Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Being well-informed can help you make treatment decisions that fit your goals and lifestyle, ask your doctor the right questions, and better advocate for quality care.
NSCLC is the more common of the two main types of lung cancer.
There are different types of NSCLC, which start in different locations depending on the cell type.
The term “NSCLC” is a group of cancers that
- Adenocarcinoma: Adenocarcinoma is common in people who smoke. It is also the most common form of lung cancer in people who do not smoke. It begins in mucus-secreting cells in the lungs. Doctors can often diagnose it before it spreads. A subtype of adenocarcinoma labeled in situ, a localized type of cancer that spreads more slowly, usually has a better outlook.
- Squamous cell (epidermoid) carcinoma (SCC): SCC begins in squamous cells, which are flat cells that line the airway, including the lungs. Doctors often find them near the main airway in the lungs. This type of NSCLC also
tends to develop in people who smoke, have a history of smoking, or have been exposed to secondhand smoke or dangerous toxins, such as asbestos. - Large cell (undifferentiated) carcinoma (LCC): LCC is a fast-growing cancer that can appear anywhere in the lungs. A subtype called large cell neuroendocrine carcinoma behaves similarly to small cell lung cancer (SCLC). Early detection and treatment
can improve a person’s outlook.
Other types of NSCLC are less common. They
- sarcomatoid carcinoma
- adenosquamous carcinoma
- primary salivary gland–type tumors of the lung
- carcinoid tumor
- unclassified carcinoma
Other types of cancer can also grow in the lungs. And different cancers, such as pancreatic cancer, may also spread to the lungs.
Many people with lung cancer have no symptoms, especially in the early stages of the disease. However, among the first noticeable symptoms will likely be an unexplained chronic cough.
Other symptoms
- chest pain
- fatigue
- unexplained weight loss
- trouble breathing or shortness of breath
- blood in the mucus or coughing up blood
- trouble swallowing
- swollen veins in the neck
- swelling in the face
If the cancer spreads to other areas of the body, it can cause additional or worsened symptoms, such as:
- difficulty breathing or swallowing
- problems with speech
- pain in areas where cancer cells have spread, such as in bones, head, back, or abdomen
- increased weakness or fatigue
Speak with a doctor if you experience these symptoms. There may be many causes other than NSCLC cancer. However, a doctor can assess your symptoms and help you find the right care.
Doctors
A doctor may recommend a series of tests, including:
- chest radiograph
- CT scan
- MRI or PET-CT scans
- sputum cytology
- thoracentesis, where a qualified healthcare professional removes fluid from the space between the chest and lung with a needle
- lung biopsy
- other procedures to examine the tissue in and around the lungs and nearby lymph nodes
These tests can help detect tumor markers that can give your doctor more information about your cells and the type of cancer, if present.
Doctors usually classify NSCLC into five stages based on how much the cancer has spread:
| Stage | Description |
|---|---|
| 0 | Also called in situ cancer, stage 0 means cancer is in the top cells of the lungs and has not spread outside the lungs. |
| 1 | Stage 1 cancer remains in the lungs but has spread deeper into the lining of the lungs. Doctors may assign the letter A or B based on how deeply the cancer has penetrated the lungs. |
| 2 | Stage 2 cancer has spread to either the lymph nodes near the lungs or to other structures in the lungs. It has not spread to other organs. The letter A or B further denotes how far the cancer has spread. |
| 3 | Stage 3 cancer has spread to the lymph nodes of the chest. The letters A, B, or C indicate how many lymph nodes it has penetrated and how far it has traveled. |
| 4 | Stage 4 cancer has metastasized. This means it has spread to other organs, such as the liver or pancreas. |
Treatment aims to cure or eliminate lung cancer in people with stages 1, 2, or 3A.
Stage 3B or 3C cancer treatment aims to manage the disease, as these stages are long term. The idea of treatment is to help people live as long and as comfortably as possible.
A person with lung cancer of any kind should regularly meet with their doctor. In addition to treatment, a person may have regular scans to monitor cancer growth.
A doctor can advise a person on their cancer treatment plan and the possibility of participating in clinical trials of new treatment options. Genetic tests can also help determine which types of treatment can work best for a particular person.
Lung cancer treatment depends on its stage and a person’s treatment goals.
Some people choose not to have chemotherapy if they have end stage cancer because they do not want to experience the side effects. Other people choose to have aggressive treatment at all stages. A person may receive more than one type of treatment at a time.
Treatment options
- Surgery: A surgeon may be able to remove the tumor, called a wedge resection, or may recommend removing a portion of the lung, called a lobectomy. In some cases, a surgeon may remove an entire lung, called a pneumonectomy, or a portion of the bronchus, called a sleeve resection.
- Chemotherapy: Chemotherapy targets cancer cells but can also kill healthy cells. It is very effective at shrinking or eliminating certain types of NSCLC. It can also prevent cancer from returning after surgery.
- Radiation therapy: Radiation uses concentrated energy beams to target and kill cancer cells. A person may need radiation after chemotherapy. Sometimes, a person may receive internal radiation. It involves placing a sealed radioactive substance in or near the cancer.
- Targeted therapies: Doctors sometimes recommend targeted therapy. It can help prevent a specific type of cancer cell from growing. A person may have targeted therapy with or instead of chemotherapy.
- Immunotherapy: Immunotherapy involves a treatment that helps the person’s immune system locate and fight cancer cells.
- Electrocautery or radiofrequency ablation: This treatment uses heat to damage cancer cells.
- Cryotherapy: This treatment damages cancer cells by freezing them.
- Laser therapy: Laser therapy involves using strong light beams to damage cancer cells.
- Experimental therapies: If the cancer does not respond well to treatment or is very aggressive, a doctor may recommend that the person participate in a clinical trial. These trials can discover new treatments, though not all do.
Recovery from treatment can depend on the type of treatment a person receives.
People may experience
Lung cancer can be aggressive. It has often spread before a doctor diagnoses it. The outlook varies from person to person. Many stages of lung cancer are eventually fatal.
According to the
For distant tumors — ones that have spread to other organs — the 5-year relative survival rate is 12%.
Is non-small cell lung cancer curable?
If detected early, doctors may be able to cure NSCLC with surgery.
Later stage NSCLC is a long term condition, but newer treatments may improve a person’s outlook. The type and stage of NSCLC a person has can affect their treatment plan.
Many people are understandably overwhelmed when they receive a lung cancer diagnosis, but doctors constantly evaluate treatment options and explore potential new cures.
People with lung cancer should work with an oncologist they trust, ask any questions they have, and talk with their loved ones for support.