Types of Lung Cancer

There are two main types of lung cancer:

• non-small cell lung cancer
• small cell lung cancer. 

It is important to know the type of lung cancer you have. This will allow your doctors to determine the best course of treatment as different types of lung cancer respond best to different treatments.

Non-small cell lung cancer

Non-small cell lung cancer is the most common form of the disease. Around 85% of people with lung cancer will have a form of non-small cell lung cancer. 

There are three common types of non-small cell lung cancer:

Adenocarcinoma (non-squamous)

This is the most common type of non-small cell lung cancer. This type of cancer develops in glandular cells in the lungs and is typically found in the outer parts of the lungs and in the lining of the bronchi. It is slower growing than other types of lung cancer. However, it can spread early on. 

Adenocarcinoma tumours tend to be more common in women and is also the most common type of lung cancer amongst people under 45.

This type of lung cancer can produce excess mucus (fluid) in the lungs, leading to a chronic cough.

Large Cell Carcinoma (non-squamous)

This is the least common type of non-small cell lung cancer. This type of lung cancer often arises in the larger air passages.

Large Cell Carcinoma, or LCC, is generally more aggressive than other types of non-small cell lung cancer and tends to spread outside the lung at an earlier stage.

Squamous Carcinoma

This is the second most common type of lung cancer after lung adenocarcinoma. However, the number of people developing squamous cell lung cancer is going down in the UK.

This can form in the larger, more central airways, originating in the bronchi. It is often found near the centre of the lung in one of the main airways.

All types of non-small cell lung cancer are potentially suitable for surgery if they are diagnosed at an early enough stage. It can also be treated with chemotherapy, radiotherapy and immunotherapy. 

Mutation driven lung cancers

Some of these cancers have genetic mutations. There are currently eight types of mutations that have available targeted treatment options:

• ALK+ (anaplastic lymphoma kinase)
• BRAF (B-Raf proto-oncogene, serine/threonine kinase)
• EGFR+ (epidermal growth factor receptor)
• KRAS (Kirsten RAt Sarcoma virus)
• MET (mesenchymal-epithelial transition factor)
• NTRK (neurotrophic tropomyosin-related kinase)
• RET (rearranged during transfection)
• ROS1 (relating to the gene c-ros oncogene 1).

Small cell lung cancer

Approximately 15% of people with lung cancer will have small cell lung cancer.

Small cell lung cancer is made up of small round cells that form fleshy lumps and usually start in the larger airways. These cells reproduce and grow very quickly. It may spread to the lymph nodes and/or other organs in the body. 

Compared to non-small cell lung cancer, small cell lung cancer grows and spreads more quickly. This means it is difficult to diagnose at early stage.

Small cell lung cancer is generally more responsive to chemotherapy treatment than other treatments, and radiotherapy may also be used. In rare cases, this type of lung cancer can be surgically removed. 

Other types of lung cancer

There are other types of cancers that can affect the lungs, but most of them are rare.

Mesothelioma 

Mesothelioma is closely associated with a history of asbestos exposure either through work or contact with a person in the asbestos industry. It generally affects older males and may take 35-40 years from the date of first exposure for the cancer to develop. 

The cancer cells are usually positioned in the lining of the lung and often produce fluid. This may require draining from time to time to improve breathing.

Mesothelioma can be difficult to treat as it is often found when it is at an advanced stage. Treatment may include chemotherapy, radiotherapy or surgery. 

Financial compensation from the government may be available if lung damage from exposure to asbestos is proven. We recommend contacting our corporate partners, Irwin Mitchell, for further advice.

Pancoast tumour

This is a rare tumour which grows at the top of the lung. People with this type of lung cancer may experience shoulder and upper back pain rather than more common respiratory symptoms. It can also cause pain in the neck, arm, or chest.

Treatment is usually the same as the non-small cell lung cancer and will depend on where the tumour is, the size of it and whether it has spread to other parts of the body.

Carcinoid tumour

This is a rare tumour disease of the lung which is generally less aggressive than other types. The tumour develops from a special type of cells in the lung called neuroendocrine cells.

There are two types of lung carcinoids:

Typical carcinoid tumour grow slowly and only rarely spread beyond the lungs. Most lung carcinoids are typical carcinoids 

Atypical carcinoid tumour grow faster and are more likely to spread to other organs. Seen under a microscope, they have more cells in the process of dividing and look like a fast-growing tumour. They are less common than typical carcinoids.

Many carcinoid tumours can be cured by surgery, but some are more aggressive and can spread to other parts of the body. In this case. treatment with chemotherapy may be required.

Malignant pleural effusion

Pleural effusion is an excessive build-up of fluid between your lungs and chest cavity. There are many causes of a pleural effusion, but unfortunately cancer is one of the most common. This is called malignant pleural effusion and occurs when there is a build-up of fluid and cancer cells that collects between the chest wall and the lung.

Rare types of lung cancer

Other tumours are so rare that current information is best given by your doctor or lung cancer nurse specialist. These unusual types of lung cancer include:

• Hamartoma
• Bronchial gland tumours
• Lymphoma
• Pleural fibroma
• Sarcoma.

Your doctors will confirm the type of lung cancer you have through a variety of different tests. This may feel quite daunting but each test provide essential information to allow your lung cancer team to decide the best treatments. The more they know about the type of lung cancer you have, the more they can do.