What Does It Mean If My Carcinoma Is Called Small Cell Carcinoma
Small cell carcinoma is a special type of lung cancer that tends to grow and spread quickly. Since it has often spread outside the lung at the time it is diagnosed, it is rarely treated with surgery. It is most often treated with chemotherapy, which might be combined with radiation. The chemotherapy used is different from what is used for other types of lung cancers.
Toxicity And Side Effect Management
Platinum-based chemotherapy, along with second active cytotoxic agents, is usually considered in patients who require chemotherapy. The chance of toxicity increases beyond four to six cycles of therapy and is not recommended beyond that. In patients with no optimal response, maintenance therapy can be continued with one or more components, but typically the platinum-based therapy is discontinued, given its severe toxicity. The patients should be monitored for nephrotoxicity, ototoxicity, cytopenias, and significant neuropathy. Folic acid, vitamin b12, and sometimes dexamethasone are usually considered to avoid some side effects of chemotherapy.
Patient Selection And Data Processing
Patient data were obtained from the SEER database using the SEER* Stat version 8.3.5 . We initially excluded other histologic subtypes of NSCLC, and selected 54,997 patients over 60 years of age who were diagnosed with squamous cell carcinoma between 2010 and 2015. The following variables were evaluated: age, sex, race, marital status , tumor site, laterality, histology grade, AJCC stage, tumor size, metastatic sites, surgery, radiation, chemotherapy, insurance, follow-up time, cancer-specific death, and all-cause death. We excluded patients who did not have complete information on all the above variables . Ultimately, we identified 32,474 eligible SCC patients for this study. All data from the SEER database was free, and this study was approved by the Institutional Research Committee of the First Affiliated Hospital of Xian Jiaotong University.
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Stages Of Squamous Cell Carcinoma
- Stage 0: the cancer is found only in the top lining of the lung and has not spread outside the lung
- Stage I : the cancer has not spread to the lymph nodes or other parts of the body. The difference between each sub-stage is based on the size of the tumor and whether it has spread to the lung lining
- Stage II : the cancer is larger than Stage I and has begun to spread to nearby lymph nodes or tissues, but not to distant organs. The difference between each sub-stage is based on the size of the tumor, its location, and whether it has spread to the lymph nodes or not
- Stage III : the cancer may be difficult to remove via surgery. The difference between each sub-stage is based on the size of the tumor, its location, and how much it has spread
- Stage IV: the cancer has spread to other areas of the body outside the lungs
How Does Treatment Differ
Like most cancers, the treatment options are dependent on the stage the disease. The pace of treatment for SCLC is generally faster than NSCLC due to the tumors ability to quickly spread. NSCLC is less aggressive however, it is typically identified at a later stage. In fact, only an approximate 25% of NSCLC patients are diagnosed at stage 1 or 2. For the minority who are diagnosed at stage 1 or 2, surgery to remove the tumor is often an option. Patients in the later stages are typically treated with chemotherapy and radiation.
The treatment for SCLC is typically done at a much faster pace, seeing as the tumor is able to quickly spread. Chemotherapy and radiation put approximately a quarter of patients into remission, however this type of cancer is likely to spread to other parts of the body. Some healthcare professionals may preventatively treat the brain with radiation, as these cancer cells are likely to end up in the brain.
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Stages Of Lung Cancer
Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic test to determine the cancers stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to recommend a treatment plan. Lung cancer is treatable at any stage.
The staging system used for squamous cell lung cancer is the TNM system, where the combination of the values assigned to a patient’s cancer on three measures T , N , and M determine the cancer’s stage. Stages range from 0 to IV. The higher the stage number, the more advanced the cancer. Only stage IV is metastatic.23,24
For more information about how stages are determined and the characteristics of each stage, see the Lung Cancer Staging section.
What Is Squamous Cell Carcinoma Lung Cancer
Squamous cell carcinoma of the lung, also known as epidermoid carcinoma, is a cancer that originates from the squamous cells. These are thin, flat cells that line the airways, much like the lining of a pipe. They provide a barrier between the air in the lungs and the lungs themselves. Squamous cell lung cancer develops when these cells become damaged, or abnormal, and begin to multiply. The majority of cases of squamous cell carcinoma start in the center of the lung compared to other parts of the respiratory system.
Squamous cell lung cancer is a subtype of non-small cell lung cancer , along with adenocarcinoma and large cell carcinoma. Squamous cell carcinomas make up 25 30% of all lung cancers, and are the most common lung cancers found in smokers. Conversely, it is very uncommon to find squamous cell carcinomas in non-smokers.
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What Is Yale Medicines Approach To Treating Non
Patients who come to Yale Cancer Center at Smilow Cancer Hospital have access to new cancer therapies that are in development. Through clinical trials, patients may be able to benefit from groundbreaking treatment options not available elsewhere. At Yale, we have led the way in developing important therapies for lung cancer patients by designing and implementing clinical trials that try to improve outcomes for our patients, says Dr. Chiang. We put the patient first and engage them as an important part of developing ground-breaking research.
