Non-small cell lung cancer (NSCLC)
How is lung cancer diagnosed?
Getting an accurate and precise diagnosis of your cancer type is essential to planning and choosing the best treatment options for you.
The most common type of lung cancer diagnosed in the United States — and seen at Roswell Park — is non-small cell lung cancer. It begins when cells in the lungs’ lining (called epithelial cells), become abnormal and grow uncontrollably. Non-small cell lung cancer has three main types, and each grows and spreads in a different way. These three non-small cell lung cancer types are named for the kind of cell where the cancer begins and how the cells look under a microscope.
- Adenocarcinoma begins in cells that line the aveoli, which exchange oxygen and carbon dioxide near the outer walls of the lungs.
- Squamous Cell Carcinoma begins in cells that line the bronchial tubes in the center of the lungs.
- Large Cell Carcinoma, also called undifferentiated lung cancer, is the name for the about 5% of non-small cell lung cancers that do not belong to either of the first two types.
Other less common types of non-small cell lung cancer include:
- Pleomorphic, which occurs in various distinct forms. The cells, or their nuclei, will vary in their size and shape.
- Unclassified carcinoma
Small cell lung cancer (SCLC)
Small cell lung cancer is one of the more aggressive cancer types, and has two main subtypes:
- Small cell carcinoma (Oat cell cancer)
- Combined small cell carcinoma
Pancoast tumor (superior sulcus tumor)
Pancoast tumor is a rare lung tumor type that begins in the upper portion (apex) of either lung and interferes with the surrounding structures — the ribs, the lining of the chest cavity (parietal pleural), the spine, nerves (brachial plexus or sympathetic chain) and blood vessels. It typically is a non-small cell cancer, but it is the location of the tumor, not the cell type, that makes it an unusual form of lung cancer.
These tumors were previously thought to be inoperable, but advances in radiation therapy and surgical techniques have greatly improved survival. Treatment of these rare tumors is complex and requires a multidisciplinary approach involving oncologists specializing in thoracic surgery, medical oncology and radiation medicine. Roswell Park is the only care center in the region that treats Pancoast Tumor.
Malignant mesothelioma is a rare type of cancer in which malignant cells develop in the lung’s outer lining, called the pleura. This cancer type is strongly associated with exposure to asbestos, particularly airborne asbestos particles, which may occur with occupations in firefighting, construction, manufacturing, power plants, railroads and shipyards.
Lung neuroendocrine tumor
This lung cancer type accounts for less than 5% of lung cancers, and typically grows slowly and rarely spreads. Neuroendocrine tumors develop in neuroendocrine cells, a type of cell in the body that can receive messages like a nerve cell and respond by releasing hormones. As part of the diffuse neuroendocrine system, these cells don’t form an actual organ, but are scattered throughout the body. Lung neuroendocrine tumors include these subtypes:
- Small Cell Lung Cancer (SCLC)
- Large Cell Neuroendocrine Carcinoma
- Carcinoid tumors
- Typical Carcinoid Tumor
- Atypical Carcinoid Tumor. This type is slightly more likely to spread to lymph nodes and is treated more aggressively.
Roswell Park’s pathologists have special expertise in differentiating these rare lung cancer types, a critical step to selecting the right treatment for you.