Knowledge is power. By learning more about your specific type of lung cancer, you can be the strongest champion for your own care.
In this section, we will review the different types and stages of lung cancer. Type and stage may help determine what testing and treatments may be right for you.
Identifying Your Type of Lung Cancer
During your initial diagnosis, your health care team may take a sample of your tumor (known as a biopsy). This sample will be used to better understand your specific type of lung cancer. A specialist known as a pathologist will look at the biopsy using a microscope to determine the type of cancer you have.
There are 2 main types: small cell lung cancer (SCLC) and non–small cell lung cancer (NSCLC).
SCLC accounts for approximately 1 out of 10 diagnoses. It usually grows quickly, spreads to other parts of the body, and causes symptoms sooner than NSCLC. SCLC is typically caused by tobacco smoking.
NSCLC accounts for nearly 9 out of 10 diagnoses. It tends to grow more slowly than SCLC. There are often no or few symptoms of NSCLC until it has advanced.
NSCLC is further categorized into subtypes. The most common subtypes of NSCLC are:
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell carcinoma
About 9 in 10
Cases of lung cancer are NSCLC
The approach to treating these 2 types of lung cancer generally differs. Treatment for SCLC is typically done at a much faster pace than for NSCLC because of the cancer's ability to rapidly spread to other parts of the body.
For NSCLC, you may also need additional testing for biomarkers before starting treatment. Biomarker testing allows your health care team to understand more about your unique cancer and to determine if specialized treatment may be appropriate for you.
Identifying Your Stage of Lung Cancer
Stage is the way doctors describe a cancer’s growth or spread in the body.
Stage is based on:
- The size of the tumor
- Where the tumor is within the lung
- If the cancer has spread to other parts of the body
| NSCLC STAGES | ALSO KNOWN AS | WHAT IT MEANS |
| 1-3 | Early stage or locally advanced |
|
| 4 | Advanced or metastatic |
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Doctors will determine the stage of your cancer by using any combination of the following scans or tests:
Computed tomography (CT) scans use a series of sophisticated x-rays to make a detailed picture of a cross-section of the body. These scans can show the location and size of tumors.
Positron emission tomography (PET) scans use a labeled sugar and a special camera. As part of this scan, a small amount of the labeled sugar is injected into a vein, and the PET machine is used to see where the sugar is used the most in the body. Since cancer cells grow faster than normal cells, they use more sugar and show up as bright spots in the PET scan images. In this way, PET scans can help determine where tumors are in the body. Other health problems can also show up as bright spots on PET scans, so cancer detected by PET scans often needs to be confirmed with a biopsy or other types of scans.
Magnetic resonance imaging (MRI) uses magnetic fields to produce detailed pictures of the body. It is useful for finding abnormal growths, including tumors in the brain.
Bronchoscopy is a procedure that allows a doctor to view your lungs and airways. A thin tube with a camera called a bronchoscope is used to look for tumors. It may also have tools to remove a small sample of tumor (biopsy) for testing.
These are some, but not all, of the scans or tests that may be performed to determine the stage of your lung cancer. The results from these scans or tests may take some time to process.
The stage of your lung cancer can affect your treatment options
- Early-stage lung cancer may be treated with surgery
- Advanced or metastatic lung cancer usually cannot be treated by surgery alone and may require a combination of more than one treatment. This is because the cancer is in more than one part of the body
Selecting the right medical management often requires additional testing
- Some treatments, known as targeted therapies, are very specific to certain types of cancer
- In order to determine if you have a type of lung cancer that can be treated with these specialized therapies, your health care team may request biomarker testing
- Biomarker testing helps to identify unique changes or mutations to your cancer cells, called biomarkers, that can help determine the right treatment for you
To learn more about biomarkers and biomarker testing, continue on to Understanding Biomarkers.
Frequently Asked Questions
What is the difference between NSCLC and SCLC?
Lung cancers are divided into these 2 main types based on the size of the cancer cells when examined under a microscope. In addition to the different sizes of the cancer cells, other differences between these 2 cancer types result in there being very different treatments for NSCLC and SCLC. Treatment for SCLC is typically done at a much faster pace than for NSCLC because of the cancer's ability to rapidly spread to other parts of the body. For NSCLC, you may also need additional testing for biomarkers before starting treatment. Biomarker testing allows your health care team to understand more about your unique cancer and to determine if specialized treatment may be appropriate for you.
Will I need surgery for NSCLC?
Surgery, or having an operation, is the physical removal of cancer cells from the body. Whether you can be treated with surgery depends on the type and stage of your cancer. Surgery is generally not recommended for advanced or metastatic NSCLC, in which the cancer has spread to other organs.
Will I need radiation therapy for NSCLC?
Radiation is the use of x-rays or other high-energy beams to damage cancer cells and stop them from growing or multiplying. Radiation treatment is directed to the site of the tumor, delivering radiation that can kill tumor (and normal) cells. Similar to surgery, radiation therapy is a form of local treatment, working directly on the area of the body where the tumor is located. Your health care team will be the best resource to discuss if radiation therapy will be a helpful part of your treatment plan.
Will I need chemotherapy for NSCLC?
Chemotherapy is a medication that travels through the bloodstream to kill rapidly dividing and growing cancer cells. It can be given at a medical office via a tube into your vein, a shot, or other route. Chemotherapy is a systemic treatment, meaning that it can affect cancer cells and healthy cells throughout the whole body. Your health care team will be the best resource to discuss if chemotherapy will be a helpful part of your treatment.
What other therapies are available for NSCLC?
Targeted therapies are treatments that are available for specific types of NSCLC. The only way to know if you may be eligible for targeted therapy is through biomarker testing. Immunotherapy is also available for NSCLC. Typically, medical experts recommend that immunotherapy only be used when targeted therapy is not an option.
How do I know if I will need biomarker testing?
Your health care team may order specific tests for you, including biomarker testing. Biomarker testing helps your health care team to gather as much information as possible about your type of lung cancer. Medical experts recommend biomarker testing for all people with advanced NSCLC. Biomarker testing can help determine your eligibility for potentially effective treatments.
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Non–small cell lung cancer (NSCLC)
The most common form of lung cancer, which is described by the way the cancer cells look under a microscope (not small).
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Targeted Therapy
A treatment that targets the driver mutations that cause cancer growth.