Thyroid cancer is a malignant neoplasm originating from follicular or parafollicular thyroid cells. Thyroid cancer is usually found in a euthyroid patient, but symptoms of hyperthyroidism or hypothyroidism may be associated with a large or metastatic well-differentiated tumor. Thyroid nodules are of particular concern when they are found in those under the age of 20. The presentation of benign nodules at this age is less likely, and thus the potential for malignancy is far greater. The most effective management of aggressive thyroid cancers is surgical removal of thyroid gland (thyroidectomy) followed by radioactive iodine ablation and TSH-suppresion therapy. Chemotherapy or radiotherapy may also be used in cases of distant metastases or advanced cancer stage.
Thyroid cancers can be classified according to their histopathological characteristics. The following variants can be distinguished (distribution over various subtypes may show regional variation):
• Papillary thyroid cancer (75% to 85% of cases) – often in young females – excellent prognosis. May occur in women with familial adenomatous polyposis and in patients with Cowden syndrome.
• Follicular thyroid cancer (10% to 20% of cases); occasionally seen in patients with Cowden syndrome
• Medullary thyroid cancer (5% to 8% of cases) – cancer of the parafollicular cells, often part of multiple endocrine neoplasia type 2.
• Poorly differentiated thyroid cancer
• Anaplastic thyroid cancer (less than 5%).It is not responsive to treatment and can cause pressure symptoms.
Others
• Thyroid lymphoma
• Squamous cell thyroid carcinoma
• Sarcoma of thyroid
5-Year Survival
10-Year
Cancer Type
Stage I
Stage II
Stage III
Stage IV
Overall
Overall
Papillary
100%
100%
93%
51%
96-97%
93%
Follicular
100%
100%
71%
50%
91%
85%
Medullary
100%
98%
81%
28%
80-86%
75%
Anaplastic
Always Stage IV
7%
7-9%
No data
Prognosis is better in younger people than in older ones.
A germ cell tumor (GCT) is a neoplasm derived from germ cells. Germ cell tumors can be cancerous or non-cancerous tumors. Germ cells normally occur inside the gonads: ovaries and testis. Germ cell tumors are broadly divided in two classes:
The germinomatous or seminomatous germ cell tumors (GGCT, SGCT) include only germinoma and its synonyms dysgerminoma and seminoma.
The nongerminomatous or nonseminomatous germ cell tumors (NGGCT, NSGCT) include all other germ cell tumors, pure and mixed.
A synovial sarcoma is a rare form of cancer, which usually occurs near to the joints of the arm, neck or leg. It is one of the soft tissue sarcomas but has been documented in most human tissues and organs, including the brain, prostate, and heart. Synovial sarcoma occurs most commonly in the young, representing about 8% of
all soft tissue sarcomas but about 15–20% of cases in adolescents and young adults. The peak of incidence is before the 30th birthday and males are affected more often than females (ratio around 1.2:1).
Squamous cell carcinoma is commonly a red, scaly, thickened patch on sun-exposed skin. Some are firm hard nodules and dome-shaped like keratoacanthomas. Ulceration and bleeding may occur. When SCC is not treated, it may develop into a large mass. Squamous cell is the second most common skin cancer.
Squamous-cell carcinoma (SCC) is a histologically distinct form of cancer. It arises from the uncontrolled multiplication of cells of epithelium, or cells showing particular cytological or tissue architectural characteristics of squamous cell differentiation, such as the presence
of keratin, tonofilament bundles, or desmosomes, structures involved in cell-to-cell adhesion.
SCC is still sometimes referred to as ‘epidermoid carcinoma’ and ‘squamous cell epithelioma’, though the use of these terms has decreased.
A sarcoma is a cancer that arises from transformed cells of mesenchymal origin. Thus, malignant tumors made of cancerous bone, cartilage, fat, muscle, vascular, or hematopoietic tissues are, by definition, considered sarcomas. Human sarcomas are quite rare. In addition to being named based on the tissue of origin, sarcomas are also assigned a grade (low, intermediate, or high) based on the presence and frequency of certain cellular and subcellular characteristics associated with malignant biological behavior. Low-grade sarcomas are usually treated surgically, although sometimes radiation therapy or chemotherapy are used. Intermediate and
high-grade sarcomas are more frequently treated with a combination of surgery, chemotherapy and/or radiation therapy. Since higher grade tumors are more likely to undergo metastasis, they are treated more aggressively. The recognition that many sarcomas are sensitive to chemotherapy has dramatically improved the survival of patients.
