Advanced Stage Non-small Cell Lung Cancer
Advanced stage non-small cell lung cancer is one of two types of lung cancers. Lung cancer is caused by abnormal proliferation and growth of lung cells. Cells that grow uncontrollably cause tumors.
Non-small cell lung cancer is the most common type of lung cancer. It constitutes 80% to 85% of lung cancers. 60% of patients are metastatic (advanced stage). Metastasis refers to the process of cancer cells leaping to the lymph nodes or to another part of the body, through the bloodstream. Cancers of the lung that metastasize are called advanced stage non-small cell lung cancer.
Stages of Non-Small Cell Lung Cancer
Non-small cell lung cancer is staged according to its size and extent of the disease. The treatment method applied according to the stages of cancer may also vary. The extension of advanced lung cancer is evaluated in different stages:
- Stage 0: This stage is called “cancer in place” (carcinoma in situ). The tumor size is quite small and has not yet spread to deeper tissues or other organs.
- Stage 1: Cancer cells begin to descend into deep tissues in the lung. It has not yet affected lymph nodes.
- Stage 2: Cancer cells tend to leap to lymph nodes and chest wall near chest cells.
- Stage 3: The tumor metastasized to the lymph nodes, trachea, esophagus, and organs such as the heart.
- Stage 4: Advanced stage of non-small cell lung cancer. Cancer has spread to other organs.
What is Advanced Stage Non-Small Cell Lung Cancer
40% of NSCLC patients are diagnosed at advanced stage. In stage 4, the cancer has spread to distant parts of the body. Organs such as the liver, heart, bones, brain or liver may be affected. The prompt treatment of these patients is critical because advanced stage non-small cell lung cancer affects multiple organs and the tumors have grown and may compromise their function.
Stage IV Non-small Cell Lung Cancer
In advanced stage non-small cell lung cancer treatment, even if the cancer cannot be completely cured, an approach focused on improving life expectancy and quality is adopted.
The 5-year lung cancer survival rate is a rate based on how many people can live for 5 years after the cancer has been diagnosed. For Stage 4 lung cancer, this rate is 4.7%. However, the success of the treatment may vary from person to person. The factors affecting this change:
- General health
- Patient’s age
- Body’s response to treatment
- Cancer biomarkers (EGFR, ROS, ALK, NTRK, BRAF, FGFR, MET, RET, etc)
Advanced Stage Non-small Cell Lung Cancer Treatments
Treatment options for stage IV lung cancer are selected by doctors depending on which areas the cancer has spread and its biomarkers. These treatment methods cannot completely heal but are applied to alleviate the side effects and improve the quality of life. Treatment options are:
- Surgery: The tumor formed in the liver, rib cage and lymph nodes can be removed surgically. However, it is not effective in cases where the tumor metastasizes to more than one organ. It can be preferred to relieve the pain and side effects caused by the tumor.
- Radiation therapy: It is preferred for tumor shrinkage and suppression of side effects caused by the tumor.
- Immunotherapy: It is a treatment method in which the natural immune system of the body is strengthened to fight cancer cells more effectively. It is effective in extending the life span.
- Targeted therapy: Targeted therapy is the use of drugs that target specific receptors and proteins to slow down the spread and growth of the tumor (e.g. EGFR, ROS, ALK, NTRK, BRAF, FGFR, MET, RET).
- Chemotherapy: It is the use of drugs that act against cancer cells. It can be used with other treatment methods.
Clinical Trials for Stage IV Non-small Cell Lung Cancer
Clinical trials for cancer disease continue to find new treatments. Innovative treatments and clinical research have been a glimmer of hope for stage IV cancer patients. Innovative methods such as newly developed smart targeted drugs or combination treatments have been tried to extend the life span of advanced cancer patients.