Lung cancer
[Τypes and Staging]
Types of lung cancer
There are two major types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). The stage of lung cancer is based on whether the cancer is local or has spread from the lungs to the lymph nodes or other organs. Because the lungs are large, tumors can grow in them for a long time before they are found. Even when symptoms—such as coughing and fatigue—do occur, people might think they are due to other causes. For this reason, early-stage lung cancer (stages I and II) is difficult to detect.
Non-Small Cell Lung Cancer
Non-small cell lung cancer accounts for about 85 percent of lung cancers and includes:
Adenocarcinoma: starts from adenomatous cells; these normally secrete substances such as mucus. This is the type found more often in current or former smokers, but also is the type commonly occurring in non-smokers. Adenocarcinoma is found more often in women than in men, and also in people of younger ages than other types. They are seen in the outer parts of the lungs in the x-rays or CTs of the chest.
Squamous cell carcinoma, starts in squamous cells, the cells that line the inside of the airways. Usually occurs in smokers and is more often seen in the central part of the lungs, close to a main airway.
Large cell carcinoma, appears in any part of the lung. Usually grows and spreads quickly. A subtype of large cell carcinoma, is the large cell neuroendocrine carcinoma, which is a fast-growing cancer, often very similar to small cell lung cancer.
Small Cell Lung Cancer
Around 10-15% of people with lung cancer have small cell lung cancer. This type of lung cancer is made up of small round cells that form fleshy lumps and usually starts in the larger airways.
Small cell lung cancer grows very quickly and it may spread to the lymph nodes and/or other organs in the body faster than NSCLC. About 70% of people with SCLC will have cancer that has already spread at the time of their initial diagnosis.
Small cell lung cancer is generally very responsive to chemotherapy and radiotherapy, and only in rare cases this type of lung cancer can be surgically removed. However, small cell lung cancer often returns within a short space of time, so it is usual for you to attend regular check-ups to ensure any recurrence is found and treated quickly.
What is Lung Cancer Staging
Lung cancer staging is the way to describe where the lung cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Treatment options are available for all stages of lung cancer, and knowing the stage helps your healthcare team:
– Understand how advanced your lung cancer is
– Recommend those treatment options that are likely to be most effective for you
– Evaluate your response to treatment
When is Lung Cancer staged?
Lung cancer may be staged once or twice. The first staging, which all patients should undergo, is carried out when a patient is initially diagnosed; it should be completed before treatment begins. This type of staging is called clinical staging. Clinical staging is based on the results of various tests, including imaging tests and biopsies. The clinical stage is not only the basis for deciding on a patient’s treatment plan, but is also the basis for comparison when checking into the patient’s response to treatment.
The second staging called pathologic or surgical staging, adds what is learned about the patient’s cancer from surgical treatment to the determination of staging. If the pathologic stage differs from the clinical stage (which it may, for example, if it is evident that the lung cancer has spread more than initially estimated), then the healthcare team can adjust the treatment more precisely.
The TNM staging system is used for non-small cell lung cancer (NSCLC). Including lung adenocarcinoma, squamous cell lung cancer, and large cell lung cancer. The same system can also be used for small cell lung cancer, although for small cell lung cancer a two stages only system, limited-stage and extensive-stage, is more often used.
Stages using TNM classifications are designated by a number, zero (0) through four. For one through four, the Roman numerals I through IV are used. The lower the stage number, the less advanced the cancer is and the better the outcome is likely to be; the higher the stage number, the more advanced the cancer is. Stages I-IV are further divided into substages.
Lung cancer Stage 0
This is called “in situ” disease, meaning that the cancer is “in place” and has not invaded or spread from where it first developed.
Lung cancer Stage I
Stage I lung cancer tumors are small primary tumors that are in one lung only. Stage I lung cancer has not spread to any lymph nodes and has not metastasized. Stage I lung cancer is divided into two substages: stage IA and stage IB, based mainly on the size of the tumor.
Smaller tumors, those no more than 3 centimeters (cm) in the greatest dimension, are stage IA, while slightly larger ones—more than 3 cm but no more than 4 cm in the greatest dimension—are stage IB. Stage IB tumors may or may not have grown into the main bronchus or the lung’s inner lining or have caused lung collapse or swelling.
