Saturday, July 15, 2023

Lung Cancer Diagnosis - What Happens Next?

Lung Cancer is a scary diagnosis.

Much to my shock, I was was recently diagnosed with adenocarcinoma in the lung, more commonly known as lung cancer.  As a lifelong non-smoker, this was the last thing I expected.  However, my parents both smoked from the time I was an infant, other members of my family still smoke, and in early adulthood I worked for a number of men who smoked in the office.  In addition, during much of my adult life, smoking was common inside of airplanes, restaurants, bars, casinos, and other social settings. My exposure to second-hand smoke was probably as high as if I had smoked myself for decades. 

While my lung cancer journey is just beginning, I realized that many of my readers have also faced the same or a similar diagnosis.  I have spent hours researching different aspects of the disease so I know what to expect in the coming months, and thought I would share what I discovered with my readers.   This is not meant to replace what your doctor tells you, but to share a concise summary of the information I have discovered in order to supplement what the doctors have shared. 

Being diagnosed with lung cancer can be a daunting experience. Lung cancer is a serious disease that affects millions of people around the world. According to the American Cancer Society, lung cancer is the leading cause of cancer deaths in both men and women, accounting for 22% of all cancer deaths. The prognosis for lung cancer can be poor, but there are treatment options available which can improve your chances of survival. Below I discuss what someone can expect after a lung cancer diagnosis and the treatment options available.

Symptoms and Diagnosis

The symptoms of lung cancer can vary depending on the type and stage of the cancer. Some common symptoms include:

Persistent cough
Chest pain
Shortness of breath
Wheezing
Fatigue
Weight loss
Loss of appetite
Bone pain
Headaches

If you experience any of these symptoms, it is important to see a doctor. A doctor will typically perform a physical exam, including listening to your lungs, and may order tests such as a chest X-ray, CT scan, biopsy or PET scan to diagnose lung cancer and see if it has spread.

Surprisingly, my lung cancer was diagnosed BEFORE I had any of the above symptoms, except for occasional shortness of breath when exerting myself.  I was doing physical therapy after a recent knee replacement surgery, and became out of breath with only minor activity. I would never have considered it a problem on my own. However, the physical therapist sent me to the ER and, after a series of tests, they discovered a mass in my lung.  Ironically, having knee surgery, and being sent to the ER, may have saved my life.  At least, I hope so, as I embark on this scary journey!

Types of Lung Cancer

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common type of lung cancer, accounting for about 85% of all cases. SCLC is less common, accounting for about 15% of all cases. Treatment options can vary depending on the type and stage of the cancer.  I have non-small cell lung cancer, the most common type.

Stages of Lung Cancer

Lung cancer is also classified into stages, which helps to determine the extent of the cancer and the best treatment options. The stages of lung cancer are:

Stage I: Cancer is confined to the lung.
Stage II: Cancer has spread to nearby lymph nodes.
Stage III: Cancer has spread to lymph nodes in the chest or other organs in the chest.
Stage IV: Cancer has spread to other parts of the body.

After having a PET scan, my doctor believed I had Stage I cancer, which was confirmed when the surgeon removed the mass, the upper lobe of my right lung, and the nearby lymph nodes, and had them biopsied.  Fortunately for me, the cancer had not spread to the lymph nodes nor, as far as they can tell, to other parts of my body.  Only time will tell if it does comes back, which frequently happens a few years after having lung cancer.  When it does return, it may show up in the brain, bones, colon or other organs, and may be more widespread.  I'll have to remain careful and get frequent exams and tests for the rest of my life to see if the cancer has returned in some other part of my body. 

Treatment Options

The treatment options for lung cancer can vary depending on the type and stage of the cancer. The main treatment options are:

DaVinci robot assisted surgery.

Surgery:
This involves removing the cancerous tissue from the lung. Surgery is usually only an option for early-stage NSCLC.  My surgeon used the DaVinci robot assisted surgery method to remove one lobe of my lung and seventeen of the nearby lymph nodes.  It is a fascinating type of surgery which is supposed to reduce pain and blood loss.  The surgeon actually sits separate from the patient, looking into a video screen which magnifies the inside of the body about 10 times.  Tubes are placed through incisions in the patient's body and they contain a camera, the operating tools, a drainage tube, etc.  The surgeon manipulates everything from the console, where he can more clearly see where he is cutting.  My surgeon told me this method makes it easier for them to make sure they get clean margins, while avoiding some of the blood vessels.

