[[{"@type":["BlogPosting"],"@id":"https:\/\/www.regionalcancercare.org\/news\/understanding-lung-cancer-types\/#BlogPosting","@context":{"@vocab":"http:\/\/schema.org\/","kg":"http:\/\/g.co\/kg"},"url":["https:\/\/www.regionalcancercare.org\/news\/understanding-lung-cancer-types\/","https:\/\/www.regionalcancercare.org\/news\/understanding-lung-cancer-types\/"],"publisher":[{"@id":"https:\/\/www.regionalcancercare.org\/"}],"author":[{"@type":"Organization","@id":"https:\/\/www.regionalcancercare.org\/news\/understanding-lung-cancer-types\/#BlogPosting_author_Organization","name":"Regional Cancer Care Associates"}],"inLanguage":"en-US","image":[{"@type":"ImageObject","@id":"https:\/\/www.regionalcancercare.org\/news\/understanding-lung-cancer-types\/#BlogPosting_image_ImageObject","url":"https:\/\/www.regionalcancercare.org\/wp-content\/uploads\/2021\/12\/doctor-looking-at-an-x-ray-for-lung-cancer.jpg"}],"headline":"Understanding Lung Cancer Types, Treatments, and Survival Rates: 3 RCCA Oncologists Provide Expert Insights","dateModified":"2022-03-11T23:10:41+00:00","datePublished":"2021-09-28T14:48:34+00:00","description":"Three of our finest oncologists provide their expertise on the different types of lung cancer, as well as methods of treatment and survival rates. Read the full article at Regional Cancer Care Associates.","articleBody":"\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\tSeptember 28, 2021\t\t\t\t\t\n\t\t\t\t\t\t\t\t\n\t\t\t\t\nWhile lung cancer remains the leading cause of cancer deaths, recent developments have enhanced physicians\u2019 ability to detect the disease early and treat its most common form more effectively, according to medical oncologists with Regional Cancer Care Associates (RCCA), one of the nation\u2019s largest networks of cancer specialists.\nAlong with declining smoking rates, those diagnostic and treatment advances have seen lung cancer deaths in the U.S. fall steadily over the past two decades, notes Denis Fitzgerald, MD, a board-certified medical oncologist who practices in RCCA\u2019s Little Silver, NJ offices. \u201cWe still have a long way to go, as lung cancer will claim an estimated 131,880 lives in the  U.S. this year, but the progress to date has been significant, and even more advances are on the near horizon,\u201d the cancer specialist says.\n\u201cWe now are able to offer people a wide range of treatment options, including improved approaches to surgery, chemotherapy, and radiation \u2013 which long have been the mainstays of lung cancer treatment \u2013 as well as immunotherapies that harness the power of the body\u2019s own immune defenses and targeted therapies that act on specific genes or gene mutations driving the cancer,\u201d says Dr. Fitzgerald. He notes that all of those therapies, as well as access to clinical trials, are available to people at RCCA\u2019s 20+ community-based care centers in New Jersey, Connecticut, Maryland, and the Washington, DC area. Dr. Fitzgerald also notes it is important to understand the differences in various types of lung cancers.\nSymptoms and Screening\nDr. Fitzgerald says the lung cancer death toll is driven in part by the fact that people often do not have symptoms in the early stages of the disease, and are not diagnosed until their cancer has advanced and become more difficult to treat successfully.\n\u201cSymptoms usually occur only when a tumor is of significant size, when it has become large enough to press on something. There\u2019s a lot of reserve in our lungs, so when the tumor is growing in the middle of the lung, it won\u2019t be pressing on anything and won\u2019t cause symptoms,\u201d he notes.\nThe cancer specialist urges people to see their doctor if a cough doesn\u2019t go away. \u201cThey should at least get a chest X-ray if a cough is lasts more than three or four weeks and there\u2019s no obvious cause,\u201d he says.\nBeyond persistent cough, other symptoms of lung cancer can include:\nshortness of breathchest painhoarsenessrecurrent pneumonia or bronchitiscoughing up blood\nDr. Fitzgerald emphasizes that many of the symptoms of lung cancer can also be signs of other conditions, ranging from the annoying but non-life-threatening, such as a post-nasal drip that triggers a chronic cough, to the non-cancerous but still serious, such as asthma with shortness of breath or heart disease with chest pain. \u201cSymptoms such as these are not cause for panic, but they are reason to see a physician without delay. Too often, people ignore or minimize symptoms, or defer going to the doctor out of fear. In most cases, seeing a physician promptly will help you avoid needless anxiety by providing reassurance that the symptom does not represent anything serious. And in those cases where evaluation does identify a significant health issue, acting sooner rather than later can make all the difference in successfully treating the condition,\u201d the cancer specialist notes.