There are both primary and secondary lung cancers. Only primary lung cancers actually begin in the lungs – secondary cancers spread to the lungs from elsewhere in the body.
Primary lung cancers can be classified in two main groups:
- small cell lung cancer
- non-small cell lung cancer
Small cell lung cancer (SCLC) is a less-common form of lung cancer, which tends to spread. Non-small cell lung cancer (NSCLC) accounts for more than 70% of all lung cancers, and occurs in three common variant forms, which tend to behave and respond in similar ways. These NSCLC sub-types are:
- adenocarcinoma, which affects mucus-making gland cells, and is the form most often encountered
- squamous cell cancer, which is usually found near the centre of the lung and affects cells lining the airways
- large cell carcinoma, which has a distinctive pattern of comparatively large and round cells
When your NSCLC cancer cells are insufficiently developed to allow positive identification, they are described as forming an undifferentiated cancer.
What treatment methods are used by lung cancer specialists?
The scale of treatment will depend upon several factors, including the developmental stage of your cancer. You may be recommended for more than one treatment at once, which could take the form of surgery, chemotherapy, radiation treatment or a targeted drug therapy.
Surgical interventions to remove lung cancers include:
- a wedge resection to take away a small portion of lung containing a tumour, plus some surrounding healthy tissue
- a segmental resection to remove a larger lung section, though not a complete lobe
- a lobectomy to take away the whole lobe from one lung
- a pneumonectomy to remove one lung in its entirety
After surgery, a respiratory therapist may introduce some breathing exercises to speed your recovery.
Chemotherapy uses a powerful combination of drugs to destroy cancer cells, and is often used alongside surgery.
Radiation therapy uses high-powered X-rays and other energy beams to eradicate cancerous cells. The treatment may use either external radiation therapy or brachytherapy (which targets cancer cells with radiation sources inside your body). Stereotactic body radiotherapy is a multi-angle form of radiation treatment designed to destroy small cancer tumours.
Targeted drug therapies
This is a more recent form of cancer treatment, often used in tandem with chemotherapy, which is designed to target specific abnormalities that have been identified in cancerous cells.
What additional qualifications are required by lung cancer specialists?
A pulmonologist is required to complete medical school training and then undertake a residency training to gain a medical qualification in internal medicine. A minimum of two further years of fellowship training are then necessary to gain certification in pulmonary medicine. Many pulmonologists later go on to study additional pulmonary specialisms, such as interventional pulmonology and paediatric pulmonology.
A thoracic oncologist will follow a similar study route in the field of oncology, and will require a doctoral degree as a minimum qualification. This particular subspecialty will require training and experience gained via internships, residencies and then a fellowship study.
Other specialists who may work collaboratively with a lung cancer specialist often include:
- a thoracic oncologist, a cancer doctor who deals with a variety of cancers in the chest and lungs. This specialist may also regularly deal with lung cancers
- a surgical oncologist, a cancer doctor who performs surgery and may become involved in removing tumours, and other cancer-related procedures
- a pain management specialist is a doctor whose professional focus is pain relief for those patients who need cancer care
- a pathologist, who may be called upon to evaluate skin samples taken during a biopsy in order to confirm whether cancerous cells are present
- a radiation oncologist is a specialist who may be required to initiate radiation therapies used to treat lung cancer
- a radiologist is a physician who oversees the use of sophisticated imaging equipment to monitor cancer patients before, during and after treatments, and who will also interpret the images and data captured on these occasions
- a respiratory therapist, who is responsible for helping patients to improve their breathing function