Lung cancer Stage II
Like stage I lung cancer, stage II lung cancer is located in the lung where it has started. Stage II lung cancers have not metastasized to distant parts of the body. Stage II lung cancer is divided into two stages: Stage IIA and stage IIB. Stage IIA tumors are more than 4 cm but no more than 5 cm in the greatest dimension and have not spread to nearby lymph nodes. The tumors may or may not have grown into the main bronchus or into the lung’s inner lining, or have caused lung collapse or swelling.
Lung cancer Stage III
Stage III lung cancer has spread within the chest but has not metastasized to distant parts of the body. It is sometimes referred to as locally advanced. Stage III lung cancer is divided into three stages: stage IIIA, stage IIIB, and stage IIIC.
Stage IIIA tumors are either:
- More than 7 cm in the greatest dimension and have not spread to nearby lymph nodes. They may have grown into the diaphragm, mediastinum, heart or its major blood vessels, windpipe, recurrent laryngeal nerve, carina, esophagus, or spine, or there are secondary tumors in the same lung but a different lobe than the primary tumor.
- More than 5 cm in the greatest dimension and have spread to the peribronchial nodes and/or to the hilar and intrapulmonary nodes of the lung with the primary tumor. The tumors have grown into the lung’s outer lining or nearby sites, including the chest wall of the heart’s lining, or there are primary or secondary tumors in the same lobe; and/or tumors have grown into the diaphragm, mediastinum, heart or its major blood vessels, windpipe, recurrent laryngeal nerve, carina, esophagus, or spine, or there are secondary tumors in the same lung but a different lobe than the primary tumor
Stage IIIB tumors are either:
- More than 5 cm in the greatest dimension and have spread to mediastinal lymph nodes, which include subcarinal nodes, near the lung with the primary tumor. Tumors have grown into the lung’s outer lining or nearby sites, including the chest wall, phrenic nerve, or the heart’s lining, or there are primary or secondary tumors in the same lobe; and/or tumors have grown in the diaphragm, mediastinum, heart or its major blood vesels, windpipe, recurrent laryngeal nerve, carina, esophagus, or spine, or there are secondary tumors in the same lung but a diferent lobe than the primary tumor
no more than 5 cm in the greatest dimension and have spread to the mediastinal or hilar nodes near the lung without the primary tumor, or to any supraclavicular, or scalene, lymph nodes. They may be in the lungs only, or may have grown into the main bronchus or the lung’s inner lining, or have caused lung collapse or swelling. - Stage IIIC tumors are more than 5 cm in the greatest dimension and have spread to mediastinal or hilar nodes near the lung without the primary tumor, or to any supraclavicular, or scalene, lymph nodes. Tumors have grown into the lung’s outer lining or nearby sites, including the chest wall, phrenic nerve, or the heart’s lining, or there are primary or secondary tumors in the same lobe, and/or tumors have grown into the diaphragm, mediastinum, heart or its major blood vessels, windpipe, recurent laryngeal nerve, carina, esophagus, or spine, or there are secondary tumors in the same lung but a different lobe than the primary tumor.
Οι όγκοι σταδίου IIIC είναι:
Lung cancer IV
Unlike the earlier stages of lung cancer, stage IV lung cancer has metastasized to distant parts of the body. The tumors may be of any size and may or may not have spread to lymph nodes.Stage IV lung cancer is divided into two stages: stage IVA and stage IVB.
- Stage IVA tumors have metastasized, either from one lung into the other lung, into the lung’s lining (and have formed secondary nodules), into the heart’s lining (and have formed secondary nodules), or into the fluid around the lungs or the heart; and/or tumors have spread to one site outside the chest area (e.g., adrenal gland or bones).
- Stage IVB tumors have metastasized to multiple sites outside the chest area (e.g., adrenal gland and bones).
Recurrence
Recurrent lung cancer is lung cancer that has come back after treatment. If there is a recurrence, the cancer may need to be staged again (“restaged”) using the system described above.
Copyright Fairlife L.C.C. © 2024