Small cell and non-small cell lung cancer: What you should know.

August 19, 2024

Swedish Cancer Team

[3 MIN READ]

Lung cancer is the third most common cancer in the United States and the number one cause of cancer death.
While there many types of lung cancer, they can be categorized into two groups: small cell lung cancer (a very specific lung cancer) and non-small cell lung cancer (a term that encompasses all other types). Non-small cell lung cancer accounts for about 85% of all lung cancer diagnoses.
A medical thoracic oncologist at Swedish Cancer Institute explains the differences between the different types of lung cancer and outlines care options and prevention strategies.

Reading through the numbers about lung cancer statistics can take your breath away. It is the third most common cancer in the country and the number one cause of cancer death, according to the U.S. Centers for Disease Control and Prevention.

Every year, nearly 240,000 people learn they have lung cancer, and more than 125,000 people with the illness draw their last breath. In fact, more people die of lung cancer than from breast, prostate and colon cancers combined, according to the American Cancer Society.

We talked to Sid Devarakonda, M.D., a medical thoracic oncologist at Swedish Cancer Institute, about the two main types of lung cancer, treatment options and prevention. Here’s what he shared.

Understanding lung cancer

Lung cancer starts in the tissues of your lungs, typically in the cells lining them on the inside (such as those lining the main airways). There are two main categories of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Each type of lung cancer develops differently, and has different treatment options.

"Small cell lung cancer is a very specific type of cancer, while the term non-small cell lung cancer can be used to represent one of many types of lung cancer," says Dr. Devarakonda.

According to Dr. Devarakonda, about 15% of lung cancers are SCLC. This fast-growing type of lung cancer typically spreads very aggressively. The remaining 85% of lung cancers are NSCLC. “Just because these cancers are termed non-small cell, it does not mean that these cancers are less aggressive or not capable of spreading. Non-small cell lung cancers can be equally aggressive”, he remarks.

There are many sub-types of NSCLC:

Adenocarcinoma is the most common form of NSCLC. It is also the most common type of lung cancer diagnosed in people who have never smoked
Squamous cell carcinoma usually starts in the flat cells lining the airways of the lungs (called bronchi)
Other rare types of NSCLC, such as large cell neuroendocrine carcinoma, and sarcomatoid carcinoma.

Causes

"Anyone with lungs can get lung cancer. In general, the most common, preventable cause of lung cancer is cigarette smoking," says Dr. Devarakonda.

Smoking causes about 80% of all lung cancers, according to the National Institutes of Health. The risk level varies by how long you’ve smoked and the number of cigarettes you smoke regularly every day.

Other causes of lung cancer can include:

Exposure to secondhand smoke.
Constant exposure to high levels of air pollution.
Drinking water with high arsenic levels.
History of radiation therapy to the lungs.
Working or living with cancer-causing chemicals such as arsenic, radon and asbestos.
Family history of lung cancer.

Recognizing the warning signs

“It’s not always easy to recognize the warning signs of lung cancer,” says Dr. Devarakonda. “Symptoms usually tend to be very generic for all lung cancers, regardless of type. Sometimes, patients may not experience any symptoms, particularly in the early stages of the disease.”

Symptoms of lung cancer may include:

Persistent cough.
Chest pain.
Hoarseness.
Unexplained weight loss.
Loss of appetite.
Shortness of breath.
Excessive fatigue.
Recurring respiratory infections, such as pneumonia and bronchitis.

Patients with metastatic cancer (cancer that has moved beyond the lung) could experience bone pain, headaches, dizziness, balance issues and swollen lymph nodes.

"Symptoms really depend on several factors. Is the tumor pushing on anything? Is it causing you to cough up blood? Is it making it harder for you to breathe? All types of lung cancers can go to the brain. They can go to the bone, they can go to the liver. So it could be symptoms related to the organ that is involved if the cancer has metastasized,” says Dr. Devarakonda.

Treatment options

Treatment of lung cancer depends on your overall health, the stage of your cancer and the specific characteristics of your cancer cells, according to Dr. Devarakonda.

Treatment options include the following:

Surgery removes the tumor. Procedures can range from a wedge resection (a small section of the lung is removed) to a pneumonectomy (an entire lung is removed).
Radiation therapy uses high-energy rays to kill cancer cells and shrink tumors. Radiation can sometimes replace surgery, be used when surgery is not an option or in combination with other treatments.
Chemotherapy drugs kill cancer cells and stop them from dividing. These drugs can be administered either by themselves or in combination with other drugs. Sometimes chemotherapy can be administered to shrink tumors or after surgery to destroy any remaining cancer cells. It can also be used in combination with radiation.
Targeted therapy uses drugs to target specific genetic mutations in cancer cells. These therapies can be very effective for cancers with certain genetic profiles.
Immunotherapy utilizes the body’s immune system to fight cancer.

Prevention and screening

The most effective way to prevent any lung cancer is to avoid smoking and exposure to secondhand smoke. If you’re a former smoker, lung cancer screening using a low-dose CT scan to look at your lungs and chest is an excellent way to detect cancer early.

“If you're actively smoking, it's always a good time to stop. If you have smoked in the past, ask your health care provider if you qualify for lung cancer screening. For those with a history of heavy smoking, annual screening with low-dose CT scans can help detect lung cancer early when it is most treatable,” says Dr. Devarakonda.

“Lung cancer is a complex disease, but advancements in diagnosis and treatment have improved outcomes for many patients,” adds Dr. Devarakonda. “Early detection and personalized treatments tailored to the genetic makeup of the specific type of cancer are paving the way for more effective management of this life-changing illness.”

Learn more and find a physician or advanced practice clinician (APC)

Our lung cancer experts at the Swedish Cancer Institute can help you find the right diagnostics and treatments. We don't just treat your lung cancer; we treat you. To speak with someone or make an appointment, call 1-855-XCANCER.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care provider. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual, you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.

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