A rhabdomyosarcoma, commonly referred to as RMS, is a type of cancer, specifically a sarcoma, in which the cancer cells are thought to arise from skeletal muscle progenitors. It can also be found attached to muscle tissue, wrapped around intestines, or in any anatomic location. Rhabdomyosarcoma is a relatively rare form of cancer. When RMS does occur, it is most commonly seen in children aged one to five years old. Less commonly, it can also present in teens aged 15 to 19, and can even develop in adulthood, though this is even more rare.
Treatment for rhabdomyosarcoma consists of chemotherapy, radiation therapy and sometimes surgery. Seventy percent of children diagnosed with localized rhabdomyosarcoma have long-term survival.
Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction.
Management strategies for prostate cancer should be guided by the severity of the disease. Many low-risk tumors can be safely followed with active surveillance. Curative treatment generally involves surgery, various forms of radiation therapy, or, less commonly, cryosurgery; hormonal therapy and chemotherapy are generally reserved for cases of advanced disease (although hormonal therapy may be given with radiation in some cases). Several studies suggest that masturbation reduces the risk of prostate cancer.
The age and underlying health of the man, the extent of metastasis, appearance under the microscope, and response of the cancer to initial treatment are important in determining the outcome of the disease. The decision whether or not to treat localized prostate cancer with curative intent is a patient trade-off between the expected beneficial and harmful effects in terms of patient survival and quality of life. The United States Preventive Services Task Force in 2012 recommended against screening for prostate cancer using the PSA testing, due to the risk of over-diagnosis and over-treatment, with most prostate cancer remaining asymptomatic.
If the cancer has spread beyond the prostate, treatment options significantly change, so most doctors who treat prostate cancer use a variety of nomograms to predict the probability of spread. Treatment by watchful waiting/active surveillance, external beam radiation therapy, brachytherapy, cryosurgery, HIFU, and surgery are, in general., offered to men whose cancer remains within the prostate. Hormonal therapy and chemotherapy are often reserved for disease that has spread beyond the prostate. However, there are exceptions: radiation therapy may be used for some advanced tumors, and hormonal therapy is used for some early stage tumors. Cryotherapy, hormonal therapy, and chemotherapy may also be offered if initial treatment fails and the cancer progresses.
Gleason score
The tissue samples are then examined under a microscope to determine whether cancer cells are present, and to evaluate the microscopic features (or Gleason score) of any cancer found. Prostate specific membrane antigen is a transmembrane carboxypeptidase and exhibits folate hydrolase activity. This protein is overexpressed in prostate cancer tissues and is associated with a higher Gleason score. A pathologist examines the biopsy specimen and attempts to give a score to the two patterns.
First – called the primary grade – represents the majority of the tumor (has to be greater than 50% of the total pattern seen).
Second -– a secondary grade – relates to the minority of the tumor (has to be less than 50%, but at least 5%, of the pattern of the total cancer observed).
These grades are then added to obtain the final Gleason score.
Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE)
Based on the results of the Cox analysis, points were assigned based on PSA (0 to 4 points), Gleason score (0 to 3), T stage (0 to 1), age (0 to 1) and percent of biopsy positive cores (0 to 1). The UCSF-CAPRA score range is 0 to 10, with roughly double the risk of recurrence for each 2-point increase in score. Recurrence-free survival at 5 years ranged from 85% for a UCSF-CAPRA score of 0 to 1 (95% CI 73%–92%) to 8% for a score of 7 to 10 (95% CI 0%–28%). The concordance index for the UCSF-CAPRA score was 0.66.
Stages
• Stage 1 – the cancer is small and contained within the prostate.
• Stage 2 – the cancer is larger and may be in both lobes of the prostate, but is still confined to the organ.
• Stage 3 – the cancer has spread beyond the prostate and may have invaded the adjacent lymph glands or seminal vesicles.
• Stage 4 – the cancer has spread to other organs, or to bone.
Choriocarcinoma is a malignant, trophoblastic cancer, usually of the placenta. It is characterized by early hematogenous spread to the lungs. It belongs to the malignant end of the spectrum in gestational trophoblastic disease (GTD). It is also classified as a germ cell tumor and may arise in the testis or ovary.
