Lung Cancer - Non-Small cell
Any pain in the chest, side, or back; breathing problem; or cough that persists, worsens, or produces blood warrants an immediate visit to a health care provider.
Follow-up
Following surgery for any operable lung Cancer, the patient has a risk of developing a second primary lung Cancer. Following any treatment, the original tumor may come back.
- Many lung Cancers come back within the first 2 years after treatment.
- The patient should undergo regular testing so that any recurrence can be identified as early as possible.
- The patient should be checked every 3-4 months for the first 2 years and every 6-12 months afterward.
Palliative and terminal care
Palliative care or hospice care refers to medical or nursing care to reduce symptoms and suffering without attempting to cure the underlying disease. Because only a small number of people with lung Cancer are cured, relief from suffering becomes the primary goal for many.
- The patient, his or her family, and the doctor will probably recognize when the patient has reached this point
- Whenever possible, the transition to palliative care should be planned in advance.
- Planning should begin with a three-way conversation between the patient, someone representing the patient (if he or she is too ill to participate), and the health-care provider.
- During these meetings, likely outcomes, medical issues, and any fears or uncertainties can be discussed.
Palliative care may be given at home, in a hospital if home care is not possible, or in a hospice facility. Palliative care consists mainly of treatments to relieve shortness of breath and pain.
- Breathlessness will be treated with oxygen and medications such as opioids, which are narcotic drugs such as opium, morphine, codeine, methadone, and heroin.
- Pain management includes anti-inflammatory medications and opioids. The patient is encouraged to participate in determining doses of the pain medication, because how much is needed to block pain will vary from day to day.
- Other symptoms, such as anxiety, lack of sleep, and depression, are treated with appropriate medications and, in some cases, complementary therapies.
Prevention
Lung Cancer remains a highly preventable disease because 90% of lung Cancers occur in smokers or former smokers. The best way to prevent lung Cancer is to not smoke.
- Cigarette smoking is highly addictive, and quitting often proves to be difficult. However, smoking rates have recently decreased in North America and in other parts of the world.
- People who smoke who use a combination of supplemental nicotine, group therapy, and behavioral training show a significant drop in smoking rates.
- People who smoke who use a sustained-release form of the antidepressant bupropion (Wellbutrin, Zyban) have a much higher quitting rate than average and a higher abstinence rate after 1 year.
The American Cancer Society does not currently recommend routine chest x-ray screening for lung Cancer. This means that many health insurance plans do not cover screening chest x-ray films.
People who smoke or used to smoke may want to have a periodic chest x-ray film anyway. They should discuss this with their health care providers.
Outlook
Overall, 14% of people with NSCLC survive for at least 5 years.
- People who have stage I NSCLC and undergo surgery have a 70% chance of surviving 5 years.
- People with extensive nonoperable NSCLC have an average survival duration of 9 months.
How well the person with NSCLC functions can have a strong effect on the survival duration. A person with small-cell lung cancer who functions well has an advantage over someone who cannot work or pursue normal activities.
Complications of NSCLC
- Spinal cord compression
- Bone pain
- Hormone or electrolyte imbalances
- Problems with mental functioning or concentration
- Visual problems
- Liver failure
- Pain in right side from enlarged liver
- Weight loss
- Severe hemoptysis
Complications of chemotherapy
- Unexplained fever (due to neutropenia or infection)
- Bleeding (due to low platelet count)
- Electrolyte imbalances
- Kidney failure
- Peripheral neuropathy (tingling, numbness, pain in extremities)
- Hearing problems