Lung Cancer (NSCLC)

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.

Introduction

Lung Cancer (NSCLC)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:

  1. Small cell – sometimes called oat cell.
  2. Non-small cell – comprised of various types including:
    • – Squamous or epidermoid carcinoma
    • – Adenocarcinoma (including bronchioloalveolar)
    • – Large cell carcinoma (sometimes called large cell anaplastic)

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%

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 N0-1 M0
T1-3 N2 M0
T3 = Tumor extends into pleura, chest wall, diaphragm or pericardium 25-40%
| 10-30%
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%

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).