Choriocarcinoma of the placenta during pregnancy is preceded by:
The most common type of pancreatic cancer, accounting for 95% of these tumors, is adenocarcinoma arising within the exocrine component of the pancreas. A minority arise from islet cells, and are classified as neuroendocrine tumors. Pancreatic cancer is the fourth most common cause of cancer-related deaths in the United States and the eighth worldwide. Pancreatic cancer has an extremely poor prognosis: for all stages combined, the 1- and 5-year relative survival rates are 25% and 6%, respectively; for local disease the 5-year survival is approximately 15% while the median survival for locally advanced and for metastatic disease, which collectively represent over 80% of individuals, is about 10 and 6 months, respectively.
TNM stages of pancreatic cancer
• Tis (carcinoma in situ) is very early stage pancreatic cancer, which has not had a chance to spread. This is not at all common with this type of cancer.
• T1 means the tumor is inside the pancreas and is 2 cm or less in any direction
• T2 means the tumor is still within the pancreas but is more than 2 cm across in any direction
• T3 means the cancer has started to grow into tissues around the pancreas. It has not grown into the nearby large blood vessels
• T4 means the cancer has grown further outside the pancreas, into the nearby large blood vessels
N0 means there are no lymph nodes containing cancer.
N1 means there are lymph nodes which contain cancer cells and so the cancer is more likely to have spread further than the pancreas itself.
M0 means the cancer has not spread into distant organs such as the liver or lungs. M1 means the cancer has spread to other organs.
There are four stages in this system – stages 1 to 4.
Stage 1 means the cancer is completely inside the pancreas and has not spread to the lymph nodes. It is divided into
• Stage 1A means the cancer is completely inside the pancreas and is smaller than 2 cm. There is no cancer in the lymph nodes or cancer spread. In TNM staging, this is the same as T1, N0, M0.
• Stage 1B means the cancer is completely inside the pancreas but is bigger than 2 cm. There is no cancer in the lymph nodes or cancer spread. In TNM staging, this is the same as T2, N0, M0.
Stage 2 is divided into
• Stage 2A means the cancer has started to grow into nearby tissues around the pancreas. It may be in the duodenum or the bile duct. But there is no cancer in the nearby large blood vessels or lymph nodes. This means that, although the cancer has been growing locally, there is a chance that it may not have spread through the blood or lymph systems. In TNM staging, this is the same as T3, N0, M0.
• Stage 2B means the cancer can be any size and may have grown into the tissues surrounding the pancreas. Cancer is also found in the nearby lymph nodes, but not the large blood vessels. In TNM staging, this is the same as T1, 2 or 3, N1, M0.
Stage 3
The cancer is growing outside the pancreas, into the nearby large blood vessels. It may or may not have spread into the lymph nodes. It has not spread to other body organs. Your doctor may call this locally advanced cancer. In TNM staging, this is the same as T4, Any N, M0.
Stage 4
The cancer has spread to distant sites such as the liver or lungs. Your doctor may call this advanced cancer. In TNM staging, this is the same as Any T, Any N, M1.
Ovarian cancer is a diverse set of diseases and amongst the most clinically significant, epithelial ovarian cancers (EOC), at least five distinct entities exist. At a broad level, the terms type I and type II EOCs are often applied, wherein high-grade serous carcinomas (HGSCs) are type II and all other histologies are type I cancers.Epidemiological evidence strongly suggests that steroid hormones, primarily estrogens and progesterone, are implicated in ovarian carcinogenesis.
Most (more than 90%) ovarian cancers are classified as ‘epithelial’ and are believed to arise from the surface (epithelium) of the ovary. However, some evidence suggests that the fallopian tube could also be the source of some ovarian cancers. [2] Since the ovaries and tubes are closely related to each other, it is thought that these fallopian cancer cells can mimic ovarian cancer. [3]
Ovarian cancer is classified according to the histology of the tumor:
• Surface epithelial-stromal tumor, also known as ovarian epithelial carcinoma, is the most common type of ovarian cancer. It includes serous tumor, endometrioid tumor, and mucinous cystadenocarcinoma.
• Sex cord-stromal tumor, including estrogen-producing granulosa cell tumor and virilizing Sertoli-Leydig cell tumor or arrhenoblastoma, accounts for 8% of ovarian cancers.
