Non-small cell lung cancer (NSCLC) carries a better prognosis than small cell lung cancer (SCLC). NSCLC is slow-growing, whereas SCLC grows far more aggressively. Additionally, NSCLC is the more common type, accounting for 85 percent of cases, whereas SCLC is rarer, accounting for 10 to 15 percent of cases.
The prognosis of NSCLC depends largely on the tumor, node, metastasis (TNM) stage at presentation:
- T describes the size of the tumor and any spread of cancer into nearby tissue.
- N describes the spread of cancer to the nearby lymph nodes.
- M describes the spread of cancer to other parts of the body (metastasis).
How well the lung cancer patient can perform their daily activities independently can predict their lifespan, regardless of the disease stage. Weight loss is also associated with a poor prognosis in NSCLC patients.
Other factors that determine prognosis include age and smoking cessation. Old age and continued smoking is associated with a bad prognosis, whereas young age and quitting smoking generally offer a better prognosis.
In patients with SCLC, the extent of the disease (stage) at presentation is the most important factor that determines prognosis:
- For patients with the limited-stage disease, median survival ranges from 15 to 20 months (which means only half of the patients can survive for 15 to 20 months after diagnosis).
- For patients with the extensive-stage disease, the median survival is 8 to 13 months (which means only half of the patients will survive for 8 to 13 months after the diagnosis).
An inability to carry out daily activities independently and weight loss can shorten the patient’s lifespan.
How are non-small cell lung cancer and small cell lung cancer staged?
Staging of cancer is done to describe how far it has spread within the body. A simple way to stage this includes the three stages of cancer:
- Localized: Cancer has not spread outside the lung.
- Regional: Cancer has spread to nearby structures or lymph nodes.
- Distant: Cancer has spread to distant parts of the body, for example, to the liver, bones, etc.
Stages of non-small cell lung cancer (NSCLC)
For this type of cancer, doctors usually use a four-stage system:
- Stage I: Cancer is only in one lung.
- Stage II: Cancer has spread to the nearby lymph nodes.
- Stage III: Cancer has reached other lymph nodes in the chest (the middle or the other side of the chest).
- Stage IV: Cancer has spread to both lungs, other parts of the body or both.
Stages of small cell lung cancer (SCLC)
Doctors generally categorize small cell lung cancer in two stages:
- The limited stage: Cancer is limited to only one side of the chest, which means it may be in one lung and, possibly, in the nearby lymph nodes.
- The extensive stage: Cancer has spread throughout the lungs, other parts of the chest and other distant organs.
What are the survival rates of non-small cell lung cancer and small cell lung cancer?
The survival rate is analyzed in a large study, in which the lifespan of a large population, after the diagnosis of cancer, is observed for a specific timeframe. It is generally presented as a five-year survival rate (what percentage of people lived for at least five years after the diagnosis).
| Stage of NSCLC | Five-year survival rate (in percentage) |
|---|---|
| Localized | 63 |
| Regional | 35 |
| Distant | 7 |
| All stages combined | 25 |
| *NCI: National Cancer Institute | |
According to the National Cancer Institute (NCI), the overall five-year survival rate for NSCLC is 25 percent. This means 25 out of 100 people with NSCLC can survive for at least five years after their diagnosis.
| Stage of SCLC | Five-year survival rate (in percentage) |
|---|---|
| Localized | 27 |
| Regional | 16 |
| Distant | 3 |
| All stages combined | 7 |
| *NCI: National Cancer Institute | |
According to the National Cancer Institute (NCI), the overall five-year survival rate for NSCLC is only seven percent. This means 7 out of 100 people with NSCLC can survive for at least five years after their diagnosis. It also means that people with NSCLC have only a seven percent chance that they will survive for at least five years after the diagnosis.
Survival rates for cancer are often used as predictors of patients’ lifespan (usually at least five years) after the diagnosis. However, these may vary depending on the patient’s age, overall health and response to treatments. Hence, patients need to discuss all these factors with their doctor to know about their life expectancy.
Patients should remember that survival rates are calculated at a particular point in time. Therefore, it may be possible that advances in treatments in the later years might have improved survival rates. Hence, patients must always ask their doctor even after they know the general survival rates.
Overall, lung cancer causes more deaths than breast, prostate, colorectal and brain cancers combined. However, more people are surviving after diagnosis, probably due to treatment advances and decreases in smoking.
QUESTION
Lung cancer is a disease in which lung cells grow abnormally in an uncontrolled way. See AnswerDo non-small cell lung cancer and small cell lung cancer differ in their treatments?
Treatment of non-small cell lung cancer (NSCLC) does differ from small cell lung cancer (SCLC) in the following ways:
Treatment of non-small cell lung cancer (NSCLC)
For patients with NSCLC, doctors decide the initial management based on the stage of the disease and other comorbidities the patient has and may include:
- Early-stage disease: Surgical removal of the lung tumor carries the maximum chances of cure. Surgical removal and concurrent chemoradiotherapy (chemotherapy and radiotherapy) are preferred for those with a more extensive spread of tumors in the chest. Chemotherapy involves administering highly powerful medications to shrink the tumor, and radiation uses high-energy beams that are targeted toward the tumor to destroy the cancer cells.
