Types of Lung and Esophageal Cancers
There are two major types of lung cancer — non-small cell lung cancer (85 percent of lung cancers) and small cell lung cancer (15 percent of lung cancers). In general, small cell lung cancer tends to be more aggressive and spreads sooner to other sites in the body. It is treated primarily with chemotherapy and radiation. Surgery is the primary treatment for early stage non-small cell lung cancer and is frequently used in conjunction with chemotherapy and radiation for more advanced disease.
Fundamentally, lung cancer is treated in three ways — with surgery, radiation and chemotherapy. These three modalities are often used in some combination. The essential overlap of the different treatments is just one reason why the coordinated, multidisciplinary approach we use at Froedtert & the Medical College of Wisconsin offers the best chance for a positive patient outcome. Our thoracic cancer team members work closely together and use all of the latest treatment approaches and technologies to offer the best possible care under one roof at our Clinical Cancer Center.
Non-Small Cell Lung Cancer (NSCLC)
Early-stage lung cancer is typically treated with surgical removal of the tumor, possibly followed by radiation and chemotherapy. For later-stage lung cancers, radiation and chemotherapy are the main treatments. Cancer that has spread to other parts of the body is usually treated with chemotherapy. Radiation is also frequently used to control symptoms.
Non-small cell can be divided into three types, named for the way the cells look under a microscope:
- Squamous cell carcinoma
- Large cell carcinoma
Small Cell Lung Cancer (SCLC)
Limited stage small cell lung cancer (confined to the chest) is mainly treated with chemotherapy and radiation to the chest and low dose radiation to the brain to prevent progression of cancer in the brain. Extensive stage disease (spread outside of the chest) is treated with chemotherapy and, in select cases, radiation to the chest and brain or other sites to control symptoms.
Cancer that develops in the lining of the lungs or abdomen, caused by inhalation of asbestos or radon and affects the mesothelium, the lining that surrounds many of the body’s internal organs. The part of this lining that protects the lungs is also known as the pleura.
Mesothelioma is generally treated with a combination of surgery, chemotherapy and radiation. Froedtert & the Medical College of Wisconsin are among the few institutions in the area that will perform a procedure called an extrapleural pneumonectomy, which involves removal of the lung. A less extensive procedure, called a pleurectomy, which involves removal of the pleura or lining covering the lungs, can be done in some cases.
Participation in clinical trials is also an important option for mesothelioma patients.
Esophageal Cancers: Adenocarcinoma and Squamous Cell Carcinoma
The two most common types of esophageal cancers are adenocarcinoma and squamous cell carcinoma. Some patients may require an esophagectomy, or surgical removal of the esophagus as part of their overall treatment. Multidisciplinary treatment is crucial for the esophageal cancer patient.
While our surgeons have unmatched expertise in performing esophagectomies, that is not enough on its own. Esophageal cancer patients often need to be seen by a radiation oncologist, a hematologist/oncologist, a gastroenterologist, a radiologist, a nutritionist and a speech pathologist. We take a true team approach to comprehensive patient care and have an entire system of specialists who understand the patient’s needs throughout this disease process.
Mediastinal Tumors and Other Less Common Tumors in the Chest
Rare cancers that develop in the chest cavity, including the mediastinum (the area between the lungs). Surgery is important for diagnosis and treatment. Multidisciplinary care and discussions are very important in situations where there may not be a standard of care and each case requires an individualized approach.
There are other unusual types of cancer that can be found in the lungs including sarcomas, lymphomas and carcinoid tumors. These all have unique treatment approaches that need be to individualized based on the type of cancer and location.