• Germ cell tumor accounts for approximately 30% of ovarian tumors but only 5% of ovarian cancers, because most germ cell tumors are teratomas and most teratomas are benign. Germ cell tumors tend to occur in young women (20s–30s) and girls. Whilst overall the prognosis of germ cell tumors tend to be favorable, it can vary substantially with specific histology: for instance, the prognosis of the most common germ cell tumor (dysgerminomas) tends to be good, whilst the second most common (endodermal sinus tumor) tends to have a poor prognosis. Stages
Stage I – limited to one or both ovaries
• IA – involves one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
• IB – involves both ovaries; capsule intact; no tumor on ovarian surface; negative washings
• IC – tumor limited to ovaries with any of the following: capsule ruptured, tumor on ovarian surface, positive washings
Stage II – pelvic extension or implants
• IIA – extension or implants onto uterus or fallopian tube; negative washings
• IIB – extension or implants onto other pelvic structures; negative washings
• IIC – pelvic extension or implants with positive peritoneal washings
Stage III – peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum
Osteosarcoma is an aggressive malignant neoplasm arising from primitive transformed cells of mesenchymal origin (and thus a sarcoma) that exhibit osteoblastic differentiation and produce malignant osteoid. It is the most common histological form of primary bone cancer.
Osteosarcoma is the eighth most common form of childhood cancer, comprising 2.4% of all malignancies in pediatric patients, and approximately 20% of all primary bone cancers.
Incidence rates for osteosarcoma in U.S. patients under 20 years of age are estimated at five per million per year in the general population. It originates more frequently in the metaphyseal region of tubular long bones, with 42% occurring in the femur, 19% in the tibia, and 10% in the humerus. About 8% of all cases occur in the skull and jaw, and another 8% in the pelvis.
Prognosis is separated into three groups.
Stage I osteosarcoma is rare and includes parosteal osteosarcoma or low-grade central osteosarcoma. It has an excellent prognosis (>90%) with wide resection.
Stage II prognosis depends on the site of the tumor (proximal tibia, femur, pelvis, etc.), size of the tumor mass (in cm.), and the degree of necrosis from neoadjuvant chemotherapy (chemotherapy prior to surgery). The prognosis for patients with metastatic osteosarcoma improves with longer times to metastases, (more than 12 months–24 months), a smaller number of metastases, and their resectability. It is better to have fewer metastases than longer time to metastases.
Initial presentation of stage III osteosarcoma with lung metastases depends on the resectability of the primary tumor and lung nodules, degree of necrosis of the primary tumor, and possibly the number of metastases. Overall survival prognosis is about 30%.
Oral cancer or mouth cancer, a subtype of head and neck cancer, is any cancerous tissue growth located in the oral cavity. It may arise as a primary lesion originating in any of the oral tissues, by metastasis from a distant site of origin, or by extension from a neighboring anatomic structure, such as the nasal cavity.
Embryonal tumors are a collection of biologically heterogeneous lesions that share the tendency to disseminate throughout the nervous system via cerebrospinal fluid (CSF) pathways. Although there is significant variability, histologically these tumors are grouped together because they are at least partially composed of hyperchromatic cells with little cytoplasm, which are densely packed and demonstrate a high degree of mitotic activity.
The most recent WHO categorization of embryonal tumors is as follows:
Neuroblastoma (NB) is the most common extracranial solid cancer in childhood and the most common cancer in infancy. It is a neuroendocrine tumor, arising from any neural crest element of the sympathetic nervous system (SNS). It most frequently originates in one of the adrenal glands, but can also develop in nerve tissues in the neck, chest, abdomen, or pelvis.
Neuroblastoma is one of the few human malignancies known to demonstrate spontaneous regression from an undifferentiated state to a completely benign cellular appearance. It is a disease exhibiting extreme heterogeneity, and is stratified into three risk categories: low, intermediate, and high risk. Low-risk disease is most common in infants and good outcomes are common with observation only or surgery, whereas high-risk disease is difficult to treat successfully even with the most intensive multi-modal therapies available
The International Neuroblastoma Staging System (INSS):
Stage 1: Localized tumor confined to the area of origin.
Stage 2A: Unilateral tumor with incomplete gross resection; identifiable ipsilateral and contralateral lymph node negative for tumor.
Stage 2B: Unilateral tumor with complete or incomplete gross resection; with ipsilateral lymph node positive for tumor; identifiable contralateral lymph node negative for tumor.
Stage 3: Tumor infiltrating across midline with or without regional lymph node involvement; or unilateral tumor with contralateral lymph node involvement; or midline tumor with bilateral lymph node involvement.
