Medical Terms
Non-Small Cell Cancer of the Lung
Adenocarcinoma is the most common non-small cell cancer of the lung that occurs in the United States. The majority of these cancers develop in the periphery (outer part) of the lung. Since these cancers are in the outer portion of the lung, the patient often does not have any symptoms when the cancer is found on a chest x-ray. Adenocarcinomas tend to metastasize (spread to other parts of the body) to the bone, the central nervous system (the brain and spinal cord), the adrenal glands, the liver and the opposite lung.
Frequently, there is scarring in adenocarcinomas. Sometimes, the cancer arises in an area of old scarring of the lung. In other cases, the scar appears to arise secondary to the growth of the cancer.
Bronchoalveolar carcinoma or alveolar cell carcinoma is a non-small cell carcinoma that can be found throughout the respiratory tract. When it is discovered as a single mass on a patient’s x-ray, this type of lung cancer has an excellent prognosis. Five year survival after surgery is in the 75-90% range. If, however, it is found in its diffuse form (meaning it has spread beyond a single mass), the prognosis is quite poor.
Squamous cell carcinomas comprise 30-40% of non-small cell carcinomas of the lung. This type of cancer tends to be located in the more central portion of the lung. Often, this is in a bronchus (a large airway of the lung). Since these cancers are located near or in these airways, they can cause symptoms earlier in their growth. Coughing and production of phlegm (sputum) that is bloody are common symptoms. The cancer can block airways which can lead to shortness of breath or pneumonia.
Large cell carcinomas represent about 10% of non-small cell cancers of the lung. This form of lung cancer has fewer structural characteristics when viewed under a microscope. It is sometimes difficult to distinguish this form of lung cancer from cancers which have spread to the lung from another place in the body.
Patient history and diagnosis
53-year-old woman presented in February 2005 with repeated chest infection. A CT scan showed a left lung mass and a soft tissue mass in relation to the left hilum. A biopsy showed consistency with non-small cell lung cancer.
The patient had no breathing difficulties and was commenced on down staging chemotherapy to which she had a partial response, with complete disappearance of left hilar mass and reduction of the apical tumor. Surgery was not possible as the tumor lay close to the pericardium and vital structures, primarily spinal cord. The patient was then referred for radiation therapy.
Non-Small Cell Lung Tumor
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This guide contains information on frequently asked questions and information on the treatment process. While this information will not necessarily correspond to the exact process adopted by an individual hospital, we hope it will provide general background information and an indication of a typical treatment process.
Simulation – Simulation uses x-rays to mirror the radiation therapy treatment, allowing patient position and radiation field to be defined
Stereotactic radiosurgery – Stereotactic refers to the location of a point within a body through the combination of three coordinates combined and calibrated with an external reference. Stereotactic radiosurgery relates to ablating a tumor or other target using high energy x-ray photons after determining its position via the external reference system. Treatment is performed in a single treatment session
Stereotaxy – Neurosurgical technique enabling the localization of a given target within the brain in terms of a geometric axis system
Rad (radiation absorbed dose) – A measure of the amount of radiation absorbed by the body, replaced by Gray.
Radiation – A term to describe waves or particles. Types of radiation include x-rays, gamma rays and electron beams
Radiation Physicist – A specialist in the subject of radiation and responsible for the choice and performance of the equipment used. The physicist assists in deciding on the optimum method for delivery of the prescribed radiation.
Radiation therapist – A physician specially trained to treat cancer with radiation therapy machines.
Radiation therapy – The use of high-energy radiation from x-rays, gamma rays, neutrons and other sources to kill cancer cells and shrink tumors. Also known as radiotherapy. Click for more on the Radiation therapy process
Radiologist – A doctor who specializes in reading and interpreting diagnostic x-rays and other imaging techniques.
Radioresistance – A term used to describe cancer cells that do not respond well to radiation
Radiosensitivity – A term used to describe how sensitive cancer cells are to radiation.
Radiosurgery – Therapeutic radiation technique, applying a field of radiation using multiple, focused, finely collimated radiation beams with surgical precision in a single session. Click for more on the Radiosurgery process
Radiotherapy – See Radiation therapy.
Recurrence – The reappearance of a disease after a period of remission.
Remission – Complete or partial disappearance of the signs and symptoms of disease. A remission, however, is not necessarily a cure.
Palliative care – Treatment aimed at relieving symptoms and pain rather than effecting a cure.
Palliative Treatment – Treatment performed which aims to relieve the symptoms (e.g., pain) of disease. Does not aim to cure. Patients presenting for palliative treatment are not normally subject to treatment planning.
PET – Positron Emission Tomography is an imaging technique which uses a computer technique to record radiation and construct an image.
