Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisStagesTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Stages
Treatment
Prognosis
Coping
Large cell lung carcinoma (LCLC) is one of several forms ofnon-small cell lung cancer (NSCLC). LCLC often develops in the outer regions of the lungs and tends to grow rapidly and spreads more aggressively than some other forms of lung cancer.Early symptoms of LCLC mainly includeshortness of breathand fatigue.
NSCLC accounts for around 85% of all lung cancers, of which roughly 10% are LCLC.Large cell lung carcinomas, also called large cell lung cancers, are so named because of the large size of the cancer cells that can be seen when the tumor is viewed with a microscope (as opposed to the tumor size, which also tends to be quite large).
PEIR Digital Library / Wikimedia Commons / Public Domain
Large Cell Lung Cancer Symptoms
Early symptoms of LCLC can easily be missed and attributed to other less serious conditions, including age.
Such symptoms include:
Because LCLC typically develops in the outer periphery of the lungs,chronic coughandcoughing up bloodare not common until later in the disease.
LCLC can cause other effects as the disease progresses. It may lead topleural effusion, a condition in which fluids accumulate in the pleural cavity (the space between the lungs and the chest wall). The symptoms include dyspnea, and pain in the chest or side that gets worse with a deep breath.
LCLC cells can also secrete hormone-like substances that causeparaneoplastic syndromes. The substances trigger theimmune systemto attack certain cells of the body.
Paraneoplastic syndromes can cause symptoms like slurred speech, impaired coordination, and difficulty walking orswallowing. In men, it can also cause enlargement of the breasts, known asgynecomastia.
Paraneoplastic syndromes occur in 5% to 10% of all lung cancers and can develop in the early stages of malignancy.
Signs and Symptoms of Non-Small Cell Lung Cancer
Though small cell lung cancer (SCLC) is more commonly linked to radon exposure, radon can contribute to the development of LCLC and other NSCLCs.Radon testingcan detect it, and mitigation services can remove it.
Research suggests that certaingene mutationsmay contribute to the risk of some types of LCLC, including mutations of the RUNX1, ERBB4, BRCA1, and EPHA3 genes.
Lung cancer is often detected with a chest X-ray. With that said,a normal chest X-ray cannot rule out cancer, as smaller tumors are not usually visible with this type of imaging.
If any symptom of LCLC is present, further testing is usually pursued even if a chest X-ray is normal.
These tests may include:
Blood tests are not used to diagnose lung cancer, althoughliquid biopsiesthat detect cancer cells in the bloodstream are increasingly used as an additional tool in the diagnostic process.
If initial imaging findings suggest cancer, your healthcare provider will order alung biopsyto provide definitive identification of the lesion. This may involvefine needle aspiration (FNA), in which a needle is inserted through the chest wall and into the tumor to extract a small sample of cells. A biopsy may also be performed during bronchoscopy if there are visible signs of possible cancer in the airways.
Undifferentiated cancer cells like LCLC (also referred to as anaplastic cells) tend todivide and spread rapidly.
The extent and severity of lung cancer is broken down into four stages.
They range fromstage 1, in which the cancer is localized within the lung and has notspread to any lymph nodes, tostage 4, in which cancer hasmetastasized(spread) todistant parts of the body.
The 4 Stages of Lung Cancer Explained
Depending on the stage of cancer, treatment options for LCLC include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, or a combination of these.Clinical trialsare also available for those who may not be responding to standard therapy.
Surgery
Lung cancer surgery offers the best chance for a cure when LCLC is caught in theearly stages.
Surgical options include:
Video-assisted thoracoscopic surgery (VATS)is a minimally invasive procedure that doesn’t involve removal or separation of the ribs. This surgery is done with several small incisions in the chest and the use of a tiny camera (thoracoscope) and instruments.
Chemotherapy
Chemotherapymay be used on its own or along with surgery. It may also be used prior to surgery to reduce the size of the tumor (neoadjuvant chemotherapy) or after surgery to ensure that no cancer cells are remaining (adjuvant chemotherapy).
