NSCLS vs. SCLC: How Are They Different?

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How are NSCLS and SCLC different? Dr. Malcom DeCamp and Dr. Paul Paik assess the nuances of both NSCLS (non-small cell lung cancer) and SCLC (small cell lung cancer) to help patients understand their conditions in relation to optimal treatment paths. 

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Susan Leclair:

So I’ve been a teacher too long. I’ve got to start at the beginning, because otherwise I’m not sure where to go after that. What’s small lung cancer? And why is that different from large cell? 

And I hear there are more than one large cell cancers for the lung.   

Dr. DeCamp:

I’ll let you take small cell.

Dr. Paik:

Okay. 

Susan Leclair:

The visiting team is, again, going first. Okay.

Dr. DeCamp:

That’s because I’m bigger. 

Dr. Paik:

So small cell lung cancer is exactly what it sounds like. So you know, these differences in terms of nomenclature have quite literally to do with what things look like under the microscope. So small cell lung cancers look like very small, blue cells, and they used to be called oat cell cancers because they looked like oats as a result. But it is a particularly aggressive form of lung cancer that happens in about 10 to 15 percent of cases,, overall. The cells are aggressive and different. They arise from normal cells that are different from other kinds of lung cancers than the non-small cell lung cancers.  

These are cells that we think, derive in part from what’s called the neuroendocrine system, and this defines some of the features that they have also. But the bottom line is that the growth rate for these cancers is much, much higher, and the division rate is much higher than for non-small cell lung cancers.

And they’re marked by spreading at a much earlier time in their development than non-small cell lung cancers.  And this is, to a large extent, or exactly why small cell lung cancer is particularly problematic from a treatment standpoint.  

Susan Leclair:

Non-small cell?  I always love the name. It’s so precise.  Non-small cell.  There are subtypes?

Dr. DeCamp:

Sure.  There are a—a number of subtypes of non-small cell lung cancer. And it’s like everything else but small cell. The most common types of non-small cell lung cancer would be adenocarcinoma, which I know a number of—I recognize some of my patients out there have. Squamous cell lung cancer, there’s large cell lung cancer, and a number of other descriptive types. And as my colleague said, a lot of this derives from how it looks under the microscope. 

We even now can subdivide.  For example, adenocarcinoma, we’re beginning to unlock the molecular and genetic aspects of it and realize that’s a family of cancers.  And each member of that family is driven by a different gene, or driver mutation in the—in the cancer genome. So it’s becoming quite technical. And almost not quite yet, displaced these old terms, these old histologic, under the microscope terms, because we look at an EGFR-driven adenocarcinoma completely differently than we do a KRAS-driven adenocarcinoma. And it helps my colleagues design the right kinds of—of precision treatments for those patients. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on August 12, 2015