This is a bit of a scary sign. If you cough up blood or pink mucus, you should definitely see a doctor.
• Voice change/hoarseness: If your voice suddenly becomes hoarse or hoarse, that should also be checked.
• Loss of appetite and weight loss: You lose the desire to eat, along with weight loss for no apparent reason.
• Shortness of breath: Feeling short of breath even with mild exertion, or feeling more tired than usual when doing things like climbing stairs.
• Tiredness/Fatigue: Feeling tired all the time , even after sleeping well.
• Wheezing (a whistling sound) when breathing.
• Frequent lung infections such as bronchitis or pneumonia.

If you have one or more of these symptoms, don't be afraid to assume that it's NSCLC. Other health conditions can cause these symptoms, too. But if these symptoms persist, it's always a good idea to see a doctor for a checkup.

Why does this cancer develop? What are the risk factors?

Well, why does this NSCLC cancer develop? In fact, doctors can't say for sure why some people get it and others don't. But they have identified several risk factors that can affect it. A risk factor is something that increases your chance of developing the disease.

The main and most common risk factor for lung cancer is smoking. This risk is higher not only for those who smoke cigarettes, but also for those who use things like bidis, cigars, and hookahs. Also, those who do not smoke but are exposed to second-hand smoke (passive smoking / second-hand smoke) are also at risk.

Just think, when you smoke, thousands of harmful chemicals enter your lungs. These damage lung cells and can eventually turn into cancer cells.

Some other risk factors are:

• Family history of lung cancer: If your parents, siblings, or other family members have had the disease, there may also be a genetic influence.
• Asbestos exposure: You can be exposed to this from things like asbestos sheets used to build some houses in the past, or when working in asbestos-related industries.
• Exposure to metal and mineral dust: People who work in some factories may be at risk for exposure to things like arsenic, chromium, and nickel.
• Exposure to radon: This is a naturally occurring radioactive gas that comes from the ground. In some areas, its levels can be high inside homes.
• Having chronic respiratory diseases such as COPD (Chronic Obstructive Pulmonary Disease) or Pulmonary Fibrosis.
• If you have had radiation therapy to your breast or chest for another disease, such as breast cancer.
• Living in an environment with high levels of air pollution can also have some impact.

Not everyone who has these things will develop cancer. But it's important to know that these things increase your risk. Avoiding smoking is the best way to reduce your risk of lung cancer.

What are the possible complications of NSCLC?

One of the most dangerous things about a cancer like NSCLC is that it can spread (metastasize) to other parts of the body. When it spreads, the situation becomes even more complicated. Here are some of the most common places where NSCLC can spread:

• Adrenal glands (these are small glands located on top of the kidneys)
• Bones
• Brain
• Liver
• Lymph nodes (like lumps)
• Skin

When it spreads in this way, symptoms can occur in different organs. For example, if it spreads to the bones, it can cause severe bone pain, and if it spreads to the brain, it can cause headaches and seizures.

How do doctors recognize this?

Okay, so now you have symptoms. How do you know for sure if it's NSCLC when you go to the doctor?

First, the doctor will ask you about your symptoms, family history, and your habits (such as smoking). Then he will perform a physical examination and listen to your lungs.

Then, if there is a suspicion of NSCLC, they will order several tests to confirm it and find out what stage the cancer is at.

The most common tests are:

• Lung biopsy: This involves taking a small piece of tissue from a suspicious area of ​​the lung and examining it under a microscope. This can tell exactly if there are cancer cells and what type they are. There are different ways to take a biopsy. It can be done during a bronchoscopy, or by inserting a thin needle through the chest (needle biopsy).
• Bronchoscopy: In this, a small camera-equipped tube is passed through the mouth or nose, down the windpipe, and into the lungs. This allows the doctor to see inside the lungs and, if necessary, take a sample (biopsy).
• Imaging tests: These take pictures of the inside of the body to see things like the location, size, and spread of the cancer.
• Chest X-ray: This is a basic test.
• CT scan: This can take clearer, cross-sectional images than an X-ray.
• PET scan: This helps find areas where cancer cells are active.
• MRI scan of the brain: This is used to see if the cancer has spread to the brain.
• Video-assisted thoracic surgery (VATS): This is also a minor surgery to look inside the chest. A camera and instruments are inserted through a few small incisions to examine and, if necessary, take a biopsy.

Based on the information obtained from these tests, the doctor determines whether you have NSCLC, if so, how far it has spread (staging), and what type of treatment is appropriate.

What are the treatments?

Many people are scared when they hear the word cancer, and that's normal. But there are now very advanced treatments for NSCLC. The type of treatment you get depends on many factors, including the type of cancer, its stage, whether there are any genetic changes in the cancer cells, and your overall health.