Since NSCLC is one of the worlds most prevalent and lethal forms of cancer, research is being conducted through Yale Cancer Centers Specialized Program of Research Excellence for lung cancer, one of the three lung cancer-focused SPOREs funded by the National Cancer Institute. The program brings together experts in oncology, immunotherapy, pharmacology, molecular biology, pathology, epidemiology and addiction science to attack this disease, says Dr. Herbst. We aim to bring results from the lab to the clinic and back again. We need to raise the bar with innovative new ideas and quality translated to the clinic.
Typical And Atypical Carcinoid
Both TC and AC are characterized histologically by a uniform population of tumor cells growing in an organoid pattern and having moderate eosinophilic, finely granular cytoplasm with finely granular nuclear chromatin . A spectrum of histological patterns occur in carcinoids including spindle cell, trabecular, palisading, rosette-like, papillary, sclerosing papillary, glandular and follicular patterns. Unusual cytological features can occur such as oncocytic, acinic cell-like, signet-ring, mucin-producing or melanocytic features.
Figure 10
Carcinoid. Typical carcinoid. This tumor shows an organoid nesting pattern of uniform cells with a moderate amount of eosinophilic cytoplasm and finely granular nuclear chromatin. Atypical carcinoid shows a punctate focus necrosis within sheets and nests of carcinoid tumor cells. Cells have finely granular nuclear chromatin. Atypical carcinoid shows single mitoses in one tumor cell.
ACs are defined as carcinoid tumors showing mitoses between 2 and 10 per 2mm2 area of viable tumor or the presence of necrosis . The presence of features such as pleomorphism, vascular invasion and increased cellularity is not as helpful in separating TC from AC. In TC, necrosis is absent and mitotic figures are rare ., Necrosis in AC usually is manifest by punctate foci within tumor nests .
Ki-67 can also be useful as it will be very high in SCLC , but low in carcinoids., , Precise Ki-67 thresholds for TC vs AC are not established.
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Squamous Cell Carcinoma Staging
Squamous cell lung carcinoma begins in the cells lining the bronchi. Over time, cancer can spread by invading nearby lymph nodes and organs and traveling through the blood to other parts of the body.
Doctors use tumor size, location, and severity of spread to classify cancer into stages. Using the TNM system, the cancer is given a number indicating tumor size , spread to the lymph nodes , and metastasis . These are then combined to classify the cancer into a stage.
There are six main stages. Stages 1 to 4 are subdivided according to tumor size, number, and location:
Moffitt Cancer Centers Approach To Squamous Cell Carcinoma
At Moffitt Cancer Center, our multispecialty team of cancer experts takes a highly individualized approach to squamous cell carcinoma treatment. We offer the latest diagnostic and treatment options, and we work closely with each patient to offer customized guidance and help ensure the best possible outcome. For instance, there are many steps a patient can take to improve his or her own squamous cell carcinoma prognosisregardless of the general survival ratesuch as:
- Performing self-examinations from head to toe, including parts of the body that are not regularly exposed to UV rays, at least monthly, and promptly reporting any suspicious or unusual changes in skin texture or appearance to a physician
- Seeing a physician for a professional skin cancer examination yearly
- Avoiding exposure to the suns ultraviolet rays while outdoors, preventive measures include seeking shade, wearing sunglasses and a brimmed hat, covering up with clothing and using a broad-spectrum sunscreen with both UVA and UVB protection
- Never using indoor tanning beds
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Looking For More Of An Introduction
If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:
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ASCO Answers Fact Sheet:Read a 1-page fact sheet that offers an introduction to lung cancer. This free fact sheet is available as a PDF, so it is easy to print.
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ASCO Answers Guide: Get this free 44-page booklet that helps you better understand this disease and treatment options, as well as keep track of the specifics. The booklet is available as a PDF, so it is easy to print.
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Cancer.Net Patient Education Video:View a short video led by an ASCO expert in lung cancer that provides basic information and areas of research.
If Lung Cancer Is Suspected A Biopsy Is Done
One of the following types of biopsies is usually used:
One or more of the following laboratory tests may be done to study the tissue samples:
- Molecular test: A laboratory test to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other body fluid. Molecular tests check for certain gene or chromosome changes that occur in non-small cell lung cancer.
- Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens in a sample of a patients tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
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What Are The Symptoms Of Squamous Cell Carcinoma
When a tumor develops in one of the lungs air passages, it can result in a variety of symptoms, including:
- A chronic cough
- Trouble breathing
- Coughing up bloody mucus
It is important to consult with a physician if you are experiencing any of these symptoms in order to receive an accurate diagnosis, as many other conditions can cause these same symptoms. Diagnosis requires an imaging scan to locate the tumor. If an abnormal growth is identified, the next step may be a biopsy, in which a pathologist tests a sample of the lesion to determine the type of lung cancer.
