- With Mayo Clinic medical oncologist
Timothy Moynihan, M.D.
read biographyclose windowBiography of
Timothy Moynihan, M.D.
Timothy Moynihan, M.D.
"As a practicing medical oncologist, I meet with patients and families every day to help manage their course through this disease called cancer. This experience provides unique insight into the needs of cancer patients, their families and loved ones and brings into sharp focus the need for reliable information to be readily available in terms that can be easily understood." — Dr. Timothy Moynihan
Dr. Timothy Moynihan believes that providing consumers accurate, timely information on the broad, complex topic of cancer is the biggest challenge facing medical Web sites. As the guiding force behind our cancer coverage, he makes sure Mayo Clinic meets the test.
Dr. Moynihan, born in Las Vegas, N.M., but raised in Denver, is a consultant in medical oncology at Mayo Clinic and an associate professor at Mayo Clinic College of Medicine. He is board certified in internal medicine, medical oncology, and hospice and palliative care medicine. He did his medical oncology training at Johns Hopkins Hospital in Baltimore, and then went on to the University of Minnesota and St. Paul Regions Medical Center in St. Paul, Minn., for seven years before moving to Mayo Clinic in 1999. Dr. Moynihan is director of the palliative care program at Mayo Clinic and associate medical director of the Mayo Clinic hospice.
Dr. Moynihan currently serves as the education chair for the Department of Medical Oncology and fellowship program director. Four times he has been selected as Teacher of the Year in medical oncology and elected to the Teacher of the Year Hall of Fame. Past honors include distinguished clinical teacher at the University of Minnesota Medical School, best internist at the Medical College of Wisconsin and recipient of The Upjohn Achievement Award for Excellence in Medicine. He serves on several national committees for the American Society of Clinical Oncology.
"The Internet provides a ready source of information on a wide range of topics of interest to those affected by cancer," Dr. Moynihan says. "The difficulty is trying to decide which sites provide reputable information and which information is relevant to each individual patient. The long history and tradition of excellence associated with Mayo Clinic assures you that information provided will be reliable, up-to-date and comprehensive."
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Question
Small cell, large cell: What do these cancer classifications mean?
Why are some cancers described as small cell and some as large cell? What do these terms mean?
Answer
from Timothy Moynihan, M.D.
The terms "small cell" and "large cell" are merely descriptive terms for the appearance of the cancer cells under the microscope. In addition to determining the appearance of the cells, your doctor will also perform tests to determine the size of the cancerous area, how abnormal the cells appear, and if the cancer has spread to the lymph nodes or other organs. While each of these factors is important, classifying a cancer based on its microscopic appearance helps your doctor determine:
- The likely course or outcome (prognosis) of the cancer
- The most effective treatment for a specific cancer
Common terms used to describe the appearance of cancer cells include:
- Clear cell. The inside of the cells appears clear. Examples include some kidney, ovarian and uterine cancers.
- Spindle cell. The ends of the cell are narrower at both ends than the center. Examples include some breast, gastrointestinal, muscle or other soft tissue, and skin cancers.
- Large cell. The cells are larger than normal cells. An example is lung cancer affecting the bronchioles.
- Small cell. The cells are smaller than normal cells. An example is small cell lung cancer, an aggressive cancer that usually spreads to other parts of your body (metastasizes).
- Squamous cell. The cells are flat in appearance. Examples include skin cancer or any other type of cancer that starts in the lining of some organs.
- Adenocarcinoma. The cells are gland-like in appearance. Examples include some lung, gastric and endometrial cancers.
Other factors that help classify a cancer include:
- Area of the body in which the cancer originated, such as the liver or breast. Cancers from certain organs may have a similar appearance. For example, the most common type of kidney cancer is classified as clear cell. On the other hand, breast cancer rarely has a clear cell appearance. So clear cells on a breast biopsy may indicate that the cancer didn't originate in the breast but perhaps spread (metastasized) from another area of the body, such as a kidney.
- Type of tissue from which the cancer evolved, including carcinomas and sarcomas. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