\nIf you are a current or former smoker, it\u2019s also important to have regular screening for lung cancer since early detection before symptoms appear can improve treatment outcomes. The U.S. Preventive Services Task Force (USPSTF), a federal advisory panel of medical experts, recommends that smokers and ex-smokers undergo annual low-dose computed tomography (CT) scans to look for changes in the lungs.\nThe USPSTF guidelines say that a person should be screened each year if he or she is between 50 and 80 years old, has a smoking history of 20 pack years or more, and either smokes now or has quit within the past 15 years. (A pack year is defined as smoking an average of one pack of cigarettes a day for one year\u2014for example, smoking one pack a day for 20 years or two packs a day for 10 years.)\nStudies have presented strong evidence that regular CT scans lead to earlier detection of lung cancer, says Frederick Smith, MD, a board-certified medical oncologist who practices with RCCA in Chevy Chase, MD. He adds, \u201cThere was a higher cure rate in the screened population than in the non-screened population.\u201d\nTwo Main Types of Lung Cancer\nAbout 85% to 90% of people with lung cancer have a type of the disease called non-small cell lung cancer (NSCLC).\nSmoking causes about 90% of NSCLC. Exposure to secondhand smoke, air pollution, radiation, and other toxic chemicals and substances such as radon, asbestos, chromium, and arsenic, cause most of the remaining 10%. A damaged gene can also contribute to NSCLC. By contrast, SCLC (small cell lung cancer) occurs almost exclusively in smokers. It is a much more aggressive disease than NSCLC that develops and is treated differently than NSCLC.\nNSCLC has three main subtypes, each distinguished by the type of cell in the lungs that the cancer strikes:\nAdenocarcinoma is the most common type of NSCLC. It forms in the cells of the alveoli, which are tiny air sacs where the exchange of oxygen and carbon dioxide occurs. Nonsmokers and younger people are more likely to develop adenocarcinoma than other lung cancers. It also affects women more often than men.Squamous cell carcinoma originates in the lining of the lungs near one of the large air passages, or bronchi, that lead from the windpipe to the lungs. It\u2019s the most common type of NSCLC in smokers, which likely explains why the number of squamous cell carcinoma cases has been steadily declining in recent years as fewer people smoke.Large cell carcinoma is a fast-growing cancer that can form anywhere in the lungs. Because it spreads, or metastasizes, quickly, it\u2019s typically more difficult to treat than other types of NSCLC. It gets its name from the large, polygonal shape of its cells.\nThe chances of surviving NSCLC for at least five years after it is detected vary depending on the extent of disease at diagnosis. The average five-year survival rate is 25%, according to the NCI\u2019s Surveillance, Epidemiology and End Results (SEER) program. If the cancer is found early, before it has spread, the five-year survival rate is 63%. Cancer that has spread outside the lungs to a nearby structure or lymph node has a 35% five-year survival rate. The survival rate for lung cancer that has spread to a distant organ, such as the brains, bones, or liver, drops to 7%.\nSmall-cell lung cancer grows and spreads quickly\u2014it will already have metastasized in nearly 70% of people by the time they are diagnosed, according to the American Cancer Society. As a result, the prognosis for those with SCLC usually is poor. Even if SCLC initially responds well to treatment, the cancer eventually returns in most patients.\nOverall, the SEER five-year survival rate is 7%. If the cancer is found early, before it spreads, that survival rate is 27%. If the cancer has spread to a nearby structure or lymph node, the five-year survival rate is 16%. Among those in whom the cancer has spread to a distant organ, that rate is only 3%.\nTreatment Advances and Improved Outcomes\nThe treatment strategy for a patient\u2019s lung cancer is determined by several factors, including the type and stage of the cancer and the patient\u2019s overall health. Over the past decade, as new treatments such as immunotherapy and targeted therapy have been introduced, the number of deaths from lung cancer, especially the non-small cell type, has dropped significantly. Both therapies, as well as other types, are available at RCCA as first-line treatments.