Thursday, 22 September 2016

Non-small cell lung cancer (NSCLC)

Non-small cell lung cancer (NSCLC)
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It usually grows and spreads more slowly than small cell lung cancer.
Histologically, non small cell lung cancer is divided into 3 subtypes:
·         Adenocarcinomas are often found in an outer area of the lung. It's the most common kind of lung cancer among both smokers and nonsmokers. It often grows more slowly than other lung cancers.
·         Squamous cell carcinomas (epidermoid)  start in cells that line the inner airways of the lungs and are usually found in the center of the lung next to an air tube (bronchus).
·         Large cell (undifferentiated) carcinomas can occur in any part of the lung. They tend to grow and spread faster than the other 2 types.
Causes
Smoking causes most cases of lung cancer. The risk depends on how many cigarettes and for how long the person has smoked. Being around the smoke from other people also raises your risk of lung cancer. But some people who have never smoked can develop lung cancer. Constant exposure to high levels of polluted air and drinking water that has a high level of arsenic can increase the risk of lung cancer. Other things that make lung cancer more likely include working with certain chemicals. Such chemicals include uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust and also certain alloys, paints, pigments, and preservatives and products using chloride and formaldehyde.

Symptoms

Like other types of lung cancer, symptoms can include:
  • Chest pain 
  • Coughing that lasts or gets worse
  • Hoarseness or voice changes
  • Harsh, raspy sounds when you breathe
  • Wheezing
  • Weight loss
  • Little appetite
  • Shortness of breath
  • Coughing up blood or mucus
  • Fatigue
  • Lasting lung problems, like bronchitis or pneumonia.
Diagnosis
After physical examination and CBC, chest x-ray is often the first test performed. Chest radiographs may show the following:
·         Pulmonary nodule, mass, or infiltrate
·         Mediastinal widening
·         Atelectasis
·         Hilar enlargement
·         Pleural effusion
In most cases, a piece of tissue is removed from the lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:
·         Bronchoscopy combined with biopsy
·         CT-scan-directed needle biopsy
·         Endoscopic esophageal ultrasound (EUS) with biopsy
·         Mediastinoscopy with biopsy
·         Open lung biopsy
·         Pleural biopsy





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