Stage 4: Dissemination of tumor to distant lymph nodes, bone marrow, bone, liver, or other organs except as defined by Stage 4S.
Stage 4S: Age <1 year old with localized primary tumor as defined in Stage 1 or 2, with dissemination limited to liver, skin, or bone marrow (less than 10 percent of nucleated bone marrow cells are tumors).
Nasopharynx cancer or nasopharyngeal carcinoma (NPC) differs significantly from other cancers of the head and neck in its occurrence, causes, clinical behavior, and treatment. It is vastly more common in certain regions of East Asia and Africa than elsewhere, with viral., dietary and genetic factors implicated in its causation. It is most common in males. It is a squamous cell carcinoma or an undifferentiated type. The World Health Organization classifies nasopharyngeal carcinoma in three types:
Type 1 (I) is squamous cell carcinoma.
Type 2a (II) is keratinizing undifferentiated carcinoma.
Type 2b (III) is nonkeratinizing undifferentiated carcinoma.
Type 2b (III) nonkeratinizing undifferentiated form also known as lymphoepithelioma is most common, and is most strongly associated with Epstein-Barr virus infection of the cancerous cells. [8]
Staging of nasophayngeal carcinoma is based on clinical and radiologic examination. Most patients present with Stage III or IV disease.
Stage I is a small tumor confined to nasopharynx.
Stage II is a tumor extending in the local area, or that with any evidence of limited neck (nodal) disease.
Stage III is a large tumor with or without neck disease, or a tumor with bilateral neck disease.
Stage IV is a large tumor involving intracranial or infratemporal regions, extensive neck disease, and/or any distant metastasis.
Multiple myeloma is also known as plasma cell myeloma or Kahler’s disease. In multiple myeloma, collections of abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells. Myeloma develops in 1–4 per 100,000 people per year. It is more common in men, and for unknown reasons is twice as common in African-Americans as it is in European-Americans. With conventional treatment, median survival is 3–4 years, which may be extended to 5–7 years or longer with advanced treatments. Multiple myeloma is the second most common hematological malignancy in the U.S. (after non-Hodgkin lymphoma), and constitutes 1% of all cancers.
Initial treatment of multiple myeloma depends on the patient’s age and co-morbidities. In recent years, high-dose chemotherapy with autologous hematopoietic stem-cell transplantation has become the preferred treatment for patients under the age of 65. The most common induction regimens used today are thalidomide–dexamethasone, bortezomib based regimens, and lenalidomide–dexamethasone. Autologous stem cell transplantation (ASCT), the transplantation of a patient’s own stem cells after chemotherapy, is the most common type of stem cell transplantation for multiple
myeloma. It is not curative, but does prolong overall survival and complete remission. Allogeneic stem cell transplantation, the transplantation of a healthy person’s stem cells into the affected patient, has the potential for a cure, but is only available to a small percentage of patients. Furthermore, there is a 5–10% treatment-associated mortality rate.
The International Staging System (ISS) for myeloma was published by the International Myeloma Working Group in 2005:
Melanoma is less common than other skin cancers. However, it is much more dangerous if it is not found early. It causes the majority (75%) of deaths related to skin cancer. There are high rates of incidence in Oceania, Northern America, Europe, Southern Africa, and Latin America, with a paradoxical decrease in southern Italy and Sicily. This geographic pattern reflects the primary cause, ultraviolet light (UV) exposure crossed with the amount of skin pigmentation in the population.
According to a WHO report, about 48,000 melanoma related deaths occur worldwide per year.
Melanoma stages: 5-year survival rates:
Stage 0: Melanoma in situ (Clark Level I), 99.9% survival
Stage I / II: Invasive melanoma, 89–95% survival
• T1a: Less than 1.0 mm primary tumor thickness, without ulceration, and mitosis < 1/mm2
• T1b: Less than 1.0 mm primary tumor thickness, with ulceration or mitoses ≥ 1/mm2
• T2a: 1.01–2.0 mm primary tumor thickness, without ulceration
F18-FDG PET/CT in a melanoma patient showing multiple lesions, most likely metastases
Stage II: High risk melanoma, 45–79% survival
• T2b: 1.01–2.0 mm primary tumor thickness, with ulceration
• T3a: 2.01–4.0 mm primary tumor thickness, without ulceration
• T3b: 2.01–4.0 mm primary tumor thickness, with ulceration
• T4a: Greater than 4.0 mm primary tumor thickness, without ulceration
• T4b: Greater than 4.0 mm primary tumor thickness, with ulceration
Stage III: Regional metastasis, 24–70% survival
• N1: Single positive lymph node
• N2: Two to three positive lymph nodes or regional skin/in-transit metastasis
• N3: Four positive lymph nodes or one lymph node and regional skin/in-transit metastases
Stage IV: Distant metastasis, 7–19% survival
• M1a: Distant skin metastasis, normal LDH
• M1b: Lung metastasis, normal LDH
• M1c: Other distant metastasis or any distant metastasis with elevated LDH
Based upon AJCC 5-year survival from initial melanoma diagnosis with proper treatment.
