Lung Cancer

Types

Non-Small Cell Cancers

Non-small cell cancers include squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Bronchioloalveolar cell is a subtype of adenocarcinoma. They are usually treated in similar ways. Adenocarcinoma, the most common type of lung cancer, is usually located on the outer surface (periphery) and may spread to the lymph glands in the lung and to the bloodstream and other organs. Squamous cell carcinoma may be found in the lining of the large bronchi (air passages) or in the periphery of the lung. Large cell carcinoma usually occurs in the periphery of the lung.

The specific combination of these therapies depends on the stage of the cancer and your general medical condition:

• Stage 0. Disease in this stage is limited to the surface of the bronchus (carcinoma in situ) and may be treated with surgical resection. Another option is photodynamic therapy — treating the affected area with a laser to kill the cancer cells.
• Stages I and II. Treatment for these stages is surgery whenever possible. If surgery is not possible, radiation with or without chemotherapy can be considered.
• Stages IIIA and IIIB. Some patients with limited Stage IIIA disease are treated with surgery with or without preoperative chemotherapy. If the tumor is inoperable, chest radiation is generally combined with chemotherapy. Surgery is not commonly used for Stage IIIB tumors.
• Stage IV. Chemotherapy provides the backbone of treatment for Stage IV disease. Radiation therapy may be given as well to small areas (not just the chest) that cause pain or other problems. Cancers at this stage are not treated with surgery.

Small Cell Cancers

Small cell lung cancer usually develops in the central areas of the lung. It can spread aggressively and occurs almost exclusively in current or former smokers. This cell type has the strongest association with smoking.

The specific combination of therapies used to treat small cell lung cancer depends on the stage of the cancer. Surgery generally is not a treatment option for small cell lung cancer unless it is in a very early stage. Doctors review all lung cancer diagnostic test results to decide the best treatment approach.

• Limited stage. Treatment generally involves a combination of chemotherapy and chest radiation. Some patients are also offered brain radiation to prevent the spread of cancer there.
• Extensive stage. Chemotherapy is the most important treatment for this stage of disease. Radiation therapy may be given to local areas (not just the chest) that cause pain or other problems.