\n\u201cIn patients who have lung cancer that has spread throughout the body, there is clearly a marked improvement in how long a person can live and even in overall survival\u201d thanks to the availability of interventions such as immunotherapy and targeted therapy, says Seth Berk, MD, a board-certified oncologist who practices with RCCA in Moorestown, NJ.\nTargeted therapy, Dr. Berk adds, has helped doctors take a highly individualized approach to patients\u2019 lung cancer. \u201cSome patients have forms of lung cancer with certain genetic profiles that enable those people to benefit from molecular therapies unique to their particular cancer.\u201d Targeted therapy is beneficial for people who have an abnormal gene, or a gene mutation, that causes cancer cells to grow and spread. The therapy uses drugs or other agents to prevent those cells from reproducing, and it\u2019s not as harsh as chemotherapy.\nWhen lung cancer is discovered early\u2014before it has had a chance to spread beyond nearby lymph nodes\u2014all or part of the lung often can be surgically removed. However, undergoing surgery may not be viable for some patients who have additional medical conditions, such as chronic obstructive pulmonary disease. Dr. Berk credits newer treatment options for improving outcomes in such patients. One example is stereotactic body radiotherapy (SBRT), which destroys cancer cells or prevents them from growing. \u201cSBRT is a sort of radiosurgery that delivers high doses of radiation to a very small defined area in patients not healthy enough to undergo surgery,\u201d Dr. Berk explains. \u201cThe long-term outcomes with SBRT are very similar to those for surgeries that remove a portion of the lung. So, it\u2019s slowly becoming a new standard for people whose health doesn\u2019t permit an operation.\u201d\nDr. Fitzgerald also points to the growing use of robotic surgery over the last 10 years. \u201cRobotic surgery allows for very small incisions to be made in the lung. The recovery time is much faster than for traditional surgery because there\u2019s minimal pain, and you can get people up and moving about. I see people in their early 80s who have had a portion of their lung removed go home from the hospital one or two days after their procedure, and they don\u2019t need any pain medication.\u201d He adds, \u201cIt has extended the ability to do surgery on people who medically may be somewhat frail. It\u2019s a less-heralded advance than other developments but a real revolution.\u201d\nOther techniques less commonly used as alternatives to surgery include cryotherapy or electrocautery, which freezes or burns cancer cells, respectively, to destroy them, and photodynamic therapy, which employs drugs and lasers.\nTreating Non-Small Cell Lung Cancer\nSurgery, or radiotherapy for patients who aren\u2019t candidates for surgery, is the treatment of choice for stage I and II NSCLC. In stage I, the tumor is no more than 3 centimeters (about 1.2 inches) in size and the cancer hasn\u2019t spread to any other tissues or lymph nodes. In stage II, the tumor ranges in size from 3 cm to 7 cm (about 3 inches), or cancer has spread to tissues surrounding the lung or the large bronchial tubes. For stage II lung cancers, chemotherapy often is used with surgery as an adjunct therapy to destroy any cancer cells that might remain after removal of the tumor or lung.\nTreatment for patients with stage III NSCLC varies depending on several factors, including tumor size and the extent of metastasis, or spread. Stage III means a tumor is larger than 3 cm and cancer has spread to nearby lymph nodes or organs. Stage III cancer often is treated with a combination of chemotherapy and radiotherapy. Surgery is sometimes performed before or after chemoradiotherapy. In some cases, immunotherapy may be added after chemoradiotherapy. This approach has been shown to improve outcomes.\nAdvances in targeted therapy and immunotherapy have significantly helped patients with stage IV non-small cell cancer. In stage IV NSCLC, the disease has spread to the other side of the chest or beyond the chest area. Both targeted therapy and immunotherapy are used as first-line treatments. If the cancer is driven by a gene mutation for which targeted therapy is available, that targeted therapy generally will be used. Otherwise, immunotherapy likely will be administered. Chemotherapy may also be part of the treatment regimen.\nWhen NSCLC has spread, additional treatment often will be directed toward the areas affected. The most common parts of the body where NSCLC metastasizes include the brain, the bones, and the area around the lungs.\nStage IV NSCLC can\u2019t be cured, but treatment can extend life and relieve symptoms.\nTreating Small Cell Lung Cancer\nTherapies directed at SCLC haven\u2019t progressed nearly as fast as those for NSCL. Still, advances in chemotherapy\u2014a cornerstone of SCLC treatment\u2014have rendered the drugs used somewhat gentler and more effective than in the past, says Dr. Smith.