Pineal body – Small conical structure attached by a stalk to the posterior wall of the 3rd ventricle of the cerebrum.
Posterior – Behind – the opposite of anterior.
Primary tumor – The original cancer site. For example, lung cancer that has spread to the bone is still called lung cancer.
Oncologist – A doctor who specializes in the treatment and prognosis of cancer. Oncologists may be specialists in particular areas such as chemotherapy, radiation or surgery.
Oncology – The study of diseases that cause cancer.
Neurinoma – Tumor of a peripheral nerve where the cell of origin is disputed.
Neurosurgeon – A doctor who specializes in surgery on the brain, spine and other parts of the nervous system.
Neurosurgery – Surgery on the nervous system.
Non-invasive – Opposite of invasive
1) Characteristic of a Benign Tumor
2) Procedure where the integrity of the body is not breached
Malignant – Another term for cancerous cells and commonly refers to a malignant tumor, the main characteristic of which is that it is likely to penetrate the tissues or organ in which it originated as well as move to other sites.
MEG – Magneto-encephalography – a non-invasive diagnostic technique that directly measures the magnetic fields produced by electrical currents in the brain. Click for more on a MEG patient examination
Melanoma – A cancer of the pigment-forming cells of the skin or the retina of the eye.
Meningioma – Benign tumor arising from the intermediate covering layer of the brain (arachnoid) and from the pia along the spinal chord.
Metastases – Secondary growths derived from a primary malignant tumor at a distant site.
Metastasis – 1) Singular of Metastases – 2) The process by which Metastases spread from one part of the body to another via the lymph system or blood vessels. read more @ Livingwithbrainmets.org
MRI – Magnetic Resonance Imaging uses magnetic resonance to produce images of the body.
Lesion – Localized pathological change in a bodily organ or tissue.
Leukemia – Cancer of the blood. White blood cells may be produced in excessive amounts and are unable to work properly which weakens the immune system.
Linear accelerator (Linac) – A medical device, that can rotate about the patient, that generates various energies of x-rays and electron beams for radiation therapy treatment. more info on linacs…
Localization – In stereotaxy the determination of the precise position of the target in terms of the stereotactic coordinates
Lymph vessels – Vessels which collect fluid left in the tissues together with protein.
Lymphoma – Lymphoma is a general term for cancers that develop in the lymphatic system. They account for about 4 percent of all cases of cancer in this country. The most common type of lymphoma is called Hodgkin’s disease. All other lymphomas are grouped together and are called non-Hodgkin’s lymphomas.
Image Guided Radiation Therapy (IGRT) – Image guided radiation therapy (IGRT) combines scanning technology, which allows planar or X-ray Volume Imaging (XVI), with IMRT. This enables physicians to adjust the radiation beam based on the position of the target tumor and critical organs, at time of treatment, optimizing the accuracy and precision of the radiotherapy.
Intensity Modulated Radiotherapy (IMRT) - Varying both the delivered dose and shape of the radiation field to match the shape of the tumor.
Intracerebral – Within the cerebrum (the large rounded structure of the brain)
Intracranial – Within the skull or cranium
Intraoperative radiation therapy (IORT) - Special technique whereby a radiation dose is delivered to a surgically exposed organ or tumor bed
Intractable – Does not respond to treatment, e.g., intractable pain
Invasive procedure – Involves invasion of the body by some foreign agent, a knife, a catheter, a cannula.
Invasive tumor – Crosses tissue boundaries into neighboring tissues – classic sign of a malignant tumor.
Inverse Planning – A sophisticated software program that interprets clinical data to determine the best course of radiation therapy treatment.
On-line image guided hypofractionation of a solitary lung metastasis using Elekta Synergy® at West China Hospital, Sichuan University, PR China
Solitary lung metastasis
A 47-year-old male previously treated for adenocarcinoma of the right upper lung presented with a metastasis in the lingua segment of the left upper lobe in March 2006. The metastasis was diagnosed using a contrast enhanced CT scan. The patient was evaluated and elected to proceed with a course of image guided hypofractionated stereotactic radiation therapy. The patient was first diagnosed as having a low-differentiated adenocarcinoma of the right upper lobe of the lung (stage IIIA) in March 2004 with the primary tumor in the upper apical-posterior segment of the right lung, right hilum, and an upper mediastinal lymph node metastasis. The patient was treated with right upper lung lobectomy and mediastinal lymph node dissection followed by adjuvant alternate chemotherapy (vinorelbine 40mg iv drip, days one and eight, cisplatin 50mg, IV drip, days one to three – 21 days per cycle for a total of four cycles) and radiation therapy.
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