“Non-small cell lung cancer” is an umbrella term that describes several lung cancers. Several treatment options are available. Early diagnosis can improve a person’s outlook.
Non-small cell lung cancer (NSCLC) is the
Understanding NSCLC can help people make treatment decisions that fit their goals and lifestyle, ask their doctor the right questions, and better advocate for quality care.
This article explains what NSCLC is. It lists the stages, possible causes, symptoms, and treatment options.
NSCLC is the
What are the types of non-small cell lung cancer?
The term “NSCLC” describes a group of cancers that includes the
- 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
- salivary gland carcinoma
- carcinoid tumor
- unclassified carcinoma
Other types of cancer can also grow in the lungs.
Different cancers, such as pancreatic cancer, may also spread to the lungs.
Learn about lung cancer mutations here.
Small cell vs. non-small cell lung cancer
The main difference between small and non-small lung cancer is that SCLC usually starts in the bronchi, which are the airway passages into the lungs. NSCLC starts in different locations depending on its subtype.
SCLC grows and spreads more quickly. Doctors usually identify NSCLC at a later stage when it may have spread.
Learn more about the differences between SCLC and NSCLC here.
Some people with NSCLC have no symptoms, especially in the early stages of the disease.
However, the first noticeable symptom will likely be an unexplained chronic cough.
Some 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
Lung cancer happens when cells divide out of control in the lungs, causing tumors or damaging healthy tissue. Doctors do not fully understand what causes cancer or why some people with risk factors develop it while others do not.
Risk factors
- a family history of lung cancer, which may indicate a genetic predisposition to cancer, especially when environmental exposures, such as smoking, are involved
- smoking
- frequent exposure to secondhand smoke
- exposure to radon, asbestos, arsenic, nickel, and some other chemicals
- exposure to some pollutants, such as car exhaust
- living in an area of high air pollution
- smoking while taking beta carotene supplements
alcohol use - having pulmonary fibrosis
- having HIV
- undergoing radiation therapy for another type of cancer, such as breast cancer
- other radiation exposure
According to some
A person who smokes a pack daily for 40 years or an equivalent amount in a different period is about 20 times more likely to develop lung cancer.
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
NSCLC stages
Doctors usually classify NSCLC into five stages based on how far 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.
There is no cure for stage 3B or 3C cancer. Treatment aims to manage the disease, helping people live as long and comfortably as possible.
Lung cancer treatment depends on its stage, whether it is curable, and a person’s treatment goals.
For example, some people choose not to have chemotherapy if they have terminal cancer because they do not want to experience the side effects. Other people choose to have aggressive treatment at all stages.
Some 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 the person participate in a clinical trial. These trials can discover new treatments, though the treatments do not always work.
Learn about immunotherapy and NSCLC here.
How long does it take to recover from treatment?
Recovery from treatment can depend on the type of treatment a person receives. A person may receive more than one type of treatment at a time.
People may experience
It is recommended a person contact a doctor if they have any symptoms of lung cancer, including a cough that does not go away or breathing difficulties.
After receiving a lung cancer diagnosis, a person should regularly meet with their doctors. In addition to treatment, the person may have regular scans to monitor cancer growth.
A person can ask their doctors about their treatment plan and the potential to participate in clinical trials of new treatment options.
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 survival rate is 9%.
Learn more about metastatic lung cancer here.
Is non-small cell lung cancer curable?
If detected early, doctors may be able to cure NSCLC with surgery.
There is no cure for NSCLC in the later stages, 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.