One of the most common questions I hear from patients and caregivers is, “Why isn’t my loved one getting the same treatment as someone else with cancer?” It’s an understandable question. After all, we often hear cancer talked about as one big disease, and it seems like treatments should be fairly standard across the board. But the truth is, not all cancers are the same.
A lung cancer diagnosis is a perfect example. If you’ve heard of someone getting immunotherapy or targeted therapy for lung cancer, you might wonder why another patient is receiving chemotherapy instead. The answer lies in the details—and those details make all the difference.
Breaking It Down: The Many Faces of Lung Cancer
Lung cancer isn’t just one disease; there are different types, each with its own behavior and treatment options. The two main categories are:
- Non-Small Cell Lung Cancer (NSCLC) – This includes subtypes like adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Treatments vary based on the presence of specific tumor markers.
- Small Cell Lung Cancer (SCLC) – A faster-growing type of lung cancer that is typically treated with chemotherapy and sometimes radiation.
Even within NSCLC, treatments are personalized based on tumor markers—biological “flags” that help determine the best therapy. For example:
- If a tumor has an EGFR mutation, targeted therapies like osimertinib may be an option.
- If the tumor expresses PD-L1, immunotherapy might be recommended.
- If none of these markers are present, traditional chemotherapy may be the best choice.
This same idea applies to other cancers too—breast cancer, for instance, is treated differently depending on whether it’s hormone receptor-positive, HER2-positive, or triple-negative.
Why This Matters
Understanding these differences can help ease frustration or confusion when seeing someone else receive a different treatment. It’s not about your oncologist withholding options—it’s about choosing the best treatment for a specific cancer type. What works for one person’s cancer may not work for another’s.
While a cancer diagnosis can feel overwhelming, knowing that treatment is tailored to the specific type of cancer can be reassuring. Every person’s journey is unique, and the goal is always to choose the approach that offers the best chance for success. If you or a loved one have questions about a treatment plan, don’t hesitate to ask your oncologist—they’re there to help you navigate this path with clarity and confidence. The more you understand, the more empowered you will be to make informed decisions.