\nSurgery is the first-line treatment for some patients with limited-stage disease\u2014cancer that hasn\u2019t spread beyond the lung or the lymph nodes between the lungs. It\u2019s typically reserved for patients with a single tumor in one lung. However, such localized cancer in SCLC is uncommon because the cancer usually has spread beyond the lungs by the time it\u2019s diagnosed. Surgery typically is followed by chemotherapy and radiation therapy to the chest.\nFor other patients with limited-stage disease, chemotherapy combined with radiation therapy typically is the first-line treatment. Additional radiation therapy may be directed at the brain in an effort to prevent cancer from spreading there.\nWhen SCLC has spread extensively, it isn\u2019t curable, and therapy will be administered to relieve symptoms and prolong life. Patients who have extensive-stage SCLC that has spread to distant areas of the body typically are treated with chemotherapy combined with immunotherapy, which has been shown to improve outcomes. Radiation therapy may also be added to the treatment regimen.\nExploring Clinical Trials\nDoctors at RCCA participate in a wide range of clinical trials and make patients aware of any studies that may be appropriate for them. They provide patients with detailed information on what a particular trial involves, and answer all questions that patients and their family members may have when considering whether they want to join the study..\n\u201cClinical trials are important,\u201d says Dr. Smith. \u201cI believe in them, and I encourage them, but they\u2019re not for everyone. We look for clinical trials that might give us an edge on the present standards of care for an individual. Further, because we are community-based cancer specialists, we offer access to clinical trials at offices near patients\u2019 homes. You don\u2019t have to travel to Houston or Boston to participate or enroll in a study.\u201d\nDr. Smith strikes an optimistic tone when it comes to current and future lung cancer therapies. \u201cAlthough the holy grail of curing advanced lung cancer may not yet be available,\u201d he says, \u201cliving\u2014and living reasonably well\u2014with advanced lung cancer is a real possibility.\u201d But, he adds, \u201cCertainly, prevention by not smoking and early detection with low-dose CT scans should always be pursued.\u201d\n*******\nDrs. Fitzgerald, Smith, and Berk are among the 80+ cancer specialists who treat patients at more than 20 RCCA care centers in New Jersey, Connecticut, Maryland, and the Washington, DC, area. Those oncologists see more than 22,000 new patients each year and provide care to more than 225,000 established patients, collaborating closely with their patients\u2019 other physicians. They offer patients the latest in cutting-edge treatments, including immunotherapies and targeted therapy, as well as access to a wide range of clinical trials. In addition to serving patients who have solid tumors, blood-based cancers, and benign blood disorders such as anemia, RCCA care centers also provide infusion services to people with many non-oncologic conditions including multiple sclerosis, Crohn\u2019s disease, asthma, and rheumatoid arthritis who take intravenously-administered medications.\nTo learn more about RCCA, call 844-928-0089 or visit RCCA.com. \nwe are here for you\nFor more information or to schedule an appointment, call (844) 301-4158. You can also schedule an appointment by calling the RCCA location nearest you.\nRELATED ARTICLES\nRegional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.\n\u00a9 2022 Regional Cancer Care Associates. 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Fight cancer with leading-edge treatments, experienced skill and local caring\/convenience from one of the nation's largest networks of cancer specialists.","email":"info@regionalcancercare.org","mainEntityOfPage":"https:\/\/www.regionalcancercare.org\/","url":"https:\/\/www.regionalcancercare.org\/","sameAs":["https:\/\/twitter.com\/rgnlcancercare","https:\/\/www.facebook.com\/regionalcancercareassoc","https:\/\/www.linkedin.com\/company\/10059183","https:\/\/www.youtube.com\/channel\/UCFlVzU4UvZcyXBCe9ZSvAUQ"],"telephone":"+1 (844) 346-7222","name":"Regional Cancer Care Associates","@id":"https:\/\/www.regionalcancercare.org\/"}],{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"News","item":"https:\/\/www.regionalcancercare.org\/news\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Understanding Lung Cancer Types, Treatments, and Survival Rates: 3 RCCA Oncologists Provide Expert Insights","item":"https:\/\/www.regionalcancercare.org\/news\/understanding-lung-cancer-types\/#breadcrumbitem"}]}]