Radiation therapy: This involves using high-energy radiation to kill cancer cells. Radiation therapy may be used alone or in combination with other treatments.

Chemotherapy: This involves using drugs to kill cancer cells. Chemotherapy may be used alone or in combination with other treatments.

Targeted therapy: This involves using drugs that target specific proteins in cancer cells to kill them. Targeted therapy is typically only used for advanced NSCLC.

Immunotherapy: This involves using drugs which help the immune system recognize and attack cancer cells. Immunotherapy may be used alone or in combination with other treatments.

The treatment plan an individual is given will depend on the type and stage of the cancer, as well as the overall health of the patient. Treatment plans may include one or more of the above options, and may be adjusted over time depending on how the cancer responds to treatment.  My doctor highly recommended the surgery, since she correctly believed they caught my cancer early.  Now that the surgery is over, the surgeon determined that I will not need any additional treatments at this time.  She removed seventeen lymph nodes, and the pathologist did not find cancer in any of them.  So far, I have been more fortunate than most lung cancer patients, who frequently only discover their cancer when it is too late for it to be removed surgically.

Support and Resources

A lung cancer diagnosis can be overwhelming, and it is important to have a support system in place. Support can come from family and friends, as well as from support groups and counseling services. The American Lung Association offers a Lung Cancer Support Community, which provides resources and support for lung cancer patients and their families.

Some people also find it helpful to join a Facebook group, where they can talk about their diagnosis with other people who are going through the same thing.  It is also a good way to learn about a variety of treatment choices and learn how others felt about those treatments. 

Financial assistance may also be available for lung cancer patients. The Cancer Financial Assistance Coalition provides a searchable database of organizations which offer financial assistance to cancer patients.

Lifestyle Changes

Making lifestyle changes can be an important part of treatment for lung cancer. Quitting smoking is one of the most important things you can do to reduce your risk of developing lung cancer, and is very important if you have been diagnosed with it. My surgeon told me she has known of smokers with lung cancer who continued to smoke, even while receiving treatment.  Understandably, this is not a good idea and lowers your risk of recovery. You may also want to do what you can to avoid other possible assaults on your lungs, such as second hand smoke, being exposed to radon or other toxins, getting Covid and other respiratory diseases, and air pollution.  Unfortunately for me, I got Covid less than two months after my lung cancer surgery.  I was given Paxlovid for it, however, and that anti-viral drug seemed to minimize any damage.

In addition, you should do everything you can to improve your overall lifestyle by getting outside in the fresh air, and exercising, when possible, as well as eating a healthy, balanced diet with plenty of fruits and vegetables. Eliminate or, at the very least, reduce your use of alcohol and drugs.

Helpful Care for the Patient

In addition to the treatment options mentioned above, there are other types of care which may be used to manage your symptoms and improve the quality of life for people with lung cancer. These include:

Palliative care: This involves a team of healthcare professionals who work together to manage your symptoms, such as pain, shortness of breath, and fatigue, and improve the quality of life for people with lung cancer and other illnesses.

Rehabilitation: This may include physical therapy, occupational therapy, or speech therapy to help people with lung cancer maintain their strength and independence during and after treatment.

Alternative therapies: These are non-traditional therapies, such as acupuncture, massage therapy, or herbal supplements which some people with lung cancer may find helpful in managing their symptoms and improving their quality of life. However, it is important to discuss any alternative therapies with your healthcare team before trying them.  This is especially true if you take herbal supplements or vitamins, because some of them can make your prescribed treatments, like chemotherapy, less effective.  For example, research has shown that Vitamin B-12 can increase your risk of a reoccurrence of lung cancer.  You may want to discuss this with your doctor. 

It is also important to note that the emotional and psychological impact of a lung cancer diagnosis can be significant. It is common to experience feelings of fear, anxiety, and depression. Seeking emotional support from loved ones or a mental health professional can be helpful in coping with these emotions.

Prevention is key when it comes to lung cancer. The most important thing you can do to reduce your risk of developing lung cancer is to quit smoking or never start smoking. Secondhand smoke can also increase the risk of lung cancer, so avoiding exposure to secondhand smoke is important as well. Other ways to reduce your risk of lung cancer include avoiding exposure to radon and other environmental toxins, eating a healthy diet, and staying physically active.

Lung Cancer is a Personal Experience

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While over 150,000 people die of lung cancer every year, each case is a personal experience for that individual.  

In my case, after getting over the initial shock of being diagnosed with lung cancer, I wanted to schedule the surgery as soon as possible, to increase my survival chances.  Fortunately, my healthcare provider immediately assigned a "cancer coordinator" to me to help guide me through the process.  Once she was in contact with me, I was set up with a series of medical appointments including meeting with a pulmonologist (lung doctor), receiving a PET scan to see if the cancer had spread outside the lungs (which it often does), having a lung function test to see if I could handle having one-third of my right lung removed, and then meeting with a thoracic surgeon (who would perform surgery on my lungs).  All of this was accomplished within six weeks of doctors first noticing a mass in my lungs.  Speed is important if you have Stage 1 cancer.  You do not want it to progress, if you can avoid it. 

If you would like to read more first-hand experiences of other people who have had lung cancer, I highly recommend the book "Roads to Meaning and Resilience with Cancer." (Ad) It contains "Forty Stories of Coping, Finding Meaning and Building Resilience While Living with Incurable Lung Cancer." (Ad)  It is written by a physician who, himself, was diagnosed with lung cancer despite the fact that, like me, he had never smoked.  I found the book to be extremely meaningful and helpful, although I was hesitant, at first, to read it.  I'm glad I did.

Conclusion:

In conclusion, a lung cancer diagnosis can be a difficult and overwhelming experience, but there are treatment options and support systems available to help you manage the disease and improve your quality of life. I encourage you to work closely with your healthcare team to develop a treatment plan which is best for you, and to seek emotional support and make lifestyle changes to improve your overall health and well-being.



Maintaining Your Serenity

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It is important to your mental well-being to try to maintain a sense of peace and serenity when living with a cancer diagnosis.  One tip is to find a way to remind yourself to focus on staying serene. This lovely tote bag may be a helpful reminder to you to try to relax and maintain your peace-of-mind whenever you begin to worry and become upset.  

You can purchase this tote bag and a variety of other items at my Etsy store.  For the moment I like the positive approach of reminding ourselves to stay serene as much as we can, considering what we are experiencing.  Check out my Etsy Store at:

DeborahDianGifts.etsy.com

I have also included a list of the citations for this article at the end, so you can do more research into your illness from reputable sources.  It will be helpful for you to learn everything you can about your diagnosis and what you can do to stay as healthy as possible, especially during and after your treatments.

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Citations:

American Cancer Society. Lung Cancer. Accessed April 22, 2023. https://www.cancer.org/cancer/lung-cancer.html.


Mayo Clinic. Lung Cancer. Accessed April 22, 2023. https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620.


National Cancer Institute. Lung Cancer Treatment (PDQ)–Health Professional Version. Accessed April 22, 2023. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq.


American Lung Association. Lung Cancer Support Community. Accessed April 22, 2023. https://www.lung.org/support-and-community/lung-cancer-support-community.


Cancer Financial Assistance Coalition. Financial Assistance. Accessed April 22, 2023. https://www.cancerfac.org/financial-assistance/.


National Comprehensive Cancer Network. NCCN Guidelines for Patients: Lung Cancer. Version 1.2023. Accessed April 22, 2023. https://www.nccn.org/patients/guidelines/lung/files/assets/basic-html/index.html#page1.


National Cancer Institute. Supportive Care. Accessed April 22, 2023. https://www.cancer.gov/about-cancer/treatment/side-effects/supportive-care.American Lung Association. Lung Cancer Symptoms. Accessed April 22, 2023


American Cancer Society. Can Lung Cancer Be Found Early? Accessed April 22, 2023. https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/detection.html.

American Cancer Society. Can Lung Cancer Be Prevented? Accessed April 22, 2023. https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection/can-lung-cancer-be-prevented.html.


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