Cancer Natural History

The Common Vein Copyright 2010

Ashley Davidoff MD


The two disease types – small cell and non small cell have very different natural histories. Small cell is aggressive, fast moving and has virtually no chance for cure as most patients have metastatic disease at presentation and surgery is not usually an option for these patients. Untreated, the survival time for patients with small cell cancer is 6 to 17 weeks.   The percentage of patients who survive with lung cancer for one year is around 42%.

Non small cell carcinoma has a slower course and depending on staging at initial presentation chance for cure is greater. However the overall outlook is dismal with a 5 year of 14%.

Lung Cancer – Growth of a mixed nodule over 18 months
CT scan at the level of the azygous vein shows a 6mm mixed nodule with a 1mm solid component. 6 months later there has been slight growth dominantly in the ground glass component (b) 1 year later there is a 12 mm solid nodule consistent with a primary carcinoma (c)
Ashley Davidoff

Extent Of Disease At Presentation

15% of patients have local disease at diagnosis;
25% have disease spread to regional lymph nodes,
and >55% have distant metastases.

Extent Of Disease At Autopsy

At autopsy extra thoracic metastatic disease is found most commonly in patients with small cell cancer(>95%), then adenocarcinoma and large cell carcinoma,(80%) and then
squamous cell (>50%).

Time o Diagnosis To Death

86% of patients with lung cancer die within 5 years of diagnosis.
Only about 14% of people who develop lung cancer survive for 5 years.

This is a post mortem specimen of a lung with lymphangitic spread of prostate carcinoma. Malignant disease is overlaid in green. Note the rounded mass of lymphadenopathy with linear extensions along the thickened bronchovascular bundles. The fine linear bands peripherally are lymphatics congested with tumor.
Ashley Davidoff MD
lungs pulmonary parenchymal mass neoplasm primary lymphatics distended metastases lymphangitis gross pathology


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