Non-small Cell Lung Cancer

Non-small Cell Lung Cancer

Introduction

Non-small cell lung cancer (NSCLC) is a general term that defines all lung cancers that are not of small-cell type. They constitute types like bronchoalveolar, adenocarcinoma, squamous cell, and large cell carcinoma. Treatment of this cancer depends on the stage of illness of someone.

Diagnosis and Treatment of NSCLC

There exists several treatment options for NSCLC patients that vary depending on the cancer stage. Surgery is mainly appropriate for stage I and stage II cancers. The victims are operated through an incision in the skin to remove the lung section where the tumour develops (Bhimani et al. 2020, P93-98). This therapy provides the best chance for long-term disease survival as well as a possibility for a cure. Cases of stage II and IV cancers are not eligible for surgery (Johnson, Tod, Brummell and Collins 2018, P12870). The two lung cancer operations are lobectomy that involves a part of the lung or pneumonectomy, which pertains to the removal of the whole lung.

Chemotherapy is approved by doctors mainly after surgery to ensure that the cancer cells do not re-emerge. Adjuvant chemotherapy is principally prescribed for patients with stage II and stage IIIA disease (Wang, Dhokia, Menon and Martindale 2018, P486). This plan consists of a combination of drugs such as cisplatin, which damages the DNA of the tumour, however, it may result in ear damage hence loss of hearing. Carboplatin and paclitaxel agents interfere with the cell division in the tumour. In cases where adjuvant remedy does not work, medical practitioners may recommend second-line chemotherapy. Furthermore, there exists neoadjuvant

chemotherapy, which is initiated before surgery and the radiation. This procedure shrinks the tumour to ease the operation; therefore, increasing the effectiveness of other therapies.

Additionally, the introduction of targeted treatments for lung cancer has provided more hope than never before. Unlike chemotherapy and surgery, where there is no specific target, targeted procedures are designed to attack the affected cells (Yang et al. 2017, P568-574). Targeted therapies test a victim’s tumour tissue to locate specific genetic alterations that can be combated using particular drugs. They achieve this by blocking such cells that appear on the surfaces. Such treatments are approved for people with advanced lung cancer with specific molecular biomarkers. For instance, the erlotinib medication blocks the epidermal growth factor receptor {EGFR} on the surface (Tsui et al. 2018, P6). This receptor acts as a doorway to allow substances inside the cell, which may facilitate the growth and spread of cancer cells.

Afatinib is also a procedure that was approved by the UK Medical Healthcare products Regulatory Agency {MHRA} for cancer therapy for the initial treatment of metastatic NSCLC in patients with the EGFR gene. It complements the erlotinib therapy. Moreover, crizotinib benefits NSCLC victims who have the ALK gene mutation (Gadgeel et al. 2018, P38-42). The medication blocks ALK and prevents further growth of the tumour. However, crizotinib was valid until 2014, where the cancer cells continued to develop even after treatment hence was replaced by ceritinib.

More inventions on cancer procedures yielded the immunotherapy. According to a preview statement from the Public Health Service of England, this method has no side effects on the patients, unlike other remedies (Hendriks and Besse 2018). The therapy uses an individuals’ immune system to mitigate the growth of cancer cells. In 2016, the MHRA approved nivolumab immunotherapy for the treatment of metastatic squamous NSCLC since chemotherapy proved to be

ineffective (Thomas 2019, P1109-1110). Nivolumab interferes with the bodies’ PD-1, which deters the ability of the immune system to attack the tumours. Other immunotherapy agents include Avastin, which prevents tumours from developing in new blood cells.

Radiation therapy is also an alternative remedy for the treatment of NSCLC recommended by the UK National Cancer Research Institute Clinical and the Translational Radiotherapy Research Working Group (NCRI CTRad). High-dose radiation treatments are advocated by cancer specialists for individuals with stage IV cancer (Hanna 2017, P662-663). It helps in the extenuation of non-small cell lung cancer symptoms.

My Option for Testing and Treatment

According to my comprehension of the available cancer testing and medication therapy, and the strong guidelines availed by cancer specialists, I opt to go for immunotherapy. The procedure involves my immune system directly; therefore, I am assured of a reliable health defence system. The therapy also has no side effects on my body compared to other treatments.

Conclusion

With the growing cancer cases, the integration of more favourable cancer therapies has helped induce the life expectancy of tumour patients. Procedures such as surgery, chemotherapy, radiotherapy, immunotherapy, and targeted treatments have assisted in relieving stress for NSCLC victims. They are assured of living a cancer-free life.

References

Bhimani, J., Philipps, L., Simpson, L., Lythgoe, M., Soultati, A., Webb, A. and Savage, P., 2020. The impact of new cancer drug therapies on-site specialized cancer treatment activity in a UK cancer network 2014–2018. Journal of Oncology Pharmacy Practice, 26(1), pp.93-98.

Gadgeel, S., Shaw, A.T., Barlesi, F., Crinò, L., Yang, J.C.H., Dingemans, A.M.C., Kim, D.W., De Marinis, F., Schulz, M., Liu, S. and Gupta, R., 2018. Cumulative incidence rates for CNS and non-CNS progression in two phase II studies of alectinib in ALK-positive NSCLC. British journal of cancer, 118(1), pp.38-42.

Hanna, G., McDonald, F., Greystoke, A., Forester, M., Brown, S., Hall, E., Faivre-Finn, C., Harrow, S., Hatton, M. and Chalmers, A., 2017, May. UK NCRI CTRad consensus on drug and radiotherapy combination platform studies in NSCLC. In Radiotherapy and Oncology (Vol. 123, pp. S662-S663). ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND: ELSEVIER IRELAND LTD.

Hendriks, L. and Besse, B., 2018. New windows open for immunotherapy in lung cancer.

Johnson, M., Tod, A.M., Brummell, S. and Collins, K., 2018. Discussing potential recurrence after lung cancer surgery: Uncertainties and challenges. European journal of cancer care, 27(5), p.e12870.

Thomas, R., 2019. WS03. 08 Panel-Emerging Therapies-Immunotherapy. Journal of Thoracic Oncology, 14(10), pp.S1109-S1110.

Tsui, D.W.Y., Murtaza, M., Wong, A.S.C., Rueda, O.M., Smith, C.G., Chandrananda, D., Soo, R.A., Lim, H.L., Goh, B.C., Caldas, C. and Forshew, T., 2018. Dynamics of multiple resistance mechanisms in plasma DNA during EGFR‐targeted therapies in non‐small cell lung cancer. EMBO molecular medicine, 10(6).

Walter, H.S., Dickens, E., Muhammad, S.U.I., Sridhar, T., Fennell, D. and Ahmed, S., 2018. Experience of immunotherapy treatment for non-small cell lung cancer within University Hospitals Leicester in patients treated both within and outside of a clinical trial. Lung Cancer, 115, p.S41.

Wang, M., Dhokia, P., Menon, S. and Martindale, B., 2018. 62P First-line systemic real-world treatment of patients with advanced/metastatic NSCLC in the UK. Annals of Oncology, 29(suppl_10), pp.mdy486-014.

Yang, J.J., Zhou, Q., Yan, H.H., Zhang, X.C., Chen, H.J., Tu, H.Y., Wang, Z., Xu, C.R., Su, J., Wang, B.C. and Jiang, B.Y., 2017. A phase III randomised controlled trial of erlotinib vs gefitinib in advanced non-small cell lung cancer with EGFR mutations. British journal of cancer, 116(5), pp.568-574.