Large Cell Carcinoma of the Lungs

Symptoms, Treatments, and Prognosis of Large Cell Lung Cancer

physician looking at an x-ray
Large cell lung cancer is one form of non-small cell lung cancer. istockphoto.com

Large cell carcinoma of the lungs is a form of non-small cell lung cancer. Non-small cell lung cancers account for 80 percent of lung cancers, and of these, roughly 10 percent are large cell carcinoma of the lung.

Large Cell Carcinoma Overview

Large cell carcinomas are also called large cell lung cancers. They are named for the appearance of large round cells when examined under the microscope, although the tumors themselves tend to be large as well when diagnosed.

Large cell carcinomas often occur in the outer regions of the lungs, and tend to grow rapidly and spread more quickly than some other forms of non-small cell lung cancer.

Symptoms

Because large cell carcinomas often begin in the outer parts of the lungs, well-known symptoms of lung cancer, such as a chronic cough and coughing up blood, may be less common until later in the disease. Early of large cell carcinomas that may be overlooked may include fatigue, mild shortness of breath, or achiness in your back, shoulder, or chest. Many people note that these initial symptoms are subtle and vague, for example, they believe that their symptoms of shortness of breath with climbing stairs are related to gaining a few pounds or being a few years older, rather than being a sign of lung cancer.

Since large cell carcinomas are often found in the outer regions of the lungs, they can cause fluid to develop in the space between the tissues that line the lung (pleural effusions)and invade the chest wall.

This can cause pain in your chest or side that worsens with a deep breath.

Large cell carcinomas can also secrete hormone-like substances that cause symptoms referred to as paraneoplastic syndrome. In men, these substances may cause enlargement of the breasts, something known as gynecomastia.

    Diagnosis

    Large cell carcinoma of the lungs is often first suspected when abnormalities are seen in an X-ray. Further evaluation may include:

    Depending upon the results, your doctor will usually want to obtain a sample of tissue to confirm the diagnosis and will order further tests to check to see if your cancer has spread. A lung biopsy to detect lung cancer may be done in one of several ways ranging from a fine needle biopsy, to an endobronchial ultrasound guided biopsy during a bronchoscopy, to an open lung biopsy.

    Stages

    Large cell carcinoma is broken down into 4 stages:

    • Stage 1 – The cancer is localized within the lung and has not spread to any lymph nodes.
    • Stage 2 – The cancer has spread to lymph nodes or the lining of the lungs, or is in a certain area of the main bronchus.
    • Stage 3 – The cancer has spread to tissue near the lungs.
    • Stage 4 – The cancer has spread (metastasized) to another part of the body.

      Learn more about the Stages of Lung Cancer.

      Causes

      Large cell carcinomas of the lungs are more strongly associated with smoking than some other types of non-small cell lung cancers, but other causes can contribute as well:

      Treatments

      Depending upon the stage, treatment for large cell carcinomas of the lung may include surgery, chemotherapy, radiation therapy, or a combination of these. Many clinical trials are in progress looking for new ways to treat lung cancer, and to help decide which treatments are most effective.

      • Surgery

        When large cell carcinomas are caught in the early stages, surgery may offer a chance for a cure.
      • Chemotherapy

        Chemotherapy may be used alone, in conjunction with radiation therapy, or following surgery for lung cancer. Examples of chemotherapy medications used with large cell carcinomas include Altima (pemetrexed) and Platinol (cisplatin).
      • Targeted Therapies

        Targeted therapies are medications that are designed to attack cancer specifically. Because they work by targeting proteins on cancer cells, or normal cells that have been “hijacked” by a tumor in its attempt to grow, they may have fewer side effects than traditional chemotherapy. Examples of targeted therapies that may be used include Tarceva (erlotinib) and Iressa (gefitinib).
      • Radiation Therapy

        Radiation therapy may be used to treat lung cancer or to control symptoms related to the spread of cancer.
      • Immunotherapy

                    Immunotherapy is an exciting new field of lung cancer treatment that has resulted in long-term control of the disease for some people.

      Learn more about lung cancer treatment options here

      Prognosis

      The 5-year survival rate for lung cancer overall is sadly only about 18 percent. For those diagnosed in the early stages of the disease, the prognosis is much better. One variant of large cell carcinoma, large cell neuroendocrine carcinoma, has a poorer prognosis than large cell carcinoma.

      Coping with Lung Cancer

      A diagnosis of lung cancer is frightening and you may feel very alone. Allow your loved ones to support you. Many people have no idea how to react towards someone who is diagnosed with cancer. Letting people know specific things they can do to help may ease their anxiety, as well as fill your need for extra support at this time.

      Ask questions. Learn as much as you can. Consider joining a lung cancer support group either through your cancer center or online. And be true to yourself. No matter what others have experienced or recommend, only you know what is best for you.

      Sources:

      American Cancer Society. Lung Cancer (Non-Small Cell.) Non-Small Cell Lung Cancer Survival Rates by Stage. 02/08/16. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-survival-rates

      National Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ). Updated 05/11/16.  http://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq

      Sheth, S. Current and emerging therapies for patients with advanced non-small cell lung cancer. American Journal of Health-System Pharmacy. 2010. 67(1 Suppl 1):S9-14.

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