Likewise, chemo may be used with or without radiation therapy. Chemotherapy medications commonly used to treat LCLC include Altima (pemetrexed) and Platinol (cisplatin).
Targeted Therapies
Targeted therapies are medications that are designed to attackcancer cellsand, in theory,normal cellsshould be largely untouched.Targeted therapies have a different side effect spectrum than chemotherapy and, in general, the side effects tend to be less severe than with chemotherapy drugs.
Molecular profilingcan be used to identify specific DNA alterations (mutations, translocations, and amplifications) in tumor cells that make them susceptible to treatment with targeted therapy.
Molecular profiling is recommended for everyone with advanced NSCLC, including LCLC.
While targeted drugs do not cure lung cancer, they can keep the malignancy in check. After an initial response, almost universally, resistance develops and the drug no longer works. When that happens, second-generation and, in some cases, third generation drugs can be used.
The Role of the EGFR Mutation in Lung Cancer
Radiation Therapy
Radiation therapymay be used to treat lung cancer in a number of different ways. It can be used before surgery to reduce the size of a tumor or after surgery to eradicate any remaining cancer cells.
With small cancers,stereotactic body radiotherapy (SBRT), a specialized form of radiation treatment, can be used as the only treatment. SBRT delivers a very high dose of radiation to a localized area of tissue with the aim of curing the malignancy. SBRT may also be used to treat isolated metastases due to lung cancer, includingthose in the brain.
Radiation may also be used as apalliative treatmentto control symptoms and improve quality of life for people with lung cancer.
Immunotherapy
How Lung Cancer Is Treated
Because undifferentiated cancers like LCLC can be aggressive, survival rates tend to be worse than with some other types of cancer. With that said, newer therapies have started to improve survival times, even for advanced disease.
According to the American Cancer Society, as of January 2021, the five-year survival rates for people with LCLC and other NSCLCs likeadenocarcinomaandsquamous cell carcinomaare:
One variant of LCLC, large cellneuroendocrine carcinoma, generally has a worse prognosis, with a median survival time of roughly six months for people who are diagnosed with stage 4 disease.
The Importance of Prognosis With Cancer
A diagnosis of lung cancer can be frightening and make you feel very alone. Allow your loved ones to support you.
Many people have no idea how to react to someone who has been diagnosed with cancer. Letting people know specific things they can do can help provide you with extra support when you need it.
Most importantly, remember that you are the captain of this journey. No matter what others have experienced or recommend, you ultimately know what is best for you.
A Word From Verywell
Although people with lung cancer have historically had less than favorable prognoses, treatments and survival times are improving every year.
If you are uncertain about a recommended treatment plan, do not hesitate to seek asecond opinion, such as from a largeNational Cancer Institute-designated treatment center. Your team of oncologists should be knowledgeable about the latest developments, and can work with you to provide you the most current and effective treatment approaches.
