| Lung Cancer (NSCLC) |
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| The Cancer Monthly database currently
has the results (survival, side effects, and more) for 60 recent therapies
for non-small-cell lung cancer including immunotherapy, chemotherapy,
alternative therapy, surgery, radiation, and biological therapy.
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| Introduction
 Lung cancer is the leading cause of cancer death in men and women. Every year, primary carcinoma of the lungs affects 93,000 men and 80,000 women in the U.S. and 86% die within 5 years of diagnosis. The incidence of lung cancer peaks between the ages 55 and 65.
The term lung cancer is for cancers arising from the respiratory epithelium (bronchi, bronchioles, and alveoli). Mesothelioma is distinct from epithelial lung cancer and are considered a different type of cancer.
There are two major subdivisions of lung cancer:
- Small cell – sometimes called oat cell.
- Non-small cell - comprised of various types including:
- - Squamous or epidermoid carcinoma
- - Adenocarcinoma (including bronchioloalveolar)
- - Large cell carcinoma (sometimes called large cell anaplastic)
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Type, Staging and Prognosis
Typical survival rates are related to type of lung cancer:
|
Type |
Frequency |
5-Year Survival Rate (All stages)
|
Small
cell |
18% |
5% |
Non-small cell: |
|
|
Squamous or epidermoid
carcinoma |
29% |
15% |
Adenocarcinoma |
32% |
17% |
Large cell carcinoma |
9% |
11% |
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In addition, typical survival rates are also related
to stage. For example in non-small cell lung cancer there are five
stages:
Stage |
TNM |
Description |
5-year Survival
Rate |
I |
T1-T2
N0 M0 |
T1 = tumor
less than 3 cm
T2 = tumor more than 3 cm
N0 = no metastases to lymph node
M0 = No known distant metastases |
60-80% |
II |
T1-T2
N1 M0 |
N1 = Metastases
in bronchopulmonary or ipsilateral hilar lymph nodes
M0 = No known distant metastases |
25-50% |
IIIA |
|
T3 = Tumor
extends into pleura, chest wall, diaphragm or pericardium |
|
IIIB |
Any
T4 or any N3 M0 |
T4 = Tumor invades
mediastinum (i.e. heart, great vessels, trachea, esophagus,
bone) |
Less
than 5% |
IV |
Any M1 |
M1 = Distant metastases |
Less
than 5% |
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Treatment The
type of treatment also typically relates to stage. For example in
patients with stages I and II non-small cell lung cancer the treatment
of choice is surgery. Radiation is often prescribed to patients
with stage III disease or those with stages I or II for whom surgery is
not performed. Radiation can provide relief of intrathoracic symptoms.
Chemotherapy provides only modest survival benefits (1 to 2 months) in
disseminated non-small cell lung cancer. The Cancer Monthly database
currently has the results (survival, side effects, etc.) for 60 recent
therapies for non-small-cell lung cancer including immunotherapy, chemotherapy,
alternative therapy, surgery, and chemotherapy.
Source: John D. Minna, Neoplasms of the Lung, in Harrison’s
Principles of Internal Medicine, pt. 5 § 75, at 506-515 (Dennis
L. Kasper, M.D. et al., eds, 16th ed 2005).
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