Rehabilitation of Non-small Cell Lung Cancer

Introduction:

Non-Small Lung Cancer is the most common form of pulmonary cancer, accounting for about 85 to 90 percent of lung cancers around the world. Various Non-Small Cell Lung Cancer varieties are available depending on the type of cancer cells that grow within the lungs. This includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. The common risk factors associated with this cancer are smoking, exposure to air pollutants, and substances like nickel, beryllium, or radiation.

What Are the Signs and Symptoms of Non-small Cell Lung Carcinoma?

The common symptoms noted are:

• Shortness of Breath (Dyspnea): Shortness of breath is initially noted only during physical exertion. In later stages, dyspnea occurs even at rest.

• Cough: Persistent cough is a common symptom that worsens over time. In later stages, blood is noted in the sputum.

• Chest Pain and Discomfort: Chest pain occurs while inhaling deeply or coughing.

• Fatigue: Generalized fatigue is noted in individuals with Non-Small Cell Lung Cancer.

• Slow unintentional weight loss.

• Hoarseness or change in the voice.

• High-pitched whistling or wheezing is noted.

How Is Non-small Cell Lung Cancer Diagnosed?

Physical examination, laboratory investigations, and imaging studies diagnose Non-Small Cell Lung cancer. The following tests and procedures are done for the diagnosis.

• Medical History and Physical Examination: A thorough personal and medical history is obtained to assess the symptoms experienced, duration of symptoms, and exposure to environmental pollutants and toxins. Physical examination reveals enlarged lymph nodes.

• Radiographic Investigations: Imaging studies like chest X-ray and computed tomography can help assess the presence of masses or nodules in the lungs. Positron Emission Tomography (PET) is a valuable tool in evaluating the extent and spread of cancer to other body parts.

• Biopsy: A biopsy is done to obtain a piece of tissue from the lungs or the adjacent lymph nodes to detect the presence of tumor cells.

• Cytology: Sputum cytology is done to look for cancer cells. Early diagnosis of the disease can help in better treatment planning and prognosis.

How Is Non-small Cell Lung Cancer Treated?

The following treatment procedures are commonly done in non-small cell lung carcinoma.

• Surgery: For people who experience Non-Small Cell Lung Cancer (NSCLC) in its early stages and have a small tumor that has not metastasized to nearby lymph nodes or other organs, surgery is a recommended treatment option. During surgery, the tumor and some surrounding tissue may be removed. In some cases, a lobe (lobectomy) or the entire lung (pneumonectomy) may need to be removed.

• Radiation Therapy: Radiation therapy can be employed as a standalone treatment or in conjunction with other therapeutic approaches, such as surgery or chemotherapy. Radiation therapy can be used as a pre-operative procedure to shrink the size of the tumor or, following surgery, to eliminate any residual cancer cells.

• Chemotherapy: Chemotherapy is often used to treat NSCLC that has spread to other body parts. Drugs used in chemotherapy reach the bloodstream and kill the cancer cells.

These treatments can be effective in treating cancer, but they can also have many side effects that can impact a person's physical, emotional, and social well-being. Hence, rehabilitation is advised for such individuals to enhance their quality of life.

What Is Rehabilitation?

Rehabilitation refers to the systematic process of recovering and enhancing functionality for individuals who have undergone a debilitating injury or illness. For those with Non-Small Cell Lung cancer, rehabilitation can help to enhance physical function, manage symptoms, and address emotional and social requirements.

How Is Rehabilitation Done in Non-small Cell Lung Cancer?

The rehabilitation goals for NSCLC are to help patients regain their physical and emotional health, improve lung function, enhance their quality of life, and provide ongoing support for survivorship. A team of healthcare professionals can work together to customize an individualized rehabilitation plan that meets the patient's requirements. Rehabilitation programs typically include exercise training, breathing techniques, education, and psychological support.

1. Exercise Training: This is a key component in pulmonary rehabilitation as it helps improve the lungs' capacity.

• Engaging in aerobic exercises can assist in improving cardiovascular fitness and endurance.

• Resistance training may involve exercises such as weight lifting or resistance bands. Resistance training can help individuals improve their muscle strength. Some patients may experience shortness of breath during this process, which medical professionals should manage immediately.

2. Breathing Techniques: Pursed-lip breathing, diaphragmatic breathing, and retraining can help manage breathlessness and improve respiratory muscle function.

• Pursed-lip breathing is a breathing technique that involves taking in air through the nose and then exhaling slowly through closed lips. This technique helps to slow down breathing and improve airflow in and out of the lungs.

• Diaphragmatic breathing involves breathing deeply from the diaphragm muscle. This technique helps to improve respiratory muscle function and increase oxygen delivery to the body.

• Breathing retraining involves learning to breathe more efficiently and effectively.

3. Educating the Patients: Education may include information about the disease, its causes, and its management, including information on medications and nutrition. Education can also help individuals better understand their condition and how to manage it.

4. Pain Management: Pain management is an important aspect of symptom management for individuals with Non-Small Cell Lung cancer. Pain can be caused by cancer itself, as well as by treatment side effects. Pain management strategies can include medication management, physical therapy, and complementary therapies such as acupuncture or massage.

5. Nutritional Support: Nutrition interventions include dietary counseling, supplementation, and enteral or parenteral nutrition. Maintaining adequate nutrition can improve the overall physical functions of individuals.

6. Psychological Support: Psychological support is also an important part. Cancer diagnosis and management can be emotionally challenging, and psychological support can help individuals manage stress and anxiety related to their condition. Psychological support may include counseling, stress management techniques, and support groups.

Why Pulmonary Rehabilitation Therapy Is Required for Non-Small-Cell Lung Cancer?

Pulmonary rehabilitation therapy can help if the patient underwent surgery to excise a part of the lung due to cancer. Rehabilitation can:

• Enhance the exercise capacity.

• Improve the problem like shortness of breath.

• Improve walking speed.

• Strengthen the lower body.

Conclusion:

Rehabilitation is important in individuals diagnosed and treated for Non-Small Cell Lung carcinoma. It helps in restoring physical and emotional well-being. It is advisable to consult medical professionals and formulate a specialized rehabilitation plan for optimal recovery and to achieve the best possible outcome.