Top 10 Cancer Hospitals in the U.S.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pelosi G, Barbareschi M, Cavazza A, Graziano P, Rossi G, Papotti M.Large cell carcinoma of the lung: a tumor in search of an author. A clinically oriented critical reappraisal.Lung Cancer. 2015;87(3):226-31. doi:10.1016/j.lungcan.2015.01.008National Cancer Institute.Non-small cell lung cancer treatment (PDQ®)–Health professional version.Roh J, Ahn HY, Kim I, et al.Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients: A multicenter retrospective study.Medicine. 2021;100(19):e25748. doi: 10.1097/MD.0000000000025748Kanaji N, Watanabe N, Kita N, et al.Paraneoplastic syndromes associated with lung cancer.World J Clin Oncol.2014;5(3):197-223. doi:10.5306/wjco.v5.i3.197Zappa C, Mousa SA.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037/tlcr.2016.06.07American Cancer Society.Lung cancer risk factors.Rodríguez-Martínez Á, Torres-Durán M, Barros-Dios JM, Ruano-Ravina A.Residential radon and small cell lung cancer. A systematic review.Cancer Lett.2018;426:57-62. doi:10.1016/j.canlet.2018.04.003Zhou Z, Zhu L, Niu X, et al.Comparison of genomic landscapes of large cell neuroendocrine carcinoma, small cell lung carcinoma, and large cell carcinoma.Thorac Cancer.2019;10(4):839-847. doi:10.1111/1759-7714.13011American Cancer Society.Tests for lung cancer.American Cancer Society.Non-small cell lung cancer stages.Vannucci F, Gonzalez-Rivas D.Is VATS lobectomy standard of care for operable non-small cell lung cancer?.Lung Cancer. 2016;100:114-119. doi:10.1016/j.lungcan.2016.08.004Gadgeel SM.Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer.Am Soc Clin Oncol Educ Book. 2017;37:630-9. doi:10.1200/EDBK_175188Barlesi F, Mazieres J, Merlio JP, et al.Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup. (IFCT).Lancet.2016 Apr;387(10026):1415-26.doi:10.1016/S0140-6736(16)00004-0American Lung Association.Targeted therapies for lung cancer.Abreu CE, Ferreira PP, De Moraes FY, Neves WF, Gadia R, Carvalho Hde A.Stereotactic body radiotherapy in lung cancer: an update.J Bras Pneumol.2015;41(4):376-87. doi:10.1590/S1806-37132015000000034Faria SL.Role of radiotherapy in metastatic non-small cell lung cancer.Front Oncol. 2014;4:229. doi:10.3389/fonc.2014.00229American Cancer Society.Immunotherapy for non-small cell lung cancer.Lim SM, Hong MH, Kim HR.Immunotherapy for non-small cell lung cancer: Current landscape and future perspectives.Immune Netw. 2020;20(1):e10. doi:10.4110/in.2020.20.e10American Cancer Society.Lung cancer survival rates.Paul D, Lander S, Cooper AR, Tyler WK.Long-term survival of large cell neuroendocrine lung carcinoma with bony metastases: A case of immunoprotectivity?.J Orthop Oncol.2016;2:110. doi:10.4172/2472-016X.1000110
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pelosi G, Barbareschi M, Cavazza A, Graziano P, Rossi G, Papotti M.Large cell carcinoma of the lung: a tumor in search of an author. A clinically oriented critical reappraisal.Lung Cancer. 2015;87(3):226-31. doi:10.1016/j.lungcan.2015.01.008National Cancer Institute.Non-small cell lung cancer treatment (PDQ®)–Health professional version.Roh J, Ahn HY, Kim I, et al.Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients: A multicenter retrospective study.Medicine. 2021;100(19):e25748. doi: 10.1097/MD.0000000000025748Kanaji N, Watanabe N, Kita N, et al.Paraneoplastic syndromes associated with lung cancer.World J Clin Oncol.2014;5(3):197-223. doi:10.5306/wjco.v5.i3.197Zappa C, Mousa SA.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037/tlcr.2016.06.07American Cancer Society.Lung cancer risk factors.Rodríguez-Martínez Á, Torres-Durán M, Barros-Dios JM, Ruano-Ravina A.Residential radon and small cell lung cancer. A systematic review.Cancer Lett.2018;426:57-62. doi:10.1016/j.canlet.2018.04.003Zhou Z, Zhu L, Niu X, et al.Comparison of genomic landscapes of large cell neuroendocrine carcinoma, small cell lung carcinoma, and large cell carcinoma.Thorac Cancer.2019;10(4):839-847. doi:10.1111/1759-7714.13011American Cancer Society.Tests for lung cancer.American Cancer Society.Non-small cell lung cancer stages.Vannucci F, Gonzalez-Rivas D.Is VATS lobectomy standard of care for operable non-small cell lung cancer?.Lung Cancer. 