Types of Lung Cancer and Care Options in NJ, CT, MA, and the Washington, D.C., Area

Lung cancer is made up of abnormal cells in the lung, but not all lung cancers are identical. Within this broad category, there are several different types based on which type of cell the cancer forms from. Each of them behaves differently and responds to different treatments. Identifying the cancer type is critical to formulating a personalized treatment plan.

Many individuals diagnosed with lung cancer turn to Regional Cancer Care Associates (RCCA) for treatment. RCCA is a group of more than 90 medical oncologists and hematologists who treat patients who have solid tumors, blood-based cancers and benign blood disorders at more than 20 locations throughout New Jersey, Connecticut, Massachusetts, and the Washington, DC area. They strive to educate patients while providing innovative care.

What Is Lung Cancer?

Lung cancer is a type of cancer that starts in the lungs. The lungs are sponge-like organs in the chest that are responsible for gas transfer. When a person inhales, air moves down passageways that branch and become smaller before they finally end in tiny air sacs. These sacs, called alveoli, are where oxygen is absorbed into the blood. They also discard carbon dioxide, which is released when the person exhales.

Cancer forms when cells in the lung develop a DNA mutation. The mutation causes the cells to change in appearance and behavior. They start reproducing much more quickly than normal cells, creating a mass of abnormal tissue that does not stop growing. This mass can become malignant, invading neighboring tissue or traveling through the bloodstream to distant parts of the body.

Types of Lung Cancer

There are several types of lung cancer based on the cells they form from. The lungs contain multiple types of cells, each with a specialized role. Lung cancer behaves differently depending on the type of cell it develops from. It also responds differently to various treatment approaches. Identifying the type of lung cancer is critical to planning a patient’s care, as it can determine which options are most likely to work.

Non-Small Cell Lung Cancer

Non-small cell lung cancer, or NSCLC, is by far the most common type of lung cancer, accounting for approximately 80% to 85% of all lung cancer cases. NSCLC is an umbrella term that refers to all lung cancers that are not small cell cancers, most of which grow slowly with a low chance of spreading. This category includes several subtypes, including:

Adenocarcinoma of the lung: Lung adenocarcinomas start in the epithelial cells of the lung. These cells produce mucus, a sticky fluid that protects the inside of the lung. Adenocarcinomas are the most common type of NSCLC.
Squamous cell carcinoma of the lung: Squamous cell carcinomas start in squamous cells, which are thin, flat cells that line the inside of the lung and surrounding airways. This type is less common than adenocarcinomas, but more likely to spread rapidly.
Large cell carcinoma: Large cell carcinomas can form anywhere in the lung and from any cell type. Its cells appear larger than normal when viewed under a microscope. Large cell carcinomas are uncommon but fast-growing.
Other NSCLCs: NSCLCs also include several rarer types of lung cancer, including adenosquamous carcinomas, sarcomatoid carcinomas, Pancoast tumors, and more. These presentations account for only a tiny fraction of all lung cancer types.

Subtypes of NSCLCs can have even smaller variations, some of them unique. People should work with their oncologists to understand their cancer type and what it means for treatment.

Small Cell Lung Cancer

Small cell lung cancer (SCLC) is the second most common type of lung cancer, accounting for about 10% to 15% of all cases. It is called small cell cancer because its cells appear much smaller than normal cells when viewed under a microscope. There are two types of SCLC, differentiated based on their appearance and cell composition:

Small cell carcinoma: The tumor contains only small cells.
Combined small cell lung cancer: The tumor contains a combination of small and large cells.

SCLC is almost always caused by the individual’s history of cigarette smoking. It tends to grow and spread very rapidly, meaning that it often metastasizes before it can be diagnosed. Though SCLC often responds well to aggressive treatments such as chemotherapy and radiation, it has a high chance of recurring after treatment.

Lung Carcinoid Tumor

Lung carcinoid tumors are a very rare type of cancer, accounting for less than 5% of all cases. They form in neuroendocrine cells in the lungs. These cells produce hormones and neurotransmitters that control a variety of lung functions, including air flow, blood flow, and cell growth. Lung carcinoid tumors can overproduce hormones, causing carcinoid syndrome.

Most lung carcinoid tumors, called typical lung carcinoid tumors, grow slowly with a low likelihood of spreading. A small percentage are called atypical lung carcinoid tumors. These grow more quickly and are more likely to spread to other tissues and new parts of the body.

Metastatic Lung Cancer

Metastatic lung cancer does not originate in the lungs. Instead, it is cancer that started elsewhere in the body and has spread (metastasized) into the lung. Any type of cancer can form a secondary lung tumor. The most common, however, are:

Even though they form in the lung, secondary lung tumors share the same characteristics and behavior as their primary cancer. For this reason, they are not considered lung cancers. Lung metastases are treated based on where they originated.

Who Is at Risk for Lung Cancer?

Lung cancer is the second most common cancer in the United States, not counting skin cancers, and the most common cause of cancer deaths. By paying attention to the risk factors, however, people can take steps to protect themselves against disease. Smoking tobacco is by far the most frequent cause of lung cancer. However, even individuals who have never smoked can still develop lung cancer. Lung cancer risk factors besides smoking include:

Secondhand tobacco smoke
Radon or asbestos exposure
Air pollution from diesel exhaust
Exposure to certain industrial chemicals
Exposure to gases from hot cooking oil
Previous radiation treatment
Lung scarring after tuberculosis
Previous lung cancer diagnosis

Like other cancers, lung cancer risk can increase based on a family history or certain genetic mutations. Cancer caused by genetic factors is rare, however. The majority of both smoking and non-smoking lung cancer cases are caused by environmental factors.

