A transparent, almost invisible ribbon is worn by survivors and families affected by Lung Cancer, a.k.a. the invisible cancer. Previously called bronchogenic carcinoma, the invisible cancer, or lung cancer, this deadly disease is rarely diagnosed before the battle is half over. The monster sneaks up for an attack and lies in wait, often taking years to cultivate its stronghold within the walls of your lung and your precious lymphatic vessels or lymph nodes. It has often spread to other areas of the body and reached a frightening size before the victim says, “Hey doc, I’ve got a little cough that won’t go away,” or maybe, “Hey doc, I get really dizzy when I walk very far.” Now the doctor does a routine chest x-ray, if the patient is lucky, and discovers the severe condition that may wreck his patient’s life – if not end it.
Lung cancer affects 130,000 + Americans each year. There are two main types of Lung Cancer: Small Cell Lung Cancer (SCLC) and Non-Small Cell Lung Cancer (NSCLC). 80% of cases are NSCLC and 90% of these were brought on by exposure to cigarette smoke. Lung cancer is now #1 in cancer related deaths in America. Early detection and aggressive treatment are crucial to surviving this silent but deadly disease.
Small Cell Lung Cancer is the most aggressive form, but is fortunately very rare. Non-Small Cell Lung Cancer (NSCLC) is more common, though just as fatal as Small Cell Lung Cancer if not detected very early. There are four main categories of NSCLC:
1 Squamous cell carcinoma: About 25% – 30% of all lung cancers are squamous cell carcinomas. They are associated with a history of smoking and tend to be found centrally, near a bronchus.
2 Adenocarcinoma: This type accounts for about 40% of lung cancers. It is usually found in the outer region of lung. People with one type of adenocarcinoma, known as bronchioloalveolar carcinoma (sometimes called bronchoalveolar carcinoma or bronchioalveolar carcinoma) tend to have a better outlook (prognosis) than those with other types of lung cancer.
3 Large-cell undifferentiated carcinoma: This type of cancer accounts for about 10% – 15% of lung cancers. It may appear in any part of the lung, and it tends to grow and spread quickly resulting in a poor prognosis.
THE BUMPY ROAD TO EARLY DETECTION
How do you detect lung cancer? There is one simple answer and many complicated ones. We will start with the simple answer: Routine chest x-rays. Any smoker over 30 should be having a yearly chest x-ray. Any non-smoker over 35 should also have one. The complicated answer: there is no single effect way to diagnose early stages of lung cancer; x-rays rarely reveal early stages insurance will not pay for PET or CAT scans unless there is already evidence of trouble, and these scans are not fool-proof. Definitive evidence is not achievable until a pathologist examines cells removed from suspicious tissue. This brings us back around to the simple answer: Routine Yearly Chest X-Rays.
Why is early detection so important? Well, if you are asking this question, then you have been lucky enough to never watch a loved one suffer through the advanced stages of cancer. With all cancer, the first and most important thing is to prevent the cancer cells from spreading to other areas of the body. As the cancer spreads, or metastasizes, it is upgraded to a more severe classification. The classifications for NSCLC are generally accepted as follows:
Stage 0: Cancer Cells have not spread beyond cells of the lungs lining
Stage I: Tumor is small (less than 3 cm) and has not spread or become intrusive
Stage II: Tumor is any size with local lymph involvement or it invades local structures (the chest wall or diaphragm)
Stage IIIA: The tumor is any size with regional lymph node involvement on same side of chest as tumor, or the tumor is invading local structures with lymph node involvement.
Stage IIIB: The tumor is any size with spread to more distant lymph nodes such as those on the other side of the chest or above the collarbone, or the tumor is invading the mediastinal region, or the fluid around the lungs contains cancerous cells.
Stage IV: The cancer has spread through the blood to other areas of the body, most commonly the brain, bone, adrenal glands, the other lung, or the liver. This is advanced NSCLC.
With each step up the cancer ladder, the chances of remission drastically decline. Doctors do not always like to put your odds on the table and the data on this can vary from one study to the next. Doctors agree on only one thing, preventing the cancer from reach the lymph system is crucial, this is reflected in the survival rates. In NSCLC, the patients average a 5 years survival at the following rates:
Stage I: 47%
Stage II: 26%
Stage III: 8%
Stage IV: 2%
These are averages and the data can be deceiving. These studies include a stagering number of patients who refused treatment, discontinued treatment, not to mention those who died from unrelated medical conditions. Various treatments, such as chemotherapy, radiation, and nutritional maintenance increase these odds dramatically.
THE LYMPH NODES
Why are cancerous lymph nodes such a catastrophe? First off, it is not a death sentence. It does, however, create a much more complicated scenario for treatment. The involvement of lymph nodes is the difference between a Stage 0 or I and a Stage II or III diagnosis.
What is it? The lymphatic system is a filtration network of vessels or nodes that reach from one end of your body to the other. When cancer cells enter the lymphatic system, they can potentially move from one area of the body to another, which is why doctors try so hard to prevent the cancer from reaching the lymph nodes. Depending on the particular lymph node, the cancer will tend to travel to specific areas of the body. Doctors will monitor the lung, liver and brain closely for further metastasis. Patients with cancerous lymph nodes must be monitored regularly for the appearance of abnormalities in affected lymphatic regions. This will be done with any combination of CAT, PET, Bone or MRI scans.