2016;100:114-119. doi:10.1016/j.lungcan.2016.08.004Gadgeel SM.Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer.Am Soc Clin Oncol Educ Book. 2017;37:630-9. doi:10.1200/EDBK_175188Barlesi F, Mazieres J, Merlio JP, et al.Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup. (IFCT).Lancet.2016 Apr;387(10026):1415-26.doi:10.1016/S0140-6736(16)00004-0American Lung Association.Targeted therapies for lung cancer.Abreu CE, Ferreira PP, De Moraes FY, Neves WF, Gadia R, Carvalho Hde A.Stereotactic body radiotherapy in lung cancer: an update.J Bras Pneumol.2015;41(4):376-87. doi:10.1590/S1806-37132015000000034Faria SL.Role of radiotherapy in metastatic non-small cell lung cancer.Front Oncol. 2014;4:229. doi:10.3389/fonc.2014.00229American Cancer Society.Immunotherapy for non-small cell lung cancer.Lim SM, Hong MH, Kim HR.Immunotherapy for non-small cell lung cancer: Current landscape and future perspectives.Immune Netw. 2020;20(1):e10. doi:10.4110/in.2020.20.e10American Cancer Society.Lung cancer survival rates.Paul D, Lander S, Cooper AR, Tyler WK.Long-term survival of large cell neuroendocrine lung carcinoma with bony metastases: A case of immunoprotectivity?.J Orthop Oncol.2016;2:110. doi:10.4172/2472-016X.1000110
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pelosi G, Barbareschi M, Cavazza A, Graziano P, Rossi G, Papotti M.Large cell carcinoma of the lung: a tumor in search of an author. A clinically oriented critical reappraisal.Lung Cancer. 2015;87(3):226-31. doi:10.1016/j.lungcan.2015.01.008National Cancer Institute.Non-small cell lung cancer treatment (PDQ®)–Health professional version.Roh J, Ahn HY, Kim I, et al.Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients: A multicenter retrospective study.Medicine. 2021;100(19):e25748. doi: 10.1097/MD.0000000000025748Kanaji N, Watanabe N, Kita N, et al.Paraneoplastic syndromes associated with lung cancer.World J Clin Oncol.2014;5(3):197-223. doi:10.5306/wjco.v5.i3.197Zappa C, Mousa SA.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037/tlcr.2016.06.07American Cancer Society.Lung cancer risk factors.Rodríguez-Martínez Á, Torres-Durán M, Barros-Dios JM, Ruano-Ravina A.Residential radon and small cell lung cancer. A systematic review.Cancer Lett.2018;426:57-62. doi:10.1016/j.canlet.2018.04.003Zhou Z, Zhu L, Niu X, et al.Comparison of genomic landscapes of large cell neuroendocrine carcinoma, small cell lung carcinoma, and large cell carcinoma.Thorac Cancer.2019;10(4):839-847. doi:10.1111/1759-7714.13011American Cancer Society.Tests for lung cancer.American Cancer Society.Non-small cell lung cancer stages.Vannucci F, Gonzalez-Rivas D.Is VATS lobectomy standard of care for operable non-small cell lung cancer?.Lung Cancer. 2016;100:114-119. doi:10.1016/j.lungcan.2016.08.004Gadgeel SM.Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer.Am Soc Clin Oncol Educ Book. 2017;37:630-9. doi:10.1200/EDBK_175188Barlesi F, Mazieres J, Merlio JP, et al.Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup. (IFCT).Lancet.2016 Apr;387(10026):1415-26.doi:10.1016/S0140-6736(16)00004-0American Lung Association.Targeted therapies for lung cancer.Abreu CE, Ferreira PP, De Moraes FY, Neves WF, Gadia R, Carvalho Hde A.Stereotactic body radiotherapy in lung cancer: an update.J Bras Pneumol.2015;41(4):376-87. doi:10.1590/S1806-37132015000000034Faria SL.Role of radiotherapy in metastatic non-small cell lung cancer.Front Oncol. 2014;4:229. doi:10.3389/fonc.2014.00229American Cancer Society.Immunotherapy for non-small cell lung cancer.Lim SM, Hong MH, Kim HR.Immunotherapy for non-small cell lung cancer: Current landscape and future perspectives.Immune Netw. 2020;20(1):e10. doi:10.4110/in.2020.20.e10American Cancer Society.Lung cancer survival rates.Paul D, Lander S, Cooper AR, Tyler WK.Long-term survival of large cell neuroendocrine lung carcinoma with bony metastases: A case of immunoprotectivity?.J Orthop Oncol.2016;2:110. doi:10.4172/2472-016X.1000110
Pelosi G, Barbareschi M, Cavazza A, Graziano P, Rossi G, Papotti M.Large cell carcinoma of the lung: a tumor in search of an author. A clinically oriented critical reappraisal.Lung Cancer. 2015;87(3):226-31. doi:10.1016/j.lungcan.2015.01.008
National Cancer Institute.Non-small cell lung cancer treatment (PDQ®)–Health professional version.
