A Rare Breed

Now that I’ve started treatment and things have settled down, I have a chance to focus on some larger topics.  I thought I’d take a moment and explain what kind of cancer I have.  I’m obviously not a physician, so this is my attempt to summarize the information available.

Lung cancer is divided into two categories: small cell (SCLC) and non-small cell (NSCLC).  They refer to the types of cells where the cancer originates.  Non-small cell lung cancer is more common, representing 80% of all lung cancer and is further divided into 4 categories: adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and other.  The distributions are roughly 40-30-15-15, respectively.

Within the adenocarcinoma category, there is a rare form of cancer known as Bronchioloalveolar carcinoma (BAC).  I’ve constructed a simple set of pie charts to show how these categories nest together.

Click to enlarge

BAC Basics

  • BAC represents only 3% of all lung cancer.
  • BAC develops in the small air sacs (alveoli) in the outer areas of the lungs.  It spreads through the tissue that separates the alveoli and through the airways.
  • Normal age at diagnosis is 50-70 years old without bias to race or gender.
  • There are also a significant number of cases seen in younger woman who have never smoked.

Types of BAC

Within the BAC family, there are two presentations:

  • Nodule – this is what many people think of as a traditional tumor.  It can be one nodule (most common) or several nodules located in one lobe of one lung.  In this form, BAC can be one of the slowest growing lung cancers.
  • Diffuse, widespread disease – this is the rarest presentation of BAC, and it may be mistaken for pneumonia on x-rays and CT scans.  In this form, BAC can be one of the fastest progressing lung cancers.

At this point, I can tell you that I have the rarest presentation (diffuse) of a rare lung cancer.  I suppose I should feel extra special.  After all, I calculated that I have a better chance of getting struck by lightning once in my lifetime than having this cancer.

Treatment Options

First I will say it is good I didn’t get sick 5 years ago.  The survival rate was 0%.  Fortunately, new treatments have been developed, and I now have the chance to control and live with this cancer.

The primary treatments for BAC are targeted therapy and chemotherapy.  For more details on my treatment plan, read this post.


The prognosis for the more common nodule form of BAC is very promising.  In fact, some patients can go for a year or more just monitoring and not even treating the tumor because it grows so slowly.

Unfortunately, I have the diffuse variety which is very aggressive and invasive.  Without treatment, I would succumb to it in the next 6 months.  Fortunately, modern science is on my side, and I have several treatments available to control the cancer, maintain a high quality of life, and LIVE with cancer.


5 responses to “A Rare Breed

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