large cell neuroendocrine carcinoma lung :: Article CreatorSmall-Cell And Non-Small-Cell Lung Cancer: What's The Difference?
Lung cancer is the leading cause of cancer deaths among both men and women. Small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) are the two main types of lung cancer. Most lung cancers are NSCLC. Only about 15% of lung cancers are SCLC.
Their names stem from what their cells look like when you look at them under a microscope. SCLC cells look round and undersized in comparison to NSCLC cells. But the big difference is how aggressive they are. SCLC is more aggressive than NSCLC and often spreads to other parts of your body.
Here are the facts about SCLC and NSCLC and how they differ.
Small-cell lung cancer is when abnormal cells in your lung grow fast and uncontrollably. It's an aggressive form of cancer that often starts in your airways and then spreads, or metastasizes, to other parts of your body.
There are two types of SCLC, which are based on which cells are affected:
Small-cell carcinoma, which is also called oat cell cancer, is the more common type of SCLC. Combined small-cell carcinoma is a rare type of SCLC that has both SCLC and NSCLC components. For most people, by the time you're diagnosed with SCLC, it has already spread to other parts of your body. The areas may include:
Adrenal glands Bone marrow Bones Brain Liver Lymph nodes Non-small-cell lung cancer is a group of lung cancers that are different from SCLC. It's more common and less aggressive than SCLC. But it's important to catch it early so it doesn't spread to other areas.
The most common types of NSCLC are:
Adenocarcinoma, which starts in the mucus-producing cells lining your smallest airways Large cell carcinoma, which starts in neuroendocrine cells in the lung Squamous cell carcinoma, which starts in flat cells lining the larger airways The main difference between SCLC and NSCLC is how aggressive they are. Another difference is how common they are. NSCLC is a less aggressive and more common form of lung cancer than SCLC.
Your doctor will know which type of lung cancer you have when they take a biopsy, or small sample of the tumor, and send it to a lab, where scientists will examine it under a microscope. They'll also see where the cancer started and how abnormal the cells are.
It's possible you won't notice any symptoms of lung cancer, especially in the early stages. It's common for doctors to find lung cancer when they do an X-ray for something else.
When present, symptoms of SCLC and NSCLC are similar:
Appetite loss or weight loss Chest discomfort Worsening cough Coughing up blood Hoarseness Swelling of your face and neck veins Tiredness Trouble breathing Trouble swallowing Because SCLC is more likely to metastasize (or spread) early on, you may have symptoms that stem from lung cancer in other organs. They may include:
Bone pain Bumps or lumps in your skin Confusion Paralysis Seizures The main risk for both SCLC and NSCLC is smoking. About 98% of SCLC cases are linked to smoking tobacco. This includes cigarettes, pipes, and cigars.
The earlier you start smoking, the longer you smoke, and the more often you smoke, the higher your risk is. If you already smoke, quitting now lowers your chances of developing lung cancer.
It's best to avoid secondhand smoke, too, because it's also a risk factor.
Other risk factors for SCLC include:
Environmental pollution Exposure to second-hand tobacco smoke Radiation Workplace carcinogens Family history of lung cancer HIV infection Other risk factors for NSCLC include:
Exposure to second-hand tobacco smoke Workplace exposure to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar Radiation therapy to your breast or chest Radon Imaging tests like CT scans Atomic bomb radiation Environmental pollution Family history of lung cancer HIV infection Being a heavy smoker and taking beta-carotene supplements The more risk factors you have, the higher chance you have of developing lung cancer.
Lung cancer develops and progresses quickly. This is why it is often diagnosed at an advanced, incurable stage. Screening for lung cancer has been introduced for high-risk people in order to catch lung cancers early when there is still a chance of cure.
If you have a history of smoking, your doctor may do regular CT screenings. The American Society of Clinical Oncology recommends with low-dose CT if you're 50 - 80 and currently smoke or if you previously smoked and have at least a 20-pack-year history or you quit within the last 15 years. Screenings can stop when you've been smoke-free for 15 years or have a health problem that limits your treatment options or life expectancy.
