There are two types of lung cancer: small cell lung cancer and non-small cell lung cancer. Large cell carcinoma is a type of non-small cell lung cancer.
This article looks at what NSCLC is, its symptoms, causes, and treatment options. We also look at the prognosis and when a person should contact a healthcare professional.
The National Cancer Institute state that large cell carcinoma is a type of cancer that can begin in several types of large cells. As the name suggests, these cancer cells appear larger than typical cancer cells when viewed under a microscope.
Other types of NSLCL include squamous cell carcinoma and adenocarcinoma. Less common types include:
- carcinoid tumor
- salivary gland carcinoma
- unclassified carcinoma
Some of the most common symptoms of large cell carcinoma and other types of lung cancer include:
- persistent cough
- coughing up blood or rust-colored phlegm
- hoarse voice
- chest pain that worsens with deep breathing, laughing, or coughing
- loss of appetite
- shortness of breath
- unexplained weight loss
- persistent or recurring infections, such as bronchitis or pneumonia
Depending on where the cancer has spread to, a person may experience different symptoms, for example:
- Cancer that has spread to the liver can cause jaundice.
- Cancer in the bones can trigger bone pain, such as back pain or pain in the hips.
- Cancer that has spread to the brain may cause a person to experience changes in their nervous system, such as headaches or seizures.
- Cancer that has spread to the lymphatic system may cause the lymph nodes to swell.
Healthcare professionals usually categorize large cell carcinoma and other NSCLC in stages using the Tumor Node Metastasis system, also known as TNM staging.
According to Cancer Research UK, the “T” in TNM refers to the size and extent of the main tumor:
|T1||The cancer is contained in the lung.|
T1a means that the cancer measures 1 centimeter (cm).
T1b means that the cancer measures between 1–2 cm.
T1c means that the cancer measures between 2–3 cm.
|T2||At this point, the cancer measures between 3–5 cm across and involves the main airway or the lining of the lung. Additionally, part or all of the lung has collapsed or is blocked.|
T2a means that the cancer measures between 2–4 cm.
T2b means that the cancer measures between 4–5 cm.
|T3||This stage means that the cancer measures between 5–7 cm, or there is more than one tumor.|
The cancer may have spread to the chest wall, the outer lining of the chest cavity, the nerve near the lung, or the outer covering of the heart.
|T4||At this point, the cancer measures more than 7 cm. |
It may also be in more than one lobe of the lung.
It may have spread to the other parts of the body, such as the heart, food pipe, spinal bone, and other sections of the lung.
“Node” refers to whether or not the cancer has spread to the lymph nodes:
- N1: This means that cancer cells are in the lymph nodes in the lung or the area near the lungs.
- N2: This means that cancer has spread to the lymph nodes in the center of the chest or where the windpipe branches off into the lung.
- N3: This means that cancer has spread to the lymph nodes:
- above the collar bone
- at the top of the lung
- the opposite side of the chest
Finally, the “M” in TNM stands for metastasis. It indicates how much the cancer has spread throughout the body:
- M0: This means the cancer has not spread.
- M1: The cancer has spread to other parts of the body, which doctors further define using the following designations:
- M1a, which means the cancer has spread to:
- both lungs
- the lining around the lung or heart
- there is fluid around the lung or heart containing cancer cells
- M1b, which means there is a single area of cancer outside of the chest
- M1c, which means that a person has one or more areas of cancer in one or more organs
- M1a, which means the cancer has spread to:
Additionally, according to the National Cancer Institute, a healthcare professional may use a staging system:
|Stage 0||This means that cancerous cells are present. However, they have not spread to nearby tissues. Healthcare professionals may refer to this as “carcinoma in situ” (CIS). This means that the cells are not cancerous but may become cancer.|
|Stages 1–3||This means that cancer is present. The higher the number, the larger the cancer is and the more it has spread.|
|Stage 5||At this stage, the cancer has spread to other parts of the body.|
The American Lung Association estimate that the cause of almost 90% of lung cancer cases is smoking.
They go on to suggest that other triggers may include:
- exposure to radon
- exposure to carcinogens such as asbestos
- outdoor air pollution
Therefore, recommendations state that people make every effort to quit or avoid smoking.
