Treatments for lung cancer will depend on the type of lung cancer, the stage of the cancer, and the patient’s overall health. There are two main types of lung cancer, which behave differently and require different treatment methods.
Non-Small Cell Lung Cancer (NSCLC)
Non-small cell lung cancer is the most common type of lung cancer, accounting for 80-85 percent of all cases. It typically grows and spreads more slowly than small cell lung cancer (SCLC).
Non-small cell lung cancer is divided into three types, based on the kind of cells found in the cancer and how the cells look when viewed under a microscope.
This is the most common type of non-small cell lung cancer, accounting for 30-35 percent of all cases. This cancer often starts in the mucus-producing cells in the lining of your airways.
Squamous cell carcinoma
Cancer that begins in squamous cells, which are flat cells that cover the surface of your airways. It usually grow near the centre of the lung, which accounts for 25 percent of all lung cancers.
Large cell carcinoma
This is so called because the cells are large and look abnormal when viewed under a microscope. It is the less common type than the other two types, accounting for about 10 percent of all cases. This type of cancer tends to grow and spread quickly.
Other less common types of non-small cell lung cancer are carcinoid tumor, pleomorphic, salivary gland carcinoma, and unclassified carcinoma.
Treatment for Non-Small Cell Lung Cancer
Surgery is the main treatment for NSCLC that has not spread beyond the chest. The type of surgery will depend on the patient’s health and the type of non-small cell lung cancer they have. It will also depend on whether other lung conditions, such as emphysema or chronic obstructive pulmonary disease (COPD), are present.
There are three types of surgery:
- Wedge resection: removes only a small part of the lung.
- Lobectomy: removes one lobe of the lung.
- Pneumonectomy: removes an entire lung.
Because surgery will remove part or entire lung, breathing may be more difficult afterwards, especially in patients with other lung conditions such as emphysema. Doctors can test lung function prior to surgery, which helps determine surgical risk and predict how lung function will be affected by surgery.
When the tumor has spread significantly, chemotherapy may be recommended to slow its growth, even if it can’t cure the disease. Chemotherapy has been shown to ease symptoms and prolong life in cases of advanced NSCLC.
Radiation therapy can also relieve the symptoms. It is often used to treat NSCLC that has spread to the bones or brain and is causing pain. It can also be used alone or with chemotherapy to treat cancer that is confined to the chest.
Small Cell Lung Cancer (SCLC)
Small cell lung cancer, also called oat cell cancer, is the less common form of lung cancer. This cancer is so called because the cells look like oats under the microscope. It often starts in the bronchi, then quickly grows and spreads to other parts of the body, including the lymph nodes.
This type of lung cancer represents fewer than 20 percent of all lung cancer cases and is typically caused by tobacco smoking. There are two types of small cell lung cancer:
- Small cell carcinoma
- Combined small cell carcinoma
Treatment for Small Cell Lung Cancer
Small cell lung cancer almost always has spread outside the lungs by the time it is discovered. So treatment can’t be done with surgery. That’s why chemotherapy (with or without radiation) is the main treatment. The earlier stage allows for more intense and effective radiation therapy within a small area.
Small cell lung cancer frequently spreads to the brain, even if there are no spots seen on CT scan or MRI of the brain. That’s done because the cancer cells that are present in the brain are often too small to be detected by the scans. Some doctors will advise radiation to the brain to wipe out microscopic cancer cells.
In people with extensive-stage cancer, chemotherapy and/or radiation is used primarily to relieve symptoms such as bone pain or neurologic symptoms like the inability to walk.
It is extremely rare that small cell lung cancer is confined to the lungs. But when that is the case, doctors will attempt to remove the tumor surgically. This works best when the tumor is at the edges of the lung. Chemotherapy may also be used.