Non-Small Cell Lung Cancer: A Beginner’s Guide to Non-Small Cell Lung Cancer

Non-Small Cell Lung Cancer: Explained

“What is non-small cell lung cancer?” 

We’ve been getting that question from some patients and patient advocates that wanted to know more about how ICER is undermining patients’ access to treatments for the disease.

In an effort to help educate patients, we’re presenting a “Beginner’s Guide to Non-Small Cell Cancer.” We understand that, for many patients, this information is basic – or may oversimplify concepts. Help us educate new patients, our families and friends. If you have a tip, edit or suggestions, join the conversation by posting your feedback in the comments. And we’ll work to update this post to deliver a dynamic page and ongoing guide for patients.

Again, what is non-small cell cancer? According to the National Cancer Institute: “Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.” Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of non-small cell lung cancer.

Each type of non-small cell lung cancer has different kinds of cancer cells. The cancer cells of each type grow and spread in different ways. The types of non-small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look under a microscope:

  • Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. This is also called epidermoid carcinoma.
  • Large cell carcinoma: Cancer that may begin in several types of large cells.
  • Adenocarcinoma: Cancer that begins in the cells that line the alveoli and make substances such as mucus.
  • Other less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumor, salivary gland carcinoma, and unclassified carcinoma.

The American Cancer Society says that non-small cell lung cancer is the most common type of lung cancer, encompassing about 85% of lung cancers.

Without a cure, innovation is critical for patients with non-small cell lung cancer. So is getting access to the right treatment — and the flexibility to switch to a new treatment when one fails to show meaningful results.

Signs and Symptoms of Non-Small Cell Cancer

Signs of non-small cell lung cancer include a cough that doesn’t go away and shortness of breath. Sometimes lung cancer does not cause any signs or symptoms. It may be found during a chest x-ray done for another condition. Signs and symptoms may be caused by lung cancer or by other conditions. Health experts at the National Cancer Institute recommend that patients check with their doctor if any of the following occurs:

  • Chest discomfort or pain.
  • A cough that doesn’t go away or gets worse over time.
  • Trouble breathing.
  • Wheezing.
  • Blood in sputum (mucus coughed up from the lungs).
  • Hoarseness.
  • Loss of appetite.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Trouble swallowing.
  • Swelling in the face and/or veins in the neck.

ICER Trying to Block Patient Access to Non-Small Cell Lung Cancer Treatments

Earlier this year, the Institute for Clinical and Economic Review, known simply as ICER, announced that it was targeting treatments for non-small cell lung cancer in another round of its cost analyses.

When the scoping document for non-small cell lung cancer was released in June, our co-founder and executive director Terry Wilcox raised some important concerns with ICER’s approach to evaluating treatments for non-small cell lung cancer. “Every patient advocate in the lung cancer community wants to help move towards more efficient, patient-focused care aimed at eliminating waste and fraud within each sector of the health care ecosystem,” Terry Wilcox, our co-founder and executive director, wrote in response to ICER’s Draft Scoping Document for Non-Small Cell Lung Cancer. “We hope that ICER will choose to genuinely and comprehensively reach out to the advocacy community for a robust exchange in search of ways to collaborate.”

That was back in June. Unfortunately, ICER has failed to welcome patients’ input. Instead, it released its preliminary analysis in August — a report that was highly criticized by patients, doctors and non-small lung cancer advocates.

One criticism: ICER’s report was riddled with factual inaccuracies. It demonstrates the risks of non-peer reviewed papers masquerading as real science. We don’t need to search far to see other examples of “hype before science” and how patients can be negatively impacted. The most trusted organizations out there, ones that rely on actual expert clinician and patient input, aren’t afraid to take their methodologies and publications through peer review.

The factual inaccuracies in ICER’s draft report, as well as its lack of transparency in its methods and calculations, nearly guarantee that the paper would never make it through peer review at a reputable journal.

Another flaw: Bad data resulted in ICER classifying some treatments, suchas anti-PD1 drugs,  as “having uncertain benefit.” Patients who are still alive because of anti-PD1 drugs would certainly disagree, as would the doctors who are successfully treating patients with these new advances. As the medical community embraces more personalized and individualized care, ICER’s report forces a one-size-fits-all approach and prevents patients from switching treatments.

What You Should Remember about Non-Small Cell Lung Cancer

  • Non-small cell lung cancer is a disease in which malignant cancer cells form in the tissues of the lung.
  • There are several types of non-small cell lung cancer, including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma
  • Smoking is the major risk factor for non-small cell lung cancer.
  • Signs of non-small cell lung cancer include a cough that doesn’t go away and shortness of breath.
  • For most patients with non-small cell lung cancer, current treatments do not cure the cancer.
  • Organizations, such as ICER, are working to limit patient access to current treatments.
  • Without a cure, innovation in treatment is critical for patients with non-small cell lung cancer.

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