Medulloblastoma is a highly malignant primary brain tumor that originates in the cerebellum or posterior fossa. Tumors that originate in the cerebellum are referred to as infratentorial because they occur below the tentorium. Another term for medulloblastoma is infratentorial primitive neuroectodermal tumor (PNET). Medulloblastoma is the most common PNET originating in the brain.
Treatment begins with maximal resection of the tumor. The addition of radiation to the entire neuraxis and chemotherapy may increase the disease-free survival. There is some evidence that Proton beam irradiation provides some benefits in terms of reducing the impact of radiation on the cochlear and cardiovascular areas and that it reduces the cognitive late effects of cranial irradiation. This combination may permit a 5-year survival in more than 80% of cases.
Lymphoma is a type of blood cancer that occurs when B or T lymphocytes, the white blood cells that form a part of the immune system divide faster than normal cells. Lymphomas may develop in the lymph nodes, spleen, bone marrow, blood or other organs and eventually they form a tumor. Typically, lymphoma presents as a solid tumor of lymphoid cells. Treatment might involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and lymphomas can be curable depending on the histology, type, and stage of the disease.
SEER Cancer Statistics Review. (2010) Data from the USA 1999–2006, All Races, Both Sexes. SEER Cancer Statistics Review, 1975–2007, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2007/
Most cancers that start in the lung, known as primary lung cancers, are carcinomas that derive from epithelial cells. The main types of lung cancer are small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC). The most common cause of lung cancer is long-term exposure to tobacco smoke, which causes 80–90% of lung cancers; non-smokers account for 10–15% of lung cancer cases. Common treatments include surgery, chemotherapy, and radiotherapy. NSCLC is sometimes treated with surgery, whereas SCLC usually responds better to chemotherapy and radiotherapy. Overall, 15% of people in the United States diagnosed with lung cancer survive five years after the diagnosis.
NSCLC
The three main subtypes of NSCLC are adenocarcinoma, squamous-cell lung carcinoma, and large-cell lung carcinoma. Nearly 40% of lung cancers are adenocarcinoma, which usually originates in peripheral lung tissue. Among people who have never smoked adenocarcinoma is the most common form of lung cancer. A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have a better long-term survival.
Squamous-cell carcinoma accounts for about 30% of lung cancers. They typically occur close to large airways. A hollow cavity and associated cell death are commonly found at the center of the tumor. About 9% of lung cancers are large-cell carcinoma.
Staging
TNM Classification of Malignant Tumors (TNM) is a cancer staging system that describes the extent of a person’s cancer.
T describes the size of the original (primary) tumor and whether it has invaded nearby tissue,
N describes nearby (regional) lymph nodes that are involved,
M describes distant metastasis.
Stages are 0, IA (one-A), IB, IIA, IIB, IIIA, IIIB and IV (four)
SCLC
In small-cell lung carcinoma (SCLC), the cells contain dense neurosecretory granules (vesicles containing neuroendocrine hormones), which give this tumor an endocrine/paraneoplastic syndrome association. Most cases arise in the larger airways (primary and secondary bronchi).[10] These cancers grow quickly and spread early in the course of the disease. Sixty to seventy percent have metastatic disease at presentation. This type of lung cancer is strongly associated with smoking
Survival Rate
5-year survival (%)
Clinical stage
Non-small-cell lung carcinoma
Small-cell lung carcinoma
IA
50
38
IB
47
21
IIA
36
38
IIB
26
18
IIIA
19
13
IIIB
7
9
IV
2
1
According to data provided by the National Cancer Institute, the median age at diagnosis of lung cancer in the United States is 70 years and the median age at death is 72 years.