Roh J, Ahn HY, Kim I, et al.Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients: A multicenter retrospective study.Medicine. 2021;100(19):e25748. doi: 10.1097/MD.0000000000025748
Kanaji N, Watanabe N, Kita N, et al.Paraneoplastic syndromes associated with lung cancer.World J Clin Oncol.2014;5(3):197-223. doi:10.5306/wjco.v5.i3.197
Zappa C, Mousa SA.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037/tlcr.2016.06.07
American Cancer Society.Lung cancer risk factors.
Rodríguez-Martínez Á, Torres-Durán M, Barros-Dios JM, Ruano-Ravina A.Residential radon and small cell lung cancer. A systematic review.Cancer Lett.2018;426:57-62. doi:10.1016/j.canlet.2018.04.003
Zhou Z, Zhu L, Niu X, et al.Comparison of genomic landscapes of large cell neuroendocrine carcinoma, small cell lung carcinoma, and large cell carcinoma.Thorac Cancer.2019;10(4):839-847. doi:10.1111/1759-7714.13011
American Cancer Society.Tests for lung cancer.
American Cancer Society.Non-small cell lung cancer stages.
Vannucci F, Gonzalez-Rivas D.Is VATS lobectomy standard of care for operable non-small cell lung cancer?.Lung Cancer. 2016;100:114-119. doi:10.1016/j.lungcan.2016.08.004
Gadgeel SM.Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer.Am Soc Clin Oncol Educ Book. 2017;37:630-9. doi:10.1200/EDBK_175188
Barlesi F, Mazieres J, Merlio JP, et al.Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup. (IFCT).Lancet.2016 Apr;387(10026):1415-26.doi:10.1016/S0140-6736(16)00004-0
American Lung Association.Targeted therapies for lung cancer.
Abreu CE, Ferreira PP, De Moraes FY, Neves WF, Gadia R, Carvalho Hde A.Stereotactic body radiotherapy in lung cancer: an update.J Bras Pneumol.2015;41(4):376-87. doi:10.1590/S1806-37132015000000034
Faria SL.Role of radiotherapy in metastatic non-small cell lung cancer.Front Oncol. 2014;4:229. doi:10.3389/fonc.2014.00229
American Cancer Society.Immunotherapy for non-small cell lung cancer.
Lim SM, Hong MH, Kim HR.Immunotherapy for non-small cell lung cancer: Current landscape and future perspectives.Immune Netw. 2020;20(1):e10. doi:10.4110/in.2020.20.e10
American Cancer Society.Lung cancer survival rates.
Paul D, Lander S, Cooper AR, Tyler WK.Long-term survival of large cell neuroendocrine lung carcinoma with bony metastases: A case of immunoprotectivity?.J Orthop Oncol.2016;2:110. doi:10.4172/2472-016X.1000110
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