Understanding lung cancer
What is lung cancer?
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. There are two major types of lung cancer: small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC).
- Small cell lung cancer—10-15% of lung cancers are small cell lung cancers. This type tends to spread quickly1. Although small cell lung cancer typically is not operable, it tends to respond better to chemotherapy than non-small cell lung cancer.
- Non-small cell lung cancer—Most lung cancers (85-90%) are non-small cell lung cancers. Non-small cell lung cancer is sub-classified as squamous or non-squamous (adenocarcinoma, large cell carcinoma). This type spreads more slowly than small cell lung cancer1.
- Along with the 2 main types of lung cancer, other tumors can occur in the lungs. Carcinoid tumors account for 1-2% of lung tumors. Most are slow growing tumors and can be cured by surgery2.
How is NSCLC treated?
If you have NSCLC, your treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy or some combination of these2. Your treatment will depend on how advanced your cancer is, as well as other factors2.
How is SCLC treated?
If you have SCLC, your treatment options may include surgery, radiation therapy and chemotherapy. Radiation and rarely surgery are usually options only if you have limited stage disease2.
Why is an accurate diagnosis so important?
Knowing what kind of cancer a patient has is key to optimal treatment
3-5. In the past, the only diagnostic decision in the pathologic classification of lung cancers that carried any therapeutic relevance was the distinction between SCLC, and NSCLC. In general, SCLC, the main sub-type of Neuroendocrine tumors, is much more responsive to chemotherapy and consequently this comprises the mainstay of treatment. This is in contrast to NSCLC which is relatively chemoresistant and thus primarily treated with surgical resection for local disease. The treatments for squamous and non-squamous NSCLC can be very different and a wrongtreatment can lead to fatal results. For example; patients with squamous NSCLC cannot receive Avastin because of a 30% mortality rate due to fatal hemoptysis
6,7. That's why it's important for your doctor to know exactly which kind of cancer you have.
- What you need to know about lung cancer. National Cancer Institute Web site. Accessed March 2, 2009.
- Detailed guide: lung cancer―non-small cell: how is non-small cell lung cancer treated? American Cancer Society Web site. Updated October 24, 2008. Accessed February 23, 2009.
- Scagliotti GV, Parikh P, von Pawel J, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol.
2008;26(21):3543-3551.
- Johnson DH, Fehrenbacher L, Novotny WF, et al. Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol. 2004;22(11):2184-2191.
- Clark GM, Zborowski DM, Santabarbara P, et al; National Cancer Institute of Canada Clinical Trials Group. Smoking history and epidermal growth factor receptor expression as predictors of survival benefit from erlotinib for patients with non-small-cell lung cancer in the National Cancer Institute of Canada Clinical Trials Group study BR.21. Clin Lung Cancer.
2006;7(6):389-394.
- Sandler A. Bevacizumab in non small cell lung cancer.Clin Cancer Res.2007;13(15 Pt 2):s4613-6.
- Herbst RS, O'Neill VJ, Fehrenbacher L, Belani CP, Bonomi PD, Hart L, Melnyk O, Ramies D, Lin M, Sandler A.Phase II study of efficacy and safety of bevacizumab in combination with chemotherapy or erlotinib compared with chemotherapy alone for treatment of recurrent or refractory non small-cell lung cancer.J ClinOncol.2007:25(30):4743-50