Signs and Symptoms of Lung Cancer

Though different types of lung cancer behave differently, they share similar symptoms. Not all people experience symptoms at first. Early stages of lung cancer may not cause problems until the tumor grows larger. When symptoms develop, they sometimes seem trivial. They can also make a person seriously ill. Every person’s experience of lung cancer is unique.

Early Lung Cancer Symptoms

Early signs and symptoms of lung cancer are caused by the tumor blocking an airway or interfering with lung function. Common symptoms include:

A cough that lasts for several weeks
Coughing up blood or rust-colored sputum
Chest pain that gets worse when breathing deeply
Wheezing or harsh breathing
Shortness of breath
Voice hoarseness
Shoulder or back pain
Recurring bronchitis or pneumonia

Late Lung Cancer Symptoms

New symptoms develop as the tumor spreads to new parts of the body. Symptoms of late-stage lung cancer depend on where the cancer settles, but may include:

Loss of appetite
Unexplained weight loss
Neck or facial swelling
Bone or joint pain
Memory loss
Headaches
Blood clots
Persistent fatigue or tiredness

Other conditions can cause symptoms similar to those of lung cancer, especially in its early stages. Nonetheless, it is important to consult a physician about these symptoms, particularly if they are pronounced, arose suddenly, or have persisted for an extended period. The sooner the cause can be identified, the sooner treatment can begin to provide relief.

Treatments for Lung Cancer

Every patient’s lung cancer treatment journey is different. Multiple factors are taken into account when choosing the best approach, including the type of lung cancer, its stage, the person’s overall health, and their personal preferences. Many people will receive multiple treatment types over the course of their care. Treatment types available include:

Chemotherapy: This approach uses strong drugs that are highly toxic to fast-growing cells, including cancer. It is most effective at controlling cancer that has begun to spread.
Surgery: This option removes the tumor surgically. It may be used as a first approach or after radiation therapy has been administered to shrink a tumor.
Radiation therapy: This approach targets cells with high-energy rays that destroy their DNA, killing the cell or preventing it from dividing to slow cancer growth.
Targeted therapy: This cutting-edge approach uses drugs that attack unique mutations found only on cancer cells, effectively killing the cancer while sparing healthy tissue.
Immunotherapy: This approach empowers the patient’s own immune system to identify and combat cancer. It often works at controlling cancer when other treatment types fail.

Along with many treatment options, RCCA also provides patients with access to clinical trials. These are carefully planned and supervised research studies into new treatments. By participating, people can have early access to therapies that are still in development while simultaneously helping researchers improve the treatments available to future patients.

Living With Lung Cancer

Lung cancer is a challenging diagnosis. It takes a toll physically, emotionally, socially, and financially. To support patients at every stage of the treatment process, RCCA offers comprehensive palliative care and integrative care. RCCA’s aim is to maximize the patient’s quality of life by managing symptoms, improving their comfort, and connecting them with therapeutic services and support groups to help them navigate this difficult time.

Find Lung Cancer Care Near You in NJ, CT, MA, and the Washington, D.C., Area

Patients in need of cancer care can find state-of-the-art services at Regional Cancer Care Associates. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.

Frequently Asked Questions About Lung Cancer

What are the early symptoms of lung cancer?

Not all people experience symptoms at the start. When symptoms develop, they commonly include a persistent cough, blood in sputum, chest pain, shortness of breath, fatigue, and unexplained weight loss.

What are the risk factors of lung cancer?

Tobacco smoking is the most prominent risk factor for lung cancer, causing most cases. Other risk factors include lung scarring from tuberculosis and exposure to harmful airborne chemicals, such as radon, asbestos, diesel exhaust, and industrial chemicals.

How does smoking cause lung cancer?

Tobacco smoke introduces harmful chemicals, called carcinogens, that damage the DNA inside cells in the lungs. These DNA changes can provoke uncontrolled cell growth and tumor formation. Cigarette smoke also irritates the lung lining. Over time, chronic lung inflammation may lead to DNA changes that result in cancer.

Is lung cancer hereditary?

Having a family history of lung cancer can slightly increase a person’s risk, especially if genetic mutations were a factor. Most cases of lung cancer, however, are caused by smoking or environmental factors.

Can previous lung diseases cause lung cancer?

Serious lung diseases such as tuberculosis and chronic obstructive pulmonary disease (COPD) can significantly increase a person’s lung cancer risk. This is because they cause long-term lung irritation and inflammation. The inflamed tissues may develop DNA changes that cause cancerous tumors to form.

How is lung cancer diagnosed?

Lung cancer is most often diagnosed with medical imaging, followed by a lung biopsy or sputum cytology to confirm that an abnormal tissue growth is cancerous. Bronchoscopy may also be used to look for tumors in a person’s airways.

Are there screening tests for lung cancer?

Annual low-dosage CT scans are recommended for high-risk patients, including smokers over the age of 50. Non-smokers and young people are not considered eligible for annual screening.