Lung Cancer

Learning About Your Specific Lung Cancer Diagnosis is Key

Receiving a lung cancer diagnosis is life-changing. Give yourself time to digest the news, and then learn as much as you can about your exact diagnosis and the types of support available. Begin by using the resources in this guide and those from your health care team.

There was a time when lung cancer was primarily found in people who had a history of smoking, but today, it is often found in non-smokers and never smokers as well. However, the outlook for many people diagnosed with lung cancer is improving significantly with the advances made in precision medicine, multidisciplinary care and research studies known as clinical trials. The presence of certain biomarkers, for example, can help your doctor choose a treatment that is most likely to be successful for you. Researchers continue to look at ways to prevent, diagnose, manage and treat all forms of lung cancer, meaning there may be additional options on the horizon.

Knowing key information, such as the stage of your cancer and any biomarkers that are present, will help you feel more prepared to make well-informed treatment decisions.


Explaining Lung Cancer

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. 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.

Lung cancer often begins in the lining of the airways when abnormal cells grow out of control, dividing faster and living longer than normal cells. Over time, these cancerous cells accumulate to form a tissue mass (primary tumor). Left untreated, a primary tumor may grow into the pleura and form secondary tumors nearby. The cancer cells can eventually crowd out the normal cells to make breathing increasingly difficult.

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.

After evaluating and analyzing the cancer cells in a biopsy specimen or fluid taken from the lung or elsewhere, a pathologist will define the type of lung cancer you have, which will help guide treatment decisions.

Adenocarcinoma is the most common subtype diagnosed, especially in people who have never smoked. It generally begins in the mucus-producing cells in the more distal (those that are farthest away) airways. It tends to grow 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 and starts in the early versions of squamous cells, the thin, flat cells that line the more central airways in the lungs. It most often develops in smokers and in the central lung. It spreads to distant sites less often than adenocarcinoma.

Large cell lung cancer, the least common type of lung cancer, 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.

Adenocarcinoma and squamous cell and large cell lung cancers are sometimes collectively referred to as non-small cell lung cancer (NSCLC), which accounts for the majority of lung cancer diagnoses. Each type has distinct characteristics and responses to treatment, which makes it important for your doctor to determine the specific type.

Small cell lung cancer (SCLC), named for its appearance under a microscope, 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.

Limited-stage SCLC is confined to one part of the chest, in just one part of the lung and in nearby lymph nodes. Extensive-stage SCLC has spread to other parts of the body, such as the bone, brain or other lung. SCLC cells may secrete proteins that cause symptoms such as neurologic weakness or abnormalities in blood electrolytes.

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

Key Takeaways

  • Knowing your exact diagnosis is important. Ask your doctor or nurse to write it down for you.
  • Your health care team is a valuable resource for learning more about your diagnosis.
  • The type of lung cancer you have will help guide the treatment that may work best for you.
  • Research is underway that may offer more treatment options in the near future.