18 Terms You Need to Know About Advanced Lung Cancer
PJ Hamel | Nov 16, 2017
Reviewed by Todd Gersten, MD on Dec 10, 2017
Once you’ve been diagnosed with lung cancer, you’ll find yourself hit with a barrage of unfamiliar terms: even the familiar word “cancer” is often translated into the more scientific “carcinoma” when you’re dealing with your medical team. As your treatment progresses, the terminology just gets more and more complicated. Here are some useful terms to know as you go through advanced non-small cell lung cancer (NSCLC) treatment.
One of the three main subtypes of NSCLC, adenocarcinoma is any cancer that grows in the lining of an organ, generally in cells that produce secretions. Adenocarcinoma, diagnosed in just over 50 percent of all of those with lung cancer, is the most common type of lung cancer. It grows in the lining of the lung’s alveoli, in cells that produce mucus.
Tiny cavity-like spaces in the lungs where the oxygen/carbon dioxide exchange takes place, alveoli are the end of the “bronchial tree.” Most of those diagnosed with NSCLC have adenocarcinoma, which is cancer growing in the lining of the alveoli.
The inability of the lungs to inflate fully, or a collapsed lung, atelectasis can be painful and produce shortness of breath.
The drug treatment used to kill cancer cells, chemotherapy is most commonly administered via an IV, though it can also be given in pill form. While it has an array of potential side effects, many can be treated to make the patient more comfortable. NSCLC isn’t as responsive to chemotherapy as many other cancers, but it’s often administered nonetheless in combination with surgery as an initial treatment or with radiation when the cancer isn’t treatable by surgery.
Also known as a CAT scan or computer tomography scan, this series of X-rays is used to provide a detailed view of your lungs, including any questionable masses. For those with potential NSCLC, a thorax or chest CT scan usually covers the liver and adrenal glands as well as the lungs, and is used to identify not only the site of any tumor or tumors, but the presence of cancer in nearby lymph nodes.
Large cell carcinoma
The least common of the three main subtypes of NSCLC, large cell carcinoma grows on the lungs’ inner lining; about 10 percent of NSCLC diagnoses are termed large cell. It’s characterized by the fact that it grows in cells that are typically larger than most lung cells.
The removal of one lobe of the lung; in NSCLC, lobectomy is done to remove cancerous tissue and try to prevent cancer’s spread. Surgery is the most common treatment for NSCLC; though chemotherapy and radiation are less effective for NSCLC than for other types of cancer, those two treatments are often nonetheless delivered: chemotherapy in conjunction with surgery and radiation with chemotherapy for patients with advanced-stage NSCLC.
The mediastinum is the area of the chest located between the lungs; a mediastinoscopy is surgery that provides a visual survey of this area. The mediastinoscope, a thin tube with an attached light and often a tool for harvesting tissue, is inserted into the chest. The surgeon is able to search the area between the lungs for abnormal-appearing tissue, as well as harvest tissue samples and lymph nodes to check for cancer.
When cancer spreads from its original site to other parts of the body, it’s said to have metastasized. The new area where cancer is discovered is called a metastasis, a.k.a. “met” or “mets.” Advanced NSCLC most often metastasizes to the other lung or to the brain, though it can also travel to the liver, kidneys, adrenal glands, bones, or the fluid around the lungs and heart.
A PET (positron emission tomography) scan is used to detect any spread of lung cancer, including advanced NSCLC, to other parts of the body. A radioactive liquid is injected into the patient, and a scanner is used to identify any malignant cells outside the lungs and nearby lymph nodes.
Pleura, pleural effusion, pleurodesis
The pleura is a protective pair of membranes in the chest: one surrounds the lungs, one lines the chest cavity. Pleural effusion is the term for fluid collecting in the space between the pleura, and is sometimes experienced by patients being treated for NSCLC. The pressure of this fluid causes chest pain and difficulty breathing. Pleurodesis is treatment that helps prevent the recurrence of pleural effusion.
The surgical removal of one lung, pneumonectomy is used when NSCLC has spread throughout the lung, and removing just a portion isn’t considered effective.
Air inside the chest (pleural) cavity but outside the lungs is termed a pneumothorax. This buildup of air can prevent the lungs from inflating to their fullest, and progressive pressure can result in shortness of breath and chest pain. In patients with NSCLC, the usual cause of pneumothorax is surgery, though it can also be caused by extensive damage to the lung or lungs from the cancer.
A common type of treatment using X-rays and/or gamma rays to kill cancer cells, radiation is carefully delivered to reach as much of the cancer (and as little healthy surrounding tissue) as possible. While radiation isn’t as effective against NSCLC as it is against other cancers, it’s often used, in combination with chemotherapy, to help stop the spread of advanced NSCLC.
Segmental resection or wedge resection
This removal of a small part or wedge of lung tissue is performed by your surgeon to remove a tumor in your lung. It’s reserved for smaller tumors, ones that haven’t grown large enough to effectively take over the lung.
Squamous cell carcinoma
One of the three main subtypes of NSCLC, squamous cell carcinoma (a.k.a. epidermoid carcinoma) accounts for about 25 percent of all lung cancers. It grows in the small, flat squamous cells lining the inner surface of the lungs.
Doctors “stage” your cancer to indicate its aggressiveness and seriousness. Your cancer stage will help determine what type of treatment you receive. In NSCLC, stage 1 means your cancer is confined to one lung. In stage 2, cancer has invaded nearby lymph nodes. Stage 3 means the cancer has moved to lymph nodes farther away in the chest cavity; and in stage 4, the cancer has traveled from one lung to the other, and/or to another organ such as the liver.
Pleural effusion refers to excessive fluid that can collect in the area between lungs and chest wall (the pleural cavity). Patients with NSCLC may find that either the cancer itself or treatment causes this effusion, which can cause pain and difficulty breathing. Thoracentesis is minor surgery used to drain the fluid and make the patient more comfortable.