Lung cancer screening for high-risk people is helpful because SCLC and some types of NSCLC grow fast and lung cancer are frequently not diagnosed before you notice symptoms. Survival depends on early diagnosis.
If your doctor is worried about lung cancer, they may:
Look for general signs of health Ask about symptoms of cough, weight loss, and shortness of breath Check for enlarged lymph nodes Ask about your smoking history Ask about other illnesses and treatments you've had Ask about your job and past jobs They may also run tests and scans, including:
If they think you have lung cancer, they'll take a biopsy of the abnormal area in the lung to evaluate for cancer cells.
There are different options for treating lung cancer. The treatment you get depends on the type and stage of your lung cancer, and other factors like your age and overall health.
Lung cancer treatment may include:
Chemotherapy Immunotherapy Radiation therapy Surgery Targeted drug therapy The most common type of treatment for SCLC is chemotherapy. Your doctor may recommend combining it with radiation.
If you have NSCLC and it hasn't affected a large part of your lungs or spread to other areas of your body, your doctor may recommend surgery to remove the cancer cells.
You may consider joining a clinical trial. This is a study done to research lung cancer and find out if new treatments are safe and effective, or if they're better than standard treatment.
Some clinical trials may offer a better treatment for your cancer. Talk to your doctor about options.
The outlook for NSCLC is better than SCLC.
Most people find out they have SCLC when it's already spread to other parts of their body. Early detection helps, but it's often found late because you may not have symptoms.
With SCLC, the 5-year survival rate is about 7%. Without treatment, survival is about 2 to 4 months. With treatment, it's longer. If you have chemotherapy, it may be about 10 months. Even if treatment is successful, the cancer often comes back.
For men, SCLC is the leading cause of cancer-related death. For women, it's the second most common cause of cancer-related death.
Your chance of survival is higher for NSCLC, but it depends on a variety of factors. They include:
The lung cancer stage, which is based on tumor size and whether or not it spread to other areas The type of NSCLC you have Whether or not it mutated, or changed, in certain genes Your overall health Your signs and symptoms The 5-year relative survival rate for NSCLC may range from 64% if you catch it early and it hasn't spread outside your lung, to 8% if it has spread to other areas of your body like your brain, bones, liver, or other lung.
For SCLC, the 5-year relative survival rate may range from 30% in early stages to 3% if it has spread to other parts of your body.
Survival For Neuroendocrine Cancer
Survival (prognosis
) for neuroendocrine cancer depends on many factors. These include your type and stage of neuroendocrine cancer. No one can tell you exactly how long you will live. Neuroendocrine cancers are a group of cancers that develop in cells of the neuroendocrine system
. You might also hear the term neuroendocrine neoplasm (NEN). This means the same as neuroendocrine cancer. There are 2 key groups of neuroendocrine cancer: NETs and NECs are very different. So it is important to know which one you have. Talk to your doctor or specialist nurse if you are not sure. Some neuroendocrine tumours (NETs) have a very good outlook. But neuroendocrine carcinomas (NECs) grow quickly and can spread to other parts of the body. And some NETs are fast growing and can also spread. These faster growing cancers can be more difficult to treat. Doctors usually work out the outlook for a certain disease by looking at large groups of people. But neuroendocrine cancer is less common than some other types of cancer, and there are many different types. So survival is harder to estimate than for other, more common cancers. Some of the statistics have to be based on a small number of people. Remember, they can't tell you what will happen in your individual case. Your doctor can give you more information about your own prognosis. You can also talk about this to the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. About these statistics The terms 1 year survival and 5 year survival don't mean that you will only live for 1 or 5 years. The NHS, other health organisations, and researchers collect information. They record what happens to people with cancer in the years after their diagnosis. 