Here is a summary of the risk factors, subtypes, staging, and treatment of lung cancer. Suffice to say, there are oncologists who devote their entire careers to lung cancer. This overview constitutes probably 1% of what is there to know about lung cancer. However, it would be an important 1%.

Lung cancer risk factors

  • Smoking
  • Asbestos
  • Pollution
  • Chemicals
  • Family history
  • Second hand smoke
  • Radon gas exposure

Types of lung cancer

  • NSCLC (about 85% of cases)
    • Adenocarcinoma
    • Squamous cell carcinoma
    • Large cell carcinoma
  • SCLC (about 15% of cases)

Lung cancer staging

Staging for NSCLC

  • Stage I: no lymphatic spread
  • Stage II: +ve nearby lymph nodes
  • Stage III “locally advanced disease”: mediastinal involvement
    • Stage IIIa: +ve lymph nodes or invasive spread at same side of chest
    • Stage IIIb: +ve lymph nodes or invasive spread at opposite side of chest or above the collar bone
  • Stage IV: lung cancer in both lungs, or presence of malignant pleural effusion, or distant metastasis

Staging for SCLC

  • Limited stage (one side of chest ± nearby lymph nodes)
  • Extensive stage (anything else)

Lung cancer treatment

These treatment options are listed in no particular order. Other regimens may exist.

Treatment for stage Ia lung cancer (NSCLC)

  • Surgery

Treatment for stage Ib, IIa, and IIIa lung cancer (NSCLC)

  • Surgery (i.e. lobectomy, sleeve resection, or pneumonectomy)
  • Adjuvant or neoadjuvant chemotherapy
    • Cisplatin with vinorelbin
    • Carboplatin with paclitaxel
  • ± Radiation therapy

Treatment for locally advanced, stage IIIa and IIIb lung cancer (NSCLC)

  • Surgery if possible
  • Chemotherapy with radiation therapy
    • Cisplatin, etoposide, radiation therapy
    • Paclitaxel, carboplatin, radiation therapy

Treatment for stage IV (metastatic) lung cancer (NSCLC)

  • Palliative radiotherapy
  • Palliative chemotherapy or immunotherapy
    • Afatinib (for EGFR +ve tumors) 30 mg PO daily until disease progression
    • Crizotinib (for ALK +ve tumors) 250 mg PO BID until no clinical benefit
    • Erlotinib (for EGFR +ve tumors) 150 mg PO daily until disease progression
    • Gefitinib (for EGFR +ve tumors)
    • Cisplatin with docetaxel
    • Cisplatin with gemcitabine
    • Cisplatin with pemetrexed (for non-squamous subtypes)
    • Cisplatin with pemetrexed and bevacizumab
    • Cisplatin with vinorelbine
    • Carboplatin with paclitaxel
    • Carboplatin with paclitaxel and bevacizumab (for non-squamous subtypes)
    • Carboplatin with paclitaxel and ipilimumab
    • Docetaxel monotherapy
    • Vinorelbine monotherapy
    • Pemetrexed monotherapy (especially for non-squamous subtypes)