Lung Cancer – Types Of Cancer, Staging & Grading, Treatment Of Lung Cancer

Lung Cancer – Types Of Cancer, Staging & Grading, Treatment Of Lung Cancer


Lung cancer is one of the most common cancers in the world with more than 1.5 million new cases diagnosed and 700,000 deaths reported worldwide in 2014. Lung cancer is the second leading cause of cancer death in men and women in the United States with a five-year survival rate of only 5-10%.

As per WHO statistics the most common in 2020 (in terms of new cases of cancer) were:

  • breast (2.26 million cases);

  • lung (2.21 million cases);

  • colon and rectum (1.93 million cases);

  • prostate (1.41 million cases);

  • skin (non-melanoma) (1.20 million cases); and

  • stomach (1.09 million cases).

The most common causes of cancer death in 2020 were:

  • lung (1.80 million deaths);

  • colon and rectum (935 000 deaths);

  • liver (830 000 deaths);

  • stomach (769 000 deaths); and

  • breast (685 000 deaths).

A recent review article published by the American Cancer Society states that “Lung cancer remains a deadly disease with high mortality rates, increased morbidity, and a poor prognosis.” The review article entitled “Recent advances in lung cancer therapy and diagnosis” focuses on current treatment options for this deadly disease. A key question that this review address is: Where does lung cancer come from?

The earliest human cases of lung cancer have been documented from 1876 on multiple dates from China, India, Europe, Russia, Japan and Australia. The first hospital case of lung cancer was recorded at Bellevue Hospital in New York City around 1900. Since then more than 600 patients have been diagnosed with this disease.

This review also notes that there are five subtypes of this disease: squamous cell carcinoma (SCC) non-small cell carcinoma (NSC) adenosquamous carcinoma (ASC) large cell carcinoma (LCC) small cell carcinoma (SCCM) M1 = Mitotic index = number of mitoses per field evaluated; M2-M5 = Mitotic index = number of mitoses per field evaluated.




1. The Growth of Lung Cancer


Lung Cancer is the second leading cause of cancer-related death in the United States. The origin of cancer is determined by a complex interaction between genetics, cell type, and environmental factors. Tumors are classified as either adenocarcinomas or squamous carcinomas based on their morphology, location, and histology. The prognosis of lung cancer has been less inspiring than that of other cancers such as breast and prostate cancer—but it is improving.

While lung cancer is the most aggressive type of non-skin cancer (the most common form of primary lung carcinoma), it is also the least common. Approximately 12% of all people will be diagnosed with this type of cancer, but only 1 in every 100 will die from it. The mortality rate for patients diagnosed with lung carcinoma remains lower than that for breast or prostate cancers.


2. The Symptoms of Lung Cancer


Common symptoms of lung cancer include.

  • Coughing that gets worse or doesn’t go away.

  • Chest pain.

  • Shortness of breath.

  • Wheezing.

  • Coughing up blood.

  • Feeling very tired all the time.

  • Weight loss with no known cause.


In 2010, new lung cancer treatments were approved for patients with early-stage disease. These treatments include chemotherapy, radiation therapy, and surgery. Lung cancer can be diagnosed through noninvasive imaging such as CT scans or positron emission tomography (PET). In addition to the above treatment options, there are also newer options such as fractionated-invasive palliation which combines chemotherapy with radiation therapy.

The goal of medicine is to eradicate or limit the spread of a malignant tumor without harming surrounding healthy tissue. This is accomplished by targeting specific cell types for treatment rather than suppressing normal cells to prevent further tumor growth. This approach has proven effective in some cases and has been shown to significantly reduce treatment-related side effects.


3. Staging and Grading Systems


Lung cancer is the most common cause of cancer death in the United States. Lung cancer is one of the most difficult cancers to diagnose and treat due to the fact that it is a heterogeneous, multifactorial disease.

Stage I: Cancer is in your lung tissues but not your lymph nodes. 

Stage II: The disease may have spread to your lymph nodes near your lungs. 

Stage III: It has spread further into your lymph nodes and the middle of your chest.

4. Diagnosis and Prognosis


Lung cancer is the leading cause of cancer death in the US and the second leading cause of cancer death globally. Lung cancer is a disease that has a high survival rate and an excellent prognosis. However, lung cancer survival rates are lower for patients diagnosed with advanced lung cancers, as well as for patients who are <50 years old.


5. Treatment for early-stage lung cancer


Lung cancer is one of the deadliest diseases. Symptoms of lung cancer can vary from a few days to decades. Traditionally, lung cancer was thought to be the most curable form of cancer. However, recent advances in treatment have given us hope that this may not have to be the case.

Lung cancer is treated in different ways, depending on the staging & Grading of Lung Cancer. People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. People with small cell lung cancer are usually treated with radiation therapy and chemotherapy.

  • Surgery. An operation where doctors cut out cancer tissue & remove it.

  • Chemotherapy. Using special medicines to shrink or kill cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.

  • Radiation therapy. Using high-energy rays (similar to X-rays) to kill cancer.

  • Targeted therapy. Using drugs to block the growth and spread of cancer cells. The drugs can be pills you take or medicines given in your veins. You will get tests to see if targeted therapy is right for your cancer type before this treatment is used.


6. Treatment for advanced-stage lung cancer


The battle for lung cancer treatment is on. There has been an improved understanding of how to treat and how to prevent lung cancer. Furthermore, the costs and benefits of treatment are becoming clearer, leading to new treatments being tested in clinical trials.

Lung cancer is cancer that starts in the lungs. It’s an aggressive disease that can spread to other organs, such as the stomach or bones. Each year, more than 1 million Americans are diagnosed with lung cancer and more than 10,000 die from it.

A variety of treatments exist for lung cancer patients – chemotherapy plus radiation therapy; surgery which removes tumors; and medications like Avastin (bevacizumab) or new immunotherapy called Gemcitabine (pazopanib).

In 2012, the Food and Drug Administration approved a new drug called Opdivo (nivolumab) for people with advanced-stage non-small-cell lung cancer who were not responding to chemotherapy — this drug was used in two clinical trials by the FDA and is now available without a prescription through doctors’ offices nationwide.


7. Treatment for metastatic disease


Lung cancer is the leading cause of cancer death in men and women across the globe, particularly in developed and developing countries where smoking rates remain high 

(1). Ironically, despite decades of scientific research, there is still no cure for lung cancer. The current understanding of how lung cancer develops gives us hope that we will one day be able to treat this form of cancer and have a greater chance of survival 

(2). However, up until the end of 2013, only 10% of patients diagnosed with lung cancer were alive 5 years after diagnosis 

(3). As a result, lung cancer remains one of the most lethal forms of the disease. Unfortunately, even with these significant advances in treatment and diagnosis, it is estimated that approximately 50% of patients with advanced-stage non-small-cell lung cancer die without receiving curative therapy 

(4). While new treatments are being developed every year to improve outcomes and reduce mortality rates, it is clear that as long as smoking remains widespread in developing nations like India, Pakistan and China this will continue to be a major challenge for both clinicians and patients.


8. Conclusions


Lung cancer is one of the deadliest forms of cancer. The prognosis for individuals diagnosed with lung cancer has been bleak, however, the past 10 years have seen important advances in treatment and diagnosis which have translated into the first improvements seen in lung cancer survival. This review highlights the major advances in treatments with curative and targeted therapies which are being used to improve lung cancer survival.



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