5 years is a common time point to measure survival. But some people live much longer than this. 5 year survival is the number of people who have not died from their cancer within 5 years after diagnosis. What affects survival Prognosis means the likely outlook for your cancer. In other words, how likely it is that treatment can cure or control your cancer, and how long you might live after your diagnosis. Your prognosis depends on many factors. These are called prognostic factors. Below are some prognostic factors for neuroendocrine cancer. Type of cancer Neuroendocrine cancer is a group of cancers that start in neuroendocrine cells. Doctors also call these cancers neuroendocrine neoplasms (NENs). There are 2 key groups of NENs: neuroendocrine tumours (NETs) neuroendocrine carcinomas (NECs) NETs are often slow growing and usually have a better prognosis than NECs. NECs are faster growing and are more likely to spread to other parts of the body. NETs and NECs are very different. So it is important to know which one you have. Talk to your doctor or specialist nurse if you are not sure. Doctors also group neuroendocrine cancers depending on the place they start growing. They call this your primary
site. For example, a lung neuroendocrine cancer starts in the lung. Your prognosis depends on the primary site of your neuroendocrine cancer. Grade of the cancer The grade affects your prognosis. The grade refers to how fast the cancer cells are growing. The higher the grade, the faster the growth. Generally, fast growing (high grade) cancers are more likely to come back after treatment than slow growing (low grade) cancers. Stage of the cancer This refers to the size of the cancer, and whether it has spread. There are 4 stages of neuroendocrine cancer - stage 1 to stage 4. The stage of the cancer affects your outlook. Cancers that are larger or that have spread are more difficult to treat than early, small cancers. Age and general health at diagnosis Your prognosis is often better if you are younger and in good health. If you are very fit and healthy, you are likely to recover quicker from treatment. Survival for the different types of neuroendocrine cancer There are no UK-wide statistics available for people with each type of neuroendocrine cancer. The following statistics come from a study in England. This looked at people diagnosed with neuroendocrine cancer in England, between 2012 and 2018. The statistics don't take into account the age of the people with neuroendocrine cancer. Statistics that do take into account the age are not available. Below we have a section of survival statistics for each primary site of neuroendocrine cancer. Each section includes statistics for: Talk to your healthcare team if you are unsure about your type or stage of neuroendocrine cancer. Incidence and survival of neuroendocrine neoplasia in England 1995−2018: A retrospective, population based studyB White and othersLancet Regional Health Europe, 2022. Volume 23, pages 1 - 11 These figures are for people diagnosed in England between 2012 and 2018. The statistics don't take into account the age of the people with neuroendocrine cancer. Statistics that do take into account the age (age-standardised statistics) are not available. Without age standardisation, the survival differences between the 4 stage groups can be influenced by the age of the people in each stage group, in addition to their disease progression or treatment. We should not use these non age-standardised figures to compare survival with other groups, such as different cancer types, stages, or populations from other countries. Survival for lung neuroendocrine cancer The following statistics are for survival for the different stages of lung neuroendocrine cancer. We have statistics for: lung neuroendocrine tumours (NETs) - these include typical carcinoid (TC) and atypical carcinoid (AC) lung neuroendocrine carcinomas (NECs) Stage 1 lung NETsAround 90 out of 100 people (around 90%) survive for 5 years or moreStage 2 lung NETsMore than 80 out of 100 people (more than 80%) survive for 5 years or moreStage 3 lung NETsAround 55 out of 100 people (around 55%) survive for 5 years or moreStage 4 lung NETsMore than 10 out of 100 people (more than 10%) survive for 5 years or more Stage 1 lung NECs75 out of 100 people (75%) survive for 5 years or moreStage 2 lung NECsMore than 45 out of 100 people (more than 45%) survive for 5 years or moreStage 3 lung NECsAround 20 out