Lung Cancer

Overview

More people are surviving and thriving after lung cancer due to the great progress being made in understanding and treating this disease. New life-saving treatments and those that enable certain diagnoses to be better managed are now available. Additionally, research in clinical trials is advancing quickly to find more effective therapies.

Improved outcomes are giving everyone affected by lung cancer cause for hope. In recent years, more people are living longer with lung cancer due to treatment advances. And, survival rates after diagnosis have improved substantially.

Though, even with this positive news, the reality is that receiving a lung cancer diagnosis is overwhelming. While you are trying to understand your cancer, you may hear many terms you haven’t heard before. Learning as much as you can about your type of lung cancer will help empower you to make the decisions ahead.


Biology Basics

Your lungs are a pair of large, spongy, expandable organs in your chest cavity that are surrounded by a thin layer of protective tissue (pleura). The right lung is a little larger with three parts (lobes), and the left lung has only two (see Figure 1).

Your lungs’ function is to help you breathe by exchanging oxygen and carbon dioxide. When you inhale, your lungs absorb oxygen, which is delivered to neighboring red blood cells that then deliver the oxygen to the rest of your body. When you exhale, your lungs rid the body of carbon dioxide. Your diaphragm helps your lungs expand and contract when you breathe.

Over time, abnormal cells in the lining of the airways can accumulate to form a tissue mass (primary tumor). A primary tumor may grow into the lining around the lung and form secondary tumors nearby.

In advanced disease, lung cancer cells may break away to form tumors in the opposite lung and distant sites such as the liver, brain or bones. These are known as metastases, which are still considered lung cancer and are treated as such.

Types of Lung Cancer


During diagnosis, your doctor likely took a biopsy specimen of the tumor or fluid from the lung or elsewhere for a pathologist to examine and determine the pathologic type of the cancer. Molecular testing may also be done to determine which type you have. Each type has distinct characteristics and responses to treatment, which makes it important for your doctor to determine the specific type.

Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer diagnoses and has several subtypes, including the following:

Adenocarcinoma is the most common NSCLC subtype diagnosed, especially in people who have never smoked. It generally begins in the mucus-producing cells that are farthest away from the airways. It usually grows more slowly than other types and tends to develop in the peripheral lung and spread to distant sites more often than other types except for small cell lung cancer.

Squamous cell lung cancer (epidermoid carcinoma) is the second most common subtype diagnosed. It starts in the early versions of squamous cells, the thin, flat cells that line the inside of the airways in the lungs. It most often develops in smokers and in the central part of the lung. It spreads to distant sites less often than adenocarcinoma.

Large cell lung cancer , the least common type of NSCLC, can develop anywhere in the lungs and tends to grow and spread quickly. When large cell lung cancer includes neuroendocrine features, such as higher than normal amounts of hormones, it may behave and be treated like small cell lung cancer, and other times it may have features more like adenocarcinoma.

Small cell lung cancer (SCLC) is named for its appearance under a microscope and often starts in the central airways (bronchi) in the center of the chest. An aggressive form of lung cancer, it most often spreads to distant parts of the body before it is found. A pathologist identifies the type of cells in the biopsy tissues and may do molecular testing on the tissues.

There are other less common types of lung cancer, which can also begin in other organs, including mesothelioma, typical and atypical carcinoid tumors, sarcoma and others.


Lung Cancer & COVID-19

Research has shown that patients with lung cancer are at a higher risk of getting COVID-19 and having complications from it. As a result, some people with lung cancer have postponed tests and treatments at clinics and hospitals because of the fear of contracting the virus. Putting off these critical appointments can have negative impacts on cancer care. Hospitals and cancer centers have strategies in place to protect these patients and minimize the risk of contracting COVID-19.

At times it may not be essential to see the medical team in person. Telehealth, also known as telemedicine, may be an option for some appointments. These visits are managed remotely through technology using computers, cameras, phones, video conferencing and the internet.

These virtual appointments are not designed to replace in-person visits, but they do offer a convenient alternative. Ask your doctor if telehealth is an option and if it is covered by your insurance plan.

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