Non Small Cell Lung Cancer and Taxotere

Classifications

The majority of cases of lung cancer fall into the category of non-small cell lung cancer (NSCLC), the kind of lung cancer that Taxotere is approved to treat. The other type, small cell lung cancer, only comprises 10-15% of cases. There are three main types of NSCLC, each affecting a different type of cell within the lung, but all have similar prognoses and courses of treatment.

Adenocarcinoma

Adenocarcinomas are the most common form of lung cancer and are linked to smoking, although they are also the most common form of lung cancer found in non-smokers. This particular kind of lung cancer develops in the outer region of the lung, in developing air sacs which would normally produce mucous. Thankfully, this common form of lung cancer grows more slowly than the others and is often found before it metastasizes to other parts of the body. Therefore, the prognosis for this type of lung cancer is generally better.

Squamous Cell (Epidermoid) Carcinoma

Squamous cells are thin flat cells, resembling fish scales, which line the inside of the airways. While squamous cells are found throughout the body, cancer which develops in these cells in the lungs is known as an epidermoid carcinoma. It usually begins in one of the bronchi, which connect the trachea to the lung, or one of the main airways. This cancer is even more strongly associated with smoking and is found in 25-30% of people who present with lung cancer.

Large Cell (Undifferentiated) Carcinoma

Large cell carcinomas are considered to be one of the more dangerous forms of lung cancer because it can grow and develop quickly. About 10-15% of lung cancer cases are undifferentiated carcinomas. This type can be found in any part of the lung and is most similar to small cell lung cancer.

Symptoms

Like all cancers, it is best if NSCLC is caught early and treatment begins immediately. Unfortunately, many of the symptoms of lung cancer are also associated with other health issues like the flu, anemia, or pneumonia. Common symptoms include

  • Chronic coughing or changes in coughing patterns
  • Coughing blood or rust-colored phlegm
  • Pronounced pain in the chest area, shoulders, or back
  • Loss of appetite and loss of weight
  • Difficulty breathing such as hoarseness, wheezing, or shallow breathing
  • Weakness, tiredness, headaches
  • Lung infections such as recurrent bronchitis or pneumonia

More severe symptoms of cancer that may have spread or metastasized include bone pain, weakness or numbness in an extremity or limb, yellowing of the eyes and skin, and enlarged lymph nodes or swollen lumps under the skin. People at particular risk for lung cancer include smokers or those with a history of smoking and people over the age of 55.

Diagnosis

Many organizations suggest that those with an increased risk of lung cancer should get regular computerized tomography (CT) scans to check for lung cancer. If patients present with symptoms of lung cancer, a doctor will most likely begin with an X-ray and then a CT scan to look for smaller lesions. In addition, they may be able to perform a sputum cytology, in which the phlegm from a persistent cough can be analyzed under a microscope for cancerous cells. If a lump or lesion is found, the doctor will perform a biopsy in which a section of the mass is removed with a needle for further analysis.

Treatment

Fortunately, NSCLC grows more slowly that small cell lung cancer, and can usually be treated in earlier stages. In stage 0 and stage I, lung cancer is almost always treated with surgery alone. Stage 0 is, by definition, a non-invasive form of lung cancer in which the tumor is not infiltrating into the lung tissue. In stage I, the tumor may have begun to invade slightly, but it is still mostly contained. The surgeon may perform a segmentectomy or wedge resection in which only part of a lobe in the lung is removed. Alternatively, a lobectomy or a pneumonectomy, in which an entire lobe or even a whole lung is removed, may be performed.

In stage II lung cancer, chemotherapy is sometimes used before and/or after surgery to shrink the tumor and then to kill any remaining cancerous cells that may have spread to different areas of the lung or body that have not yet been detected.

With stage III and IV lung cancer, in which the cancer has spread to lymph nodes, a combination of chemotherapy, surgery, and radiation is generally advised. At this point, the cancer cannot be completely removed through surgery and it is much more difficult to cure.

Taxotere as a Treatment Option for NSCLC

Taxotere is almost never a primary chemotherapy treatment option for patients with lung cancer. Generally, it is used as what is known as a “second line treatment.” This means if another course of chemotherapy fails (usually a platinum-based therapy), Taxotere may be used as a secondary option to give a patient more time in late stages of the disease. In this case, Taxotere is usually administered on its own, not in combination with other chemotherapy drugs. On average, the use of Taxotere as a second-line treatment for NSCLC can add three months to a patient's life. Research in drug treatment for lung cancer focuses on developing targeted therapies and immunotherapies which are more specific to the particular growth mechanisms of lung cancer.

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