What If My Report Mentions Margins
The margin is the edge or the boundary of the specimen that was removed by the surgeon. It is where the surgeon has sectioned across the lung to remove the tumor.
The margin may be free of the tumor that is, a rim of uninvolved tissues may surround the tumor, indicating that the tumor has been removed completely. This is sometimes referred to as a negative margin.
Alternatively, the tumor could extend to the edge of the specimen , implying that the tumor has not been completely removed. This is sometimes referred to as a positive margin.
The status of the margin is an important indicator of the potential for the tumor to recur and of the need for further treatment. Talk with your doctor about the best approach for you if cancer is found at the margins.
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Small Cell Lung Cancer Vs Non
Lung cancer diagnoses are broken down into two main groups: small cell lung cancer and non-small cell lung cancer .
SCLC often starts in the bronchi, or the airways that lead from the trachea into the lungs and then branch off into progressively smaller structures. After affecting the bronchi, SCLC quickly grows and spread to other parts of the body, including the lymph nodes. This type of lung cancer represents fewer than 20% of lung cancers and is typically caused by tobacco smoking. SCLC itself is broken down into another two categories: small cell carcinoma and combined small cell carcinoma. These two categories are used to distinguish the small cells when viewed under a microscope. Small cell carcinoma is the most common type of SCLC and looks flat under a microscope, much like oats. Combined small cell carcinoma refers to a tumor made up of small cell carcinoma cells and a small number of non-small cell lung cancer cells.
What Does It Mean If My Carcinoma Is Well Differentiated Moderately Differentiated Or Poorly Differentiated
These terms are assigned by a pathologist based on how the cancer cells look under the microscope:
- Well-differentiated carcinomas tend to look a lot like the type of cells from which they arose.
- Moderately-differentiated carcinomas retain only some of the features of the cells from which they arose.
- Poorly-differentiated carcinomas look very different from the cells from which they arose.
Unlike carcinomas that start in organs such as the breast, prostate, and kidney, the differentiation of a lung carcinoma has not been shown to be helpful in predicting a personâs prognosis .
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Fresenius Kabi Introduces New Generic For The Treatment Of Non
Expanding access to oncology medicines
LAKE ZURICH, Ill.—- Fresenius Kabi announced today the immediate availability in the U.S. of PEMEtrexed for Injection, USP, a new generic equivalent to Alimta®. Fresenius Kabi produces its PEMEtrexed for Injection, USP in the United States, where the company offers the most comprehensive injectable oncology portfolio of any pharmaceutical manufacturer.
This press release features multimedia. View the full release here:
Fresenius Kabi PEMEtrexed for Injection, USP
Fresenius Kabi PEMEtrexed for Injection, USP is an affordable treatment option for adult patients with non-squamous non-small cell lung cancer and malignant pleural mesothelioma.
Available in four presentations for intravenous use, Fresenius Kabi now has the broadest portfolio of PEMEtrexed for Injection, USP products available from any manufacturer in the U.S., including two new strengths designed to help streamline pharmacy operations and reduce drug waste:
- PEMEtrexed for Injection, USP 100 mg per single-dose vial
- PEMEtrexed for Injection, USP 500 mg per single-dose vial
- New strength: PEMEtrexed for Injection, USP 750 mg per single-dose vial
- New strength: PEMEtrexed for Injection, USP 1 gram per single-dose vial
Important Safety Information
INDICATIONS AND USAGE
Pemetrexed for Injection is a folate analog metabolic inhibitor indicated:
IMPORTANT SAFETY INFORMATION
Lactation: Advise not to breastfeed.
Taking Care Of Yourself
As you follow your treatment plan, pay attention to any changes you feel. Tell your doctor how youâre doing, both physically and emotionally.
Some days, your appetite may not be great. But you’ll need to eat well to keep your strength and energy up. Try to eat several small meals throughout the day instead of a few large ones.
If you have trouble breathing, oxygen from a tank may help. So can practicing relaxation techniques, like meditation, listening to music, or picturing yourself in a peaceful place. Complementary treatments, including gentle massage and aromatherapy, may put you more at ease. Talk to your doctor about what you can do when you’re tired, in pain, or breathless.
Finding out that you have cancer is very hard to deal with. You may be afraid, angry, or sad. Strong emotions are normal. A support group or a counselor who works with people who have cancer could help you work through your feelings. Look online or in your community, or ask your doctor for suggestions and about other professionals who can help support you — perhaps social workers, nurses, clergy, or other doctors.
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What Does Infiltrating Or Invasive Mean
Carcinomas can start in the cells that line the inside of the bronchi, bronchioles, or alveoli. If the carcinoma cells are only in the top layer of cells lining these structures, it is called in-situ carcinoma . This is considered a pre-cancer.
When carcinoma cells grow into the deeper layers of the lung, it is called invasive or infiltrating carcinoma. At this point the cancer cells can spread outside of the lung to lymph nodes and other parts of your body. Invasive carcinomas are considered true lung cancers and not pre-cancers.