Patients diagnosed with any stage should fight it aggressively. You hit the monster hard and relentlessly with chemotherapy and radiation and you fight through the side effects. Of all Stage IV patients, only 2% are surviving 5 years, but they are beating it. You must look at the patients who have made it and see why they made it. Here are some things many have in common:
1 Treatments: they followed an aggressive treatment plan laid out by their oncologist and radiologist, sticking it out even in the toughest of times.
2 Nourishment: they found ways to nourish their bodies despite episodes of severe nausea, diarrhea, and abdominal cramps. This helped reduce side effects and also decreased chances of treatment interruption, never giving the cancer cells a fighting chance.
3 Determination: attitude has a remarkable affect on the survival rate of all cancer patients. The patient with a determined attitude is more likely to reach remission than one who has given up.
4 Spiritual Foundation: patients with a spiritual belief system seem to handle the above three better than those who feel they are on their own in this. These patients feel they have someone or something much bigger than themselves or their doctors working on their behalf. A spiritual belief system statistically improves a patient’s chances for remission, the ultimate goal.
The above tips are important, regardless of the stage. Many patients make the mistake of thinking, “Oh, I’ve only got Stage I,” or, “Its only Stage II.” Remember- if the cancer is not eradicated, then you will not remain a Stage I or Stage II for long! You must stop the cancer in its tracks and prevent it from spreading to your lymph system and other vital organs.
THE CANCER MYTHS
1 Cancer Treatment is worse than Living with Cancer
This is a sad belief that results in many cancer related deaths. There are even old-school physicians who still believe this. Today’s treatments are made to keep you active and provide a much better quality of life than in previous generations. Each patient responds differently to the side effects of chemotherapy as with any medication. Living with cancer is an oxymoron! You certainly won’t have a very high quality of life once the cancer has spread to additional vital organs and that life will be significantly shorter (living months rather than years after diagnosis).
2 Cancer Always Comes Back
This is not a given. Many tumors, when removed early and treated aggressively, never return. Your doctor will monitor you for several years after treatment to be safe.
3 There is a Cure and They don’t want Us to know
If you are told by any person or organization that they know the Secret to curing cancer you should be weary, even afraid. There are countless predators who will try to take advantage of you in your weakened state. They may offer supplements or other cures and protocol for treating cancer. They will claim to have beat it themselves, or to have helped to cure dozens or hundreds of people. This is not only unlikely, it is ridiculous. Today’s leaders in cancer research are pursuing every avenue of treatment. If there is a cure, you can bet they will find it before the snake oil salesmen! If you have any doubts about your recommended treatments, then please call 1-800-FDA-1088 to check on questionable regimen or products.
THE NUTRITION FACTOR
Without fail, cancer patients receive unsolicited advise from their concerned family and friends. The most common advise involves nutrition. Frequent suggestions may include: “Don’t eat sugar, it feeds tumors,” and, “Drink a gallon of green tea per day, it will kill the cancer and cure you.” Beware, advise from amateur nutritionists can actually hurt you. Sugar does not feed tumors. Herbal tea does not cure cancer, but it can be harmful if consumed in too large of a quantity or combined with certain medications or conditions.
Although there is evidence that a diet rich in fruits and vegetables can prevent cancer, there is not a shred of credible evidence that a change of diet will improve your chances of survival. Your doctor will advise you to eat healthy when possible, but his/her main concern is that you consume adequate fluids, calories and protein – in whatever form you can handle it. The best thing to do is ask your oncologist to recommend a nutritionist.
Everyone knows that exercise is good for them, and yet few actually get any. The benefits of exercise for lung cancer patients are the same as those for a healthy person. Physical benefits are: increased energy, decrease in body aches and pains, better circulation of blood and oxygen, and a more restful sleep. Emotional effects are perhaps as important to a cancer patient as the physical benefits. Patients report higher spirits and a stronger will to fight the cancer when they are charged up with a little exercise.
CAM, or complementary and alternative medicine have been popular since the 70’s. If you are interested in CAM treatments, you should first discuss them with your oncologist. Many CAM practitioners and product manufacturers are not aware of the possible complications and adverse effects that alternative treatments can cause. When taken in conjunction with pharmaceutical medications or taken by patients with complicated health issues, the risks increase.
There are several consumer watch groups which can aid you in your investigations. To check the reliability of therapies marketed for cancer patients, visit: NCCAM, OCCAM, and Quackwatch. The site provides reviews and critiques of various treatments. Because dietary supplements are not regulated by the FDA, health professionals recommend great caution. Efficacy (the drug’s effectiveness against the disease) cannot be verified because it has not been validated by independent investigators. Thoroughly check the credentials of alternative healthcare providers, including acupuncturists and massage therapists. And again, check with your oncologist before moving forward with CAM, for even a simple massage can be dangerous for a cancer patient.
THE GOOD NEWS
New treatments are introduced yearly and huge strides have been made in the last ten years. Not so many years ago, any cancer meant sure death. This is the first generation to have the technology and the will to beat even the harshest Stage IV Lung Cancer. Being #1 in cancer death also makes it #1 in cancer research. As mentioned above, the keys to success are:
Hit it Hard
Stayed Well Nourished (Eat- Eat- Eat)
Believe You Can Win!
If you or someone you love is fighting NSCLC, please seek education and support.