- Advanced disease (Stage IV): Patients can choose to either take chemotherapy medications or opt for palliative care. Palliative care includes taking only those medications or undergoing only those procedures that manage the symptoms of cancer but do not cure it. Patients who chose palliative care over chemotherapy expect only a better quality of life in the time they have left.
Treatment of small cell lung cancer (SCLC)
- Limited-stage disease: Primarily treatment involves using a combination of chemotherapy and radiation therapy.
- Extensive-stage disease: A combination of chemotherapy and immunotherapy is used as the initial therapy. Patients can even opt for palliative care. Immunotherapy is a novel therapy that uses the patient’s immune system to fight cancer.
Doctors devise tailor-made approaches while treating and administering medications to each patient. The team of doctors, including an oncologist, pulmonologist, surgeon, radiologist and other team members, will discuss with the patient the best options that suit their problem.
Midthun DE. Overview of the Initial Treatment and Prognosis of Lung Cancer. UpToDate. https://www.uptodate.com/contents/overview-of-the-initial-treatment-and-prognosis-of-lung-cancer
Top Which Is More Aggressive, SCLC or NSCLC Related Articles
Can You Smoke When You Have Lung Cancer?
Continuing to smoke after the diagnosis or during the treatment of lung cancer is usually not recommended because it may decrease the survival rate and even interfere with the treatment process.
Can You Survive Metastatic Lung Cancer?
Once cancer spreads to other parts of the body (metastasis), it is much harder to treat, which means metastatic lung cancer typically has a five-year survival rate of seven percent.
How Do You Test Yourself for Lung Cancer?
Lung cancer is the second leading cause of death in the United States. It is hard to detect in the early stages because it does not cause obvious signs and symptoms. Signs and symptoms most often appear when lung cancer has grown deep and extensively inside the lung tissue and/or spread to other organs.
How Long Does Lung Cancer Take to Develop?
The time taken for lung cancer to develop is variable. It takes several years for cancer to develop in the lungs. Early lung cancer does not alert obvious physical changes. Moreover, patients can live with lung cancer for many years before they show any signs or symptoms.Lung Cancer
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due to tobacco smoke. Lung cancers are classified as either small-cell or non-small-cell lung cancers.
Lung Cancer Myths/Facts
Learn about lung cancer myths and facts. Explore how cigar smoke, menthol, and pollution can increase your risk of lung cancer and learn what to avoid.Lung Cancer Picture
Cancer of the lung, like all cancers, results from an abnormality in the body's basic unit of life, the cell. See a picture of Lung Cancer and learn more about the health topic.
Know Your Lung Cancer Facts Quiz
Lung cancer is the number one cause of cancer deaths in both men and women in the U.S. and worldwide. Get the facts about lung cancer with this quiz.
Small Cell Lung Cancer vs. Non-Small Cell Lung Cancer
Non-small cell lung cancers (NSCLC) consist of large cell carcinomas, adenocarcinomas, and squamous cell carcinomas. Small cell lung cancer (SCLC) usually starts in the bronchi and typically appears in those who smoke. SCLC and NSCLC are staged in different manners, and SCLC tends to metastasize more quickly than NSCLC. Signs and symptoms of NSCLC and SCLC include shortness of breath, coughing up blood, recurring lung infections, and chest pain. Treatment may involve radiation therapy, chemotherapy, and surgery.What Are the Four Types of Lung Cancer?
The four types of lung cancer are classified by what kind of cells the cancer affects and what the tumor cells look like under a microscope. Lung cancers can be small-cell or non-small cell, further classified as squamous cell carcinoma or adenocarcinoma.What Is Usually the First Sign of Lung Cancer?
Most often, lung cancer does not show any signs and symptoms until it has advanced to higher stages when it becomes difficult to treat. The initial signs and symptoms vary among patients but may include cough that remains unrelieved and gets worse over time, hemoptysis (coughing up blood) or reddish spit, chest pain that worsens on breathing or laughing, hoarseness of voice, weight loss, persistent chest pain, and frequent lung infections.What Percentage of Smokers Get Lung Cancer?
According to the Centers for Disease Control and Prevention (CDC), lung cancer develops in around 10 to 20 percent of all smokers. Scientists believe that smoking is responsible for over 80 percent of lung cancers.Will a Chest X-Ray Show Lung Cancer?
When diagnosing lung cancer, chest X-rays do not provide a definitive diagnosis of lung cancers at an early stage (when they are more treatable). Until the lung cancer shows up on a chest X-ray, the tumor is often too far advanced to be cured. Often, many things seen on a chest X-ray turn out to be treatable problems or artifacts.