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Types of Lung Cancer

Lung cancer can be broken down into two main groups:
Small cell lung cancer
Non small cell lung cancer

Although very imprecise there are some characteristics of each type of lung cancer that suggest their differentiation. Their treatments differ to some extent although the modalities of surgery, radiotherapy and chemotherapy can be applied in all types. Prognosis is determined most by the stage of the disease, although cell type has some influence.

Small cell lung cancer

The most important steps in the diagnosis and management of lung cancer is in defining the cell type and the stage of the disease. This entails defining the exact site and size of the tumour, and its local extent. A full appreciation of the involvement of local and distant lymph nodes is vital, as is the presence of distant spread to bone, liver and brain. This characterisation of the cancer dictates the form of treatment that will be offered more than anything else. The vigour with which a tumour can be treated depends upon the physical state of the patient hence an overall assessment of the patients' health and condition is vital.

Types of lung cancer – small cell lung cancer

Small cell lung cancer is sometimes referred to as oat cell cancer due to the size and shape of the cancer cells. It is the least common of the two types of lung cancer accounting for approximately 12% of all lung cancer cases. Small cell lung cancer spreads quickly and hence patients are often in more advanced stages of lung cancer when diagnosed where surgery is no longer possible. This type of lung cancer is usually caused by smoking and it is rare for a non-smoker to develop small cell lung cancer. Surgical resection may be possible but treatment usually consists of chemotherapy which may be supplemented with radiotherapy. Occasionally the tumour may remain localised and surgery may have a role to play.

Types of lung cancer – non small cell lung cancer

The most common type of lung cancer is non small cell lung cancer and accounts for approximately 88% of all lung cancers. Non small cell lung cancer is grouped into three further types:

  • Squamous cell carcinoma – the most common type of lung cancer that is also known as epidermoid carcinoma. It usually occurs in the larger airways close to the centre of the lungs and is often caused by smoking. As a result, incidence of this form of lung cancer is now on the decline as smoking rates decline. This type of lung cancer tends to be slow growing and, because the tumours present in the airways, it can cause symptoms such as pneumonia and collapsed lung much earlier than other forms of lung cancer and can be detected at an earlier stage.
  • Adenocarcinoma – This type of lung cancer is the most common lung cancer found in women and the incidence is on the rise. It most commonly develops in the outer parts of the lungs. Because of this it presents few symptoms in the early stages of the disease making it difficult to detect. Adenocarcinoma may be found in non-smokers and is the most common type of lung cancer in Asians and people under 45.
  • Large cell carcinoma – Named as such due to the size of the cells in the tumour when viewed under a microscope. This type of lung cancer is most typically found in the outer regions of the lungs. It can be difficult to detect large cell lung cancer in the early stages as typical symptoms such as coughing up blood or a persistent cough may be less apparent. More obvious symptoms such as shortness of breath and chest pain (Pleurisy) can be caused by irritation of the lining of the lung (the pleura). The breathlessness may be caused by the production of excessive fluid between the pleural layers that line the lung. Pain in the chest may be worse when taking a deep breath. In some instances, large cell lung cancers can secrete a hormone like substance that can lead to paraneoplastic symptoms including breast swelling in men (see lung cancer symptoms for more information about paraneoplastic syndrome).

Types of Lung Cancer – Mesothelioma

Mesothelioma is a rare type of lung cancer but, unfortunately, incidence of this type of lung cancer is increasing. Most cases of mesothelioma are caused by exposure to asbestos in the workplace and, in most cases, development of the disease can take place many years after initial exposure. It is also possible to develop mesothelioma from radiation exposure and a virus called simian virus has also been linked to the disease.

The mesothelium is a membrane that protects the lungs, heart and abdominal cavity and mesothelioma is a cancerous tumour that grows on the mesothelium. The symptoms are very similar to many other respiratory conditions so diagnosis can be difficult. A lung biopsy will be needed to confirm any initial diagnosis from X-Rays or other types of scan.

Mesothelioma is one of the few cancers there are definitive prevention measures, e.g. wearing the correct protective equipment when working with asbestos and being aware of the dangers of asbestos in buildings.

Less common types of lung cancer

The types of lung cancer listed above are not complete. There are many other less common types of lung cancer including: pleomorphic, carcinoid tumour, salivary gland carcinoma and unclassified carcinoma.

If you are worried about lung cancer, have lung cancer symptoms or think you may be at risk then please contact us to arrange a LungCheck. LungCheck, lung cancer screening involves an online risk assessment followed by a blood test.

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