Non-small Cell Lung Cancer

Lung cancer affects the lungs in your body, the organ that is responsible for taking in oxygen and releasing carbon dioxide (the process of breathing), and is the leading cause of death worldwide. There are two main types of lung cancers:

Small cell lung cancer: this type of cancer grows and spreads rapidly and has two stages based on when it is discovered and treated. When found in only one lung it is at the limited stage. However, it is considered to be at the extensive stage if found in both lungs and other parts of the body. This form of cancer is mostly found in heavy smokers.

Non-small cell lung cancer: this is the more common form of lung cancer, as a number of different types of cancers are grouped under non-small cell lung cancer since they behave in the same way, even though they affect different types of cells. There are three main types of non-small cell lung cancer:

  • Squamous cell carcinoma: begins in the middle of the lungs where it affects the squamous cells

  • Large cell carcinoma: affects large cells and may begin anywhere in the lung, spreading rapidly

  • Adenocarcinoma: common amongst people whose cancer is not a result of smoking, it begins in the outer edges of the lung.

Risk factors typically associated with lung cancer include:

  • Smoking or second hand smoke

  • Exposure to radon or asbestos

  • Exposure to toxic elements at the workplace such as radioactive substances, arsenic, coal, chromium, nickel or diesel exhaust

  • Family history of lung cancer

​In its earliest stages, lung cancer does not cause any signs or symptoms. Only once the cancer has progressed and is more advanced, do symptoms start to manifest themselves. Common symptoms are:

  • A cough that does not go away

  • Chest pain

  • Coughing of blood

  • Shortness of breath

  • Wheezing

  • Hoarseness

  • Loss of weight

  • Tiredness

  • In some cases, depending on the location of the cancer, it can also cause a swelling of the face or the neck​

As the disease progresses, you may experience additional symptoms including:

  • Trouble swallowing

  • Coughing up large amounts of mucus

  • Hypercalcemia, which is the removal of calcium from the bones which is released in the bloodstream and causes fatigue, nausea and constipation.​

​If you find any of the signs and symptoms associated with lung cancer, consult your family doctor. If your doctor fears that there may be indications of non-small cell lung cancer he/she will refer you to a specialist. You can consult the qualified staff of the Oncology Service Line at the Aga Khan University Hospital.
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​​

After an examination by the specialist, he/she may ask you to undergo any one of these tests to diagnose lung cancer:

  • Physical exam: using a physical exam, your doctor will check for tiredness or shortness of breath as well as checking overall health.

  • Imaging: using X-ray or Computerized Tomography (CT) scan, your lungs are examined for effects of cancer such as lesions or nodules.

  • Laboratory tests: samples of your tissue, blood or urine may be taken to check for disease.

  • Sputum cytology: sputum is the mucus you cough up which the doctors use to check for cancer cells by examining it under a microscope.

  • Biopsy: a small sample of cancer cells is taken from your lungs in this procedure to diagnose for cancer cells.

  • Bronchoscopy: a thin, flexible tube is inserted into your lungs via your mouth or nose to look for abnormalities or indications of cancer. If needed, samples can also be extracted of tissue for further examination.​

​Treatment of non-small cell lung cancer is dependent upon the stage at which it is diagnosed, along with your age, medical history and overall health. Based on these factors, your doctor may recommend any one of these following procedures for treatment:

Surgery: there are four types of surgery which are used to treat non-small cell lung cancer depending upon the size, location and extent of the cancer as well as your overall health at the time:

  • Wedge resection: removes a small section of the affected lung along with some normal tissue

  • Lobectomy: removes the entire lobe of the lung

  • Pneumonectomy: removes an entire lung

  • Sleeve resection: removes a part of the bronchus after which the lung is reunited with the healthy bronchus

Radiation therapy: X-ray or other radiation beams are used to kill cancer cells or to stop them from growing. Radiation therapy can be administered in one of two ways: either from outside the body using radiation beams, or internally through the use of capsules or injections

Chemotherapy: using anticancer drugs, cancerous cells are killed or restricted from growing. There are a number of anticancer drugs available. Which drug will suit your treatment depends on the stage and location of the cancer. Chemotherapy is not necessarily a stand-alone treatment and may be given in conjunction with one of the other treatments for non-small cell lung cancer. Additionally, targeted therapy is another form of treatment using drugs that targets specific areas of cancer cells in order to stop them from growing. These have been found to be especially useful in treatment of some non-small cell lung cancers

Photodynamic therapy (PDT): drugs and laser light are used in combination for the elimination of cancer cells. Inert drugs are introduced into the body, and these have a tendency to attach themselves to cancer cells. Subsequently, with the use of laser light, these drugs are made active causing them to kill the cancer cells. Little or no damage is caused to normal cells.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

​Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​​

​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.