• Surgery: If the cancer is confined to the lungs, meaning it has not spread to other areas (in the early stages), surgery is the first option. This involves removing the cancer and a small amount of healthy tissue around it. Sometimes, depending on how far the cancer has spread, a section of the lung (lobectomy) or the entire lung (lung resection / pneumonectomy) may be necessary.

Imagine, there is a weed in a garden. This surgery is like pulling it out first. But not everyone can do the surgery, you have to be qualified for it.

• Chemotherapy: You may have heard of this. This involves giving the body drugs that kill cancer cells. These drugs can be given as injections or as pills. This is the most common treatment for NSCLC. Chemotherapy may be given alone, to shrink the tumor before surgery, to kill any remaining cells after surgery, or in combination with radiation therapy.

• Immunotherapy: This is a relatively new, but very effective treatment. It involves stimulating your body's own immune system to recognize and destroy cancer cells. It's like training your own soldiers to fight cancer. It doesn't work for all types of NSCLC, and special tests are being done for that, too.

• Targeted therapy: This is also a very specific treatment. It uses drugs that target specific genetic mutations or proteins that help cancer cells grow and spread. The advantage of this is that it causes much less damage to healthy cells than chemotherapy. This also requires testing your cancer cells for those specific mutations.

• Radiation therapy: This uses high-energy X-rays to kill cancer cells. These rays are aimed at the exact location of the cancer. This can be given in combination with chemotherapy, alone, or before or after surgery. Sometimes, this treatment is also used to reduce pain.

Often, because NSCLC is less likely to be detected early, doctors will use one or more of these treatments together (combination therapy). Your oncologist will develop the treatment plan that is best for you.

How long does it take to heal?

The recovery time after NSCLC treatment varies from person to person. It depends on many factors, including the size of the cancer, where it is located, the type of treatment you received (such as surgery, chemotherapy, radiation), and your body's ability to heal. Some people may recover in a few months. Others may take years, and may need to have follow-ups. So, it's best to ask your doctor how long it will take and what to expect based on your situation.

When should you see a doctor?

If you are being treated for NSCLC, or have just finished treatment, there are times when you may need to see a doctor quickly. Be aware of these things:

• It's okay if you have new shortness of breath or if your existing shortness of breath worsens.
• If you have a fever over 100.4 degrees Fahrenheit (38 degrees Celsius), especially while receiving chemotherapy.
• If you experience severe pain (e.g., in the chest, bones) that does not subside despite taking medication.
• If new symptoms appear (e.g., difficulty speaking, loss of consciousness, severe headache), or if existing symptoms become severe,
• If you have persistent vomiting or diarrhea.

In such a situation, notify your oncologist or his/her team immediately. If not, go to the emergency department of the nearest hospital.

What will life be like with this situation?

You may be wondering, "What is life like with this condition?" In fact, the length of time you can live with NSCLC (life expectancy) depends on many factors, including the stage of the cancer at diagnosis, the type of NSCLC, and your overall health.

For example, in early-stage (localized) NSCLC , meaning the cancer is confined to the lungs, the five-year survival rate is about 65% . This means that 65 out of 100 people diagnosed with this condition will still be alive after five years.

If the cancer has spread to nearby tissues or lymph nodes (regional NSCLC) , this figure is about 37% . If the cancer has spread to distant sites in the body (e.g., liver, brain, bones) (metastatic / distant NSCLC) , the five-year survival rate is about 9% .

But remember: These survival rates are just averages based on data from a large group of people. They don't tell you exactly how long you'll live or how your body will respond to treatment. Everyone's journey is different. So it's important to talk to your doctor about how these statistics affect you.

Recently, these survival rates have been improving due to new treatments (especially targeted therapy and immunotherapy).

NSCLC is a curable disease, especially if detected and treated early. However, factors such as the type of cancer, its stage, and your overall health determine the outcome (prognosis).

Although NSCLC cannot be cured, in most cases it can be controlled and symptoms can be reduced (treatable). Many people with NSCLC successfully manage their symptoms and live a good quality of life.

The most important thing we need to keep in mind is

Finding out you have cancer can be one of the most difficult experiences you'll ever face. It's normal to feel scared, anxious, and frustrated. No matter what stage of Non-Small Cell Lung Cancer (NSCLC) you have, treatment can help reduce your symptoms and improve your quality of life.

Talk to your doctor about your options, treatment plan, and possible side effects. Don't be afraid to ask questions. During this uncertain time, it can be helpful to talk to your family, friends, and, if necessary, a counselor or social worker.

Also, joining a support group, whether online or in your area, can help you feel less alone, learn from others' experiences, and gain strength. Remember, you are not in this fight alone.

` Lung cancer, NSCLC, Non-Small Cell Lung Cancer, Cancer symptoms, Cancer treatment, Smoking, Respiratory diseases