of 100 people (around 20%) survive for 5 years or moreStage 4 lung NECsAround 5 out of 100 people (around 5%) survive for 5 years or more Survival for stomach neuroendocrine cancer The following statistics are for survival for each stage of stomach neuroendocrine cancer. Stage refers to the size of your cancer and whether it has spread. There are 4 stages. This is different to the 3 types of stomach neuroendocrine tumour (NET). You can read about the different types of stomach NETs at the link below. There are 3 types of stomach NETs. The prognosis for type 1 is usually excellent, type 2 is usually good, and type 3 is less good than 1 and 2. Below we have statistics for: all types of stomach neuroendocrine tumours (NETs) - this includes type 1, type 2 and type 3 stomach NETs all stomach neuroendocrine carcinoma (NECs) - this includes large cell and small cell stomach NECs Stage 1 stomach NETsAround 85 out of 100 people (around 85%) survive for 5 years or moreStage 2 stomach NETsMore than 70 out of 100 people (more than 70%) survive for 5 years or moreStage 3 stomach NETs70 out of 100 people (70%) survive for 5 years or moreStage 4 stomach NETsAround 20 out of 100 people (around 20%) survive for 5 years or more Stage 1 stomach NECsMore than 35 out of 100 people (more than 35%) survive for 5 years or moreStage 2 stomach NECsAlmost 20 out of 100 people (almost 20%) survive for 5 years or moreStage 3 stomach NECsMore than 20 out of 100 people (more than 20%) survive for 5 years or moreStage 4 stomach NECs2 out of 100 people (2%) survive for 5 years or more Survival for small bowel neuroendocrine cancers The following statistics are for survival for each stage of small bowel neuroendocrine cancer. The small bowel is also called the small intestine. There are different parts of the small bowel. The following statistics are for neuroendocrine cancers that start in the: We have statistics for: small bowel neuroendocrine tumours (NETs) small bowel carcinomas (NECs) Stage 1 small bowel NETsAround 85 out of 100 people (around 85%) survive for 5 years or moreStage 2 small bowel NETsAlmost 75 out of 100 people (almost 75%) survive for 5 years or moreStage 3 small bowel NETs80 out of 100 people (80%) survive for 5 years or moreStage 4 small bowel NETsAlmost 45% out of 100 people (almost 45%) survive for 5 years or more Stage 1 small bowel NECs60 out of 100 people (60%) survive for 5 years or moreStage 2 small bowel NECsAround 45 out of 100 people (around 45%) survive for 5 years or moreStage 3 small bowel NECsAlmost 60 out of 100 people (almost 60%) survive for 5 years or moreStage 4 small bowel NECsMore than 30 out of 100 people (more than 30%) survive for 5 years or more Survival for large bowel neuroendocrine cancers The following survival statistics are for each stage of large bowel neuroendocrine cancer. The large bowel is also called the colon or the large intestine. We also have survival statistics for neuroendocrine cancers that start in the caecum. The caecum is part of the large bowel. It is the pouch that connects the large bowel to the small bowel. We have statistics for: large bowel neuroendocrine tumours (NETs) large bowel carcinomas (NECs) neuroendocrine tumours (NETs) of the caecum neuroendocrine carcinomas (NECs) of the caecum We have a separate section below about survival for rectal neuroendocrine cancers. The rectum (back passage) is the last part of the large bowel. Stage 1 large bowel NETs95 out of 100 people (95%) survive for 5 years or moreStage 2 large bowel NETsAround 75 out of 100 people (around 75%) survive for 5 years or moreStage 3 large bowel NETsAlmost 65 out of 100 people (almost 65%) survive for 5 years or moreStage 4 large bowel NETsAlmost 20% out of 100 people (almost 20%) survive for 5 years or more Stage 1 large bowel NECs80 out of 100 people (80%) survive for 5 years or moreStage 2 large bowel NECsAlmost 60 out of 100 people (almost 60%) survive for 5 years or moreStage 3 large bowel NECsAround 30 out of 100 people (around 30%) survive for 5 years or moreStage 4 large bowel NECsAlmost 5 out of 100 people (almost 5%) survive for 5 years or more Stage 1 caecal NETs90 out of 100 people (90%) survive for 5 years or moreStage 2 caecal NETs75 out of 100 people (75%) survive for 5 years or moreStage 3 caecal NETsMore than 80 out of 100 people (more than 80%) survive for 5 years or moreStage 4 caecal NETsAlmost 50% out of 100 people (almost 50%) survive for 5 years or more Stage 1 caecal NECs50 out of 100 people (50%) survive for 5 years or moreStage 2 caecal NECsAlmost 55 out of 100 people (almost 55%) survive for 5 years or moreStage 3 caecal NECsAround 20 out of 100 people (around 20%) survive for 5 years or moreStage 4 caecal NECsAround 5 out of 100 people (around 5%) survive for 5 years or more Survival for rectal neuroendocrine cancers The following survival statistics are for each stage of rectal neuroendocrine cancer. The rectum (back passage) is the last part of the large bowel. We also have separate survival statistics for neuroendocrine cancers that start in the large bowel. You can see these higher up the page. We have statistics below for: rectal neuroendocrine tumours (NETs) rectal neuroendocrine carcinomas (NECs) Stage 1 rectal NETsMore than 95 out of 100 people (more than 95%) survive for 5 years or moreStage 2 rectal NETsMore than 85 out of 100 people (more than 85%) survive for 5 years or moreStage 3 rectal NETs65 out of 100 people (65%) survive for 5 years or moreStage 4 rectal NETsMore than 20% out of 100 people (more than 20%) survive for 5 years or more Stage 1 rectal NECsAround 75 out of 100 people (around 75%) survive for 5 years or moreStage 2 rectal NECsAround 30 of 100 people (around 30%) survive for 5 years or moreStage 3 rectal NECsAround 20 out of 100 people (around 20%) survive for 5 years or moreStage 4 rectal NECs1 out of 100 people (1%) survive for 5 years or more Survival for pancreatic neuroendocrine cancer The following statistics are for survival for the different stages of all types of pancreatic neuroendocrine cancer. We have statistics for: all types of pancreatic neuroendocrine tumours (NETs) - this includes insulinoma, gastrinoma, VIPoma, glucagonoma, somatostatinoma and non functioning pancreatic NETs pancreatic neuroendocrine carcinomas (NECs) Stage 1 pancreatic NETsMore than 85 out of 100 people (more than 85%) survive for 5 years or moreStage 2 pancreatic NETs85 out of 100 people (85%) survive for 5 years or moreStage 3 pancreatic NETsAround 70 out of 100 people (around 70%) survive for 5 years or moreStage 4 pancreatic NETsAround 25% out of 100 people (around 25%) survive for 5 years or more Stage 1 pancreatic NECsAround 70 out of 100 people (around 70%) survive for 5 years or moreStage 2 pancreatic NECsAround 60 out of 100 people (around 60%) survive for 5 years or moreStage 3 pancreatic NECsAlmost 35 out of 100 people (almost 35%) survive for 5 years or moreStage 4 pancreatic NECsAround 10 out of 100 people (around 10%) survive for 5 years or more Coping with neuroendocrine cancer You might have physical changes to your body because of your cancer or the treatment. These changes can be hard to cope with and can affect the way you feel about yourself. It can help to talk to friends and family. Or join a support group to meet people in a similar situation. We have a discussion forum called Cancer Chat. It is a place for anyone affected by cancer. You can share experiences, stories and information with other people with cancer. You might need practical advice about benefits or financial help. There is help and support available. There are also organisations to support and provide information to people affected by neuroendocrine cancer.
Refractory Neuroendocrine Tumor—response To Liposomal Doxorubicin And Capecitabine
Background. A 61-year-old patient with no relevant medical or family history presented with a 2 month history of refractory dry cough that led to the diagnosis of typical carcinoid tumor of the lung metastatic to the mediastinal lymph nodes and liver. She initially received a long-acting somatostatin analog (octreotide) and chemotherapy with cisplatin and etoposide, which was ineffective.
Investigations. Physical examination, laboratory test, chromogranin A test, CT scan, 111In-diethylenetriaminepentaacetic acid (DTPA)-octreotide scan, 18F-FDG-PET scan, fine-needle and tissue core liver biopsies.
Diagnosis. Pulmonary spindle-cell carcinoid tumor with metastases to mediastinal lymph nodes and liver.
Management. Systemic treatment with oral capecitabine (1,500 mg/m2 daily from day 1 to day 21) and intravenous liposomal doxorubicin (10 mg/m2 on days 1, 8 and 15), both repeated every 4 weeks, administered concomitantly with long-acting octreotide 30 mg every 3 weeks. The patient achieved a significant and long-lasting response with the combination of capecitabine and liposomal doxorubicin. She reported no severe adverse effects.
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