Depending on the stage of large cell carcinoma and how far it has spread, a healthcare professional may recommend various treatment options.
According to the National Cancer Institute, the treatment options are as follows:
In the earlier stages of large cell carcinoma, a person may only require surgery. Here, a healthcare professional will remove all or part of the cancer, depending on the size and location.
There are four types of surgery for large cell carcinoma:
- Wedge resection: Involves removing the tumor and some of the normal tissue around it.
- Lobectomy: Removes the whole lobe or section of the lung.
- Pneumonectomy: Involves removing one entire lung.
- Sleeve section: A surgeon will remove part of the bronchus.
If a surgeon cannot remove the whole cancer, a person may require additional treatments. If there is a high chance of the cancer returning, a person may need chemotherapy or radiation therapy after surgery.
Chemotherapy is a systemic treatment for large cell carcinoma, where a healthcare professional will provide a combination of drugs with the aim of killing the cancer cells throughout the body.
Targeted therapy involves the use of drugs to target cancer cells without affecting normal cells.
Healthcare professionals may also refer to it as precision or personalized medicine.
To help with this technique, doctors may perform biopsies to extract a sample of the cancerous tissue. Healthcare professionals can then find out the exact genetic makeup of the cancer cells, put together the best treatment to attack them, and even stop them from replicating.
Radiation therapy kills cancer cells using high-energy particles such as X-rays.
For tumors in the airways, a healthcare professional uses an endoscope to apply the radiation directly to the tumor.
This treatment option helps the body’s natural immune system fight off the cancer cells.
Doctors achieve this by stimulating the natural defenses so the immune system can find and attack the cancer cells.
Additional treatment options
Other treatment techniques include:
- laser therapy
- cryosurgery to freeze and destroy cancerous tissue such as CIS
- electrocautery, where a healthcare professional uses a needle to destroy cancerous tissue
Depending on what stage the cancer is at during the diagnosis process, the prognosis varies.
The current 5-year survival rate may not be accurate as it does not consider any recent breakthroughs in cancer treatment.
However, according to the
|Stage at diagnosis||5-year relative survival rate|
|Localized, meaning that the cancer has not spread outside of the lung.||63.1%|
|Regional, meaning that the cancer has spread outside of the lung to nearby areas and lymph nodes.||35.4%|
|Distant, meaning that the cancer has spread to other parts of the body, such as the liver, bones, brains, or the other lung.||6.9%|
|All stages combined||24.9%|
During the diagnosis stage, a doctor will ask about a person’s medical history and perform a physical exam.
Additionally, individuals may undergo the following scans to look for signs of large cell carcinoma:
- CT scan
- MRI scan
- PET scan
- bone scan
A healthcare professional may also diagnose large cell carcinoma lung cancer by examining a sample of lung cells under a microscope. They can do this using one of the following methods:
- Sputum cytology: This involves examining a sample of mucus coughed up from the lungs.
- Thoracentesis: A healthcare professional will remove some fluid from around the lungs and examine the cells.
- Needle biopsy: A healthcare professional will use a hollow needle to acquire a small sample of lung cells.
It is important to note that the symptoms of large cell carcinoma and other lung cancers are more likely to develop due to causes other than cancer.
However, it is vital to see a healthcare professional as soon as a person first notices symptoms. This may result in an early diagnosis, meaning that treatments may be more effective.
Questions to ask the doctor
Some questions that a person may want to ask their healthcare provider include:
- What type of cancer is it?
- How far has the cancer spread?
- What stage is it at, and what does this mean?
- What are the recommended treatment options?
- When can treatment start?
- Will certain activities make the symptoms worse?
- What might the long-term effects of cancer and the treatment involve?
- What lifestyle changes are needed?
If a person receives a diagnosis of large cell carcinoma, they can speak to their healthcare providers about their treatment options.
They can also find additional resources and support from:
Large cell carcinoma is a type of NSCLC. Symptoms can include a persistent cough, coughing up blood, and shortness of breath.
A person should contact a healthcare provider if they are experiencing common symptoms of lung cancer.
If an individual receives a diagnosis of large cell carcinoma, it is vital to receive treatment as soon as possible.