Which form of lung cancer is almost always metastatic and not curable by surgery, but may respond initially to radiation?

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Small cell lung carcinoma is the form that is almost always systemic by diagnosis and is not curable by surgery. It grows very rapidly and tends to metastasize early to liver, bone, brain, and other sites, so removing the primary tumor does not achieve a cure. Because of its biology, the main treatment approach is chemotherapy and radiation; it often shows an initial response to radiation even though the overall prognosis remains poor due to early dissemination. In contrast, non-small cell lung cancers like adenocarcinoma and squamous cell carcinoma can be localized at diagnosis and may be curable with surgical resection when detected early. A benign pulmonary nodule is not cancer and would not be described as responding to cancer-directed therapies.