Understanding ALK-Positive Lung Cancer: A Beginner's Guide

If you or a loved one has been diagnosed with ALK-positive lung cancer, you may have many questions. This guide will help you understand what ALK-positive lung cancer is, its symptoms, how it's diagnosed, and the available treatment options. We'll also discuss support resources to help you navigate this challenging time.

What Is ALK-Positive Lung Cancer?

ALK-positive lung cancer is a small subgroup of non-small-cell lung cancer (NSCLC) caused by a mutation in the ALK (anaplastic lymphoma kinase) gene. This mutation causes the gene to produce a faulty protein that promotes the growth and spread of cancer cells. ALK-positive lung cancer is usually adenocarcinoma, which starts in the mucous glands of the lungs.

Who Is at Risk for ALK-Positive Lung Cancer?

About 5% of people with NSCLC have an ALK rearrangement. Unlike other lung cancers, ALK-positive cancer tends to affect younger people, with about half of the cases diagnosed in people 50 or younger. It's also more common in people who have never smoked and isn't linked to other lung cancer risk factors like asbestos or air pollution. ALK-positive lung cancer is slightly more common in females or those assigned as females at birth.

Symptoms of ALK-Positive Lung Cancer

Lung cancer symptoms may not appear until the disease has spread to other parts of the body. Some common symptoms include:

• Persistent cough

• Chest pain that worsens with deep breathing, coughing, or laughing

• Hoarseness

• Unexplained weight loss and loss of appetite

• Coughing up blood

• Shortness of breath

• Fatigue

• Wheezing

When the cancer reaches stage IV, it may cause additional symptoms such as bone pain, neurological problems, and yellowing of the eyes or skin.

Diagnosing ALK-Positive Lung Cancer

If you have NSCLC, your doctor should test for the ALK genetic mutation to determine the best treatment plan. This involves taking a small sample of the tumor (biopsy) and sending it to a lab for analysis. Your doctor will also run imaging tests to see how far the cancer has spread.

Treatment Options for ALK-Positive Lung Cancer

The main treatment for ALK-positive lung cancer is targeted therapy using ALK inhibitors (also called tyrosine kinase inhibitors or TKIs). These drugs block the abnormal ALK protein, preventing cancer cells from growing. Standard ALK inhibitors include alectinib (Alecensa) and brigatinib (Alunbrig). Other options are crizotinib (Xalkori), ceritinib (Zykadia), and lorlatinib (Lorbrena). Targeted therapy is often highly effective and has improved both survival and life quality.

ALK inhibitors are sometimes combined with chemotherapy, radiation, or surgery. If the cancer develops resistance to an ALK inhibitor, your doctor may prescribe a different one, increase the dose, or consider other treatments.

Potential Side Effects of ALK Inhibitors

Common side effects of ALK inhibitors include:

• Diarrhea

• Fatigue

• Nausea

• Vomiting

• Blurry vision

In rare cases, some people may develop pneumonitis (lung inflammation) or heart problems.

Support and Palliative Care for ALK-Positive Lung Cancer

Dealing with a lung cancer diagnosis can be emotionally challenging. Support groups like the ALK Positive Group and the American Lung Association's online support community can help you connect with others who understand what you're going through. Your doctor can also refer you to individual or group therapy.

Palliative care is an essential part of cancer treatment, focusing on managing symptoms and side effects to improve your quality of life. This may include medications for pain and nausea, extra oxygen, or counseling. You can start palliative care at any point during your treatment. Talk to your healthcare team about incorporating palliative care into your plan.

Remember, you are the most important member of your healthcare team. Don't hesitate to ask questions, express concerns, or seek support when you need it. For more information on ALK-positive lung cancer, visit the American Cancer Society website.