[Verse 1]
Out at the edges, adenocarcinoma squats quiet,
the most common tenant in the branching lung estate,
squamous moves in closer, hugging the big bronchus,
small cell parks dead-center, the hub where cables wait.
Three names, two tribes — non-small and small split the chart,
one's a slow river, the other's a fuse already lit,
small cell loves the middle, rarely meets a scalpel's edge,
chemo and radiation do the heavy lifting on that bit.
[Chorus]
Adeno's the front-runner, squamous grabs the calcium crown,
small cell hides in the middle and the surgeons mostly stay down,
sixty percent's the ticket, FEV1 and DLCO clear,
Pancoast steals your eyelid, Horner whispers in your ear.
[Verse 2]
Nineteen ninety-five, the Lung Cancer Study Group spoke clear,
lobectomy beat the lesser cuts, became the gold-stamped rule,
but small tumors whisper softer — two centimeters, skin-deep, shy,
JCOG-oh-eight-oh-two said segmentectomy plays it cool.
Save the lung tissue when the tumor's small and parked outside,
spare the breath you'll need for stairs and chasing down the bus,
surgery's a tailor now, not a one-size-coat for everyone,
measure twice, cut the segment, that's the modern surgeon's fuss.
[Chorus]
Adeno's the front-runner, squamous grabs the calcium crown,
small cell hides in the middle and the surgeons mostly stay down,
sixty percent's the ticket, FEV1 and DLCO clear,
Pancoast steals your eyelid, Horner whispers in your ear.
[Verse 3]
Before you ever open chest, go check the breathing gauge,
FEV1 above sixty means the lung can take the stage,
DLCO tells you how the oxygen trades hands in there,
both above sixty percent, the risk is one you dare.
Then go stage the middle ground, the lymph nodes hiding low,
EBUS needle through the airway, ultrasound to guide the show,
or mediastinoscopy, a scope beneath the breastbone's door,
know the nodes before you cut, that's the rule you can't ignore.
[Verse 4]
Listen to the body talk, it tattles on the tumor's name,
SIADH floods you with water, Cushing swells the moon-faced frame,
both of those are small cell's calling cards, hormones run amok,
squamous throws a different stone — PTHrP cranks the calcium up.
High in the chest, the apex, where Pancoast tumors creep and hide,
pressing on the nerve that holds your eyelid and your pupil wide,
droopy lid, small pupil, dry one cheek — that's Horner's face,
a local sign of trouble parked in a very narrow space.
[Bridge]
Now before the knife, we're adding medicine ahead of time,
chemo locks arms with immunotherapy, a modern rhyme,
CheckMate eight-sixteen proved it — shrink it first, resect it clean,
neoadjuvant armor dressing tumors down to something lean.
[Chorus]
Adeno's the front-runner, squamous grabs the calcium crown,
small cell hides in the middle and the surgeons mostly stay down,
sixty percent's the ticket, FEV1 and DLCO clear,
Pancoast steals your eyelid, Horner whispers in your ear.