From a distance, lung cancer may seem straightforward and cut-and-dried. The name itself sparks an immediate mental image of two sponge-like organs located in the chest cavity. It’s common knowledge that tobacco smoking is the leading cause of lung cancer, and that it is one of the most common types of cancer. While these are important facts to know, there is actually quite a bit more information about lung cancer that is less commonly known.
Small Cell Lung Cancer vs. Non-Small Cell Lung Cancer
Lung cancer diagnoses are broken down into two main groups: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
SCLC often starts in the bronchi, or the airways that lead from the trachea into the lungs and then branch off into progressively smaller structures. SCLC typically grows quickly and may spread to other parts of the body, including nearby lymph nodes and distant organs. This type of lung cancer represents approximately 10% to 15% of lung cancers and is strongly associated with tobacco smoking. SCLC itself is broken down into two main categories: small cell carcinoma and combined small cell carcinoma. These two categories are used to distinguish the different types of cancer cells present in the tumor. Small cell carcinoma is the most common type of SCLC and has cells that often appear small and oval-shaped under a microscope, sometimes resembling oats. Combined small cell carcinoma refers to a tumor made up of small cell carcinoma cells and a component of non-small cell lung cancer.
NSCLC accounts for approximately 80% to 85% of lung cancer diagnoses and typically grows at a slower rate than SCLC. This type of lung cancer often develops slowly and may cause few or no symptoms in its early stages. There are three main types of NSCLC: adenocarcinoma of the lung, squamous cell carcinoma, and large-cell undifferentiated carcinoma. Adenocarcinoma is the most common form of NSCLC. This type of cancer is also found in other organs, including the breast and prostate. In NSCLC, it is often found in the outer regions of the lung and develops from cells that produce substances such as mucus. Squamous cell lung cancer is generally linked to smoking. This type of cancer typically develops in the central airways of the lung. Large-cell undifferentiated carcinoma is a less common subtype of NSCLC. It can begin in any part of the lung and is known to grow and spread quickly.
How Does Treatment Differ?
Like most cancers, the treatment options are dependent on the stage of the disease as well as the patient’s overall health and the characteristics of the tumor. SCLC generally grows and spreads more quickly than NSCLC, which can influence treatment planning. Both types of lung cancer may be diagnosed at an advanced stage. For patients diagnosed with early-stage NSCLC, surgery to remove the tumor is often an option. Patients in the later stages may receive treatments that include chemotherapy, radiation therapy, immunotherapy, and targeted therapy, alone or in combination, depending on the stage and tumor characteristics. Biomarker testing may also help identify treatments that target specific genetic or molecular changes in the cancer.
Because SCLC tends to grow and spread rapidly, treatment often involves therapies that work throughout the body. For limited-stage SCLC, treatment often involves chemotherapy combined with radiation therapy to the chest. Some patients whose cancer has not progressed after chemoradiation may also receive immunotherapy. For extensive-stage SCLC, treatment commonly involves chemotherapy combined with immunotherapy. Although SCLC may respond well to initial treatment, the disease has a high risk of recurrence or further spread. Some healthcare professionals may recommend preventive radiation therapy to the brain for selected patients because SCLC has a tendency to spread there. Regular monitoring with brain MRI scans may also be considered for some patients instead of preventive brain radiation. The decision depends on the patient’s individual circumstances and potential treatment risks and benefits.
What Does This All Mean?
Though it may feel like lung cancer is a simple diagnosis, it is actually a very complex disease. Knowing the details of a diagnosis can help patients better understand their treatment options and make informed decisions with their healthcare team. Terms such as SCLC and NSCLC can be confusing, or even overwhelming, at first. Even with an understanding of the general difference between SCLC and NSCLC, patients are encouraged to speak up when something in their diagnosis or treatment plan doesn’t make sense. Patients may also wish to ask about their cancer’s stage, subtype, and whether biomarker testing could help guide treatment. Medical teams are committed to caring for the patient, whether that means administering treatment or explaining what medical terms mean.
Source:
https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html
https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq
https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq
