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Lung Cancer, Non-Small cell

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 whose goal is 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 of suffering becomes the primary goal for many.

  • The patient, her family, and her doctor generally recognize when the patient has reached this point.
  • Whenever possible, the patient should plan the transition to palliative care in advance.
  • Planning should begin with a conversation between the patient (or someone representing the patient if she is too ill to participate) and her health care provider.
  • During these meetings, the patient can discuss likely outcomes, medical issues, and any fears or uncertainties she may have.

Palliative care may be given at home, in a hospital if the patient cannot be cared for at home, or in a special hospice. Palliative care consists mainly of treatments to relieve shortness of breath and pain.

  • Breathlessness is treated with oxygen and medications such as opioids (narcotic drugs such as opium, morphine, codeine, methadone, and heroin).
  • Pain treatment includes anti-inflammatory medications and opioids. The patient is encouraged to participate in determining doses of the pain medication because the amount needed to block pain varies from day to day.
  • Other symptoms such as anxiety, lack of sleep, and depressionare treated with appropriate medications and, in some cases, complementary therapies.

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Prevention

Lung Cancer remains a highly preventable disease because 85% of lung cancers occur in people who smoke or used to smoke. The best way to prevent lung cancer is not to smoke.

  • Cigarette smoking is highly addictive, and quitting often proves to be difficult. However, smoking rates have decreased recently 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.

Screening for lung cancer

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.

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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

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