Understanding Non-Small Cell vs. Small Cell Lung Cancer

by Eileen Bailey Health Writer

There are two major types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), and each one has several subtypes. The differences are based on how the cells for each type look under a microscope. Your treatment may vary depending on the type and subtype of cancer you have.

X-ray of cancerous lungs.
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Non-small cell lung cancer

About 85 percent of lung cancers are non-small cell lung cancers (NSCLC), according to American Cancer Society. Within this category there are numerous subtypes. Traditionally, these have been treated as one disease with a one-size fits all perspective. Treatment varied only by the stage of the cancer when diagnosed.

Doctor viewing cancerous lung x-ray.
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Treating by subtypes

Research has shown that basing treatment on the subtypes may positively impact treatment, according to a report published in the journal Lung Cancer. The researchers found that the subtypes differ in cell of origin, location within the lung, and growth pattern. Determining the subtype can allow the use of more targeted therapies.

Squamous cell carcinoma under microscope.
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Subtypes of non-small cell lung cancer

  • Squamous cell carcinoma:__ This subtype accounts for 25% of all lung cancers, according to Lungcancer.org.
  • Adenocarcinoma: The most common type of lung cancer in the U.S., according to Lungcancer.org.
  • Large-cell carcinoma: This accounts for 10 percent of NSCLC’s, according to Lungcancer.org.
Carcinoid tumor under microscope.
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Less common subtypes of non-small cell lung cancer

Less common subtypes include pleomorphic, carcinoid tumor, salivary gland carcinoma, and unclassified. These subtypes account for only a small percentage of NSCLC’s, according to a report published in the journal Lung Cancer.

Weight lose, pants to big.
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Signs and symptoms

Many of the signs and symptoms of the different subtypes are similar. A biopsy can help determine the specific subtype. Some of the symptoms of NSCLC,:

  • Cough that doesn’t go away and gets worse over time
  • Chest discomfort or pain
  • Trouble breathing
  • Wheezing
  • Blood in sputum
  • Hoarseness
  • Loss of appetite
  • Weight loss without an apparent reason
  • Fatigue
  • Trouble swallowing
  • Swelling in face and neck
Surgeon reviewing lung x-ray before surgery.
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Treatments for non-small cell lung cancer

Treatments for NSCLC include surgery to remove parts of the lung, radiation, chemotherapy, immunotherapy, laser therapy, photodynamic therapy, cryosurgery, and electrocautery.

Small cell carcinoma under microscope.
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Small cell lung cancer

Small cell lung cancer (SCLC), often called oat cell cancer, makes up about 10-15 percent of lung cancers, according to th Aemerican Cancer Society. These cancers spread quickly but are more responsive to chemotherapy than NSCLC, Lungcancer.org reports.

Micrograph of small cell lung cancer
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Subtypes of small cell lung cancer

  • Small cell carcinoma (oat cell cancer): This is the majority of SCLC’s, and is called oat cell because the cells are small, round, and resemble oats.
  • Combined small cell carcinoma: This is small cell carcinoma combined with an additional component, such as NSCLC, according to a report in the American Journal of Clinical Pathology. Response to chemotherapy is very poor.
Scanning electron microscope image of lung cancer cells.
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Most aggressive form of lung cancer: small cell lung cancer

SCLC is the most aggressive form of lung cancer. It usually starts in breathing tubes in the center of the chest and spreads rapidly to other parts of the body including the brain, liver, and bone.

Man seeing doctor about persistent cough.
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Symptoms of small cell lung cancer

Some of the symptoms of SCLC, according to the National Cancer Institute, are:

  • Blood in the sputum
  • Chest pain
  • Cough
  • Loss of appetite
  • Weight loss
  • Shortness of breath
  • Wheezing
Lung cancer patient undergoing chemo in hospital.
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Treatment for small cell lung cancer

Because SCLC spreads quickly, surgery is not usually an option. Most treatment plans include chemotherapy and radiation. Even after surgery, chemotherapy and radiation are often needed to help control or stop the spread of the cancer.

Eileen Bailey
Meet Our Writer
Eileen Bailey

Eileen Bailey is an award-winning author of six books on health and parenting topics and freelance writer specializing in health topics including ADHD, Anxiety, Sexual Health, Skin Care, Psoriasis and Skin Cancer. Her wish is to provide readers with relevant and practical information on health conditions to help them make informed decisions regarding their health care.