Your Guide to Non-Small Cell Lung Cancer (NSCLC)
Read on to find out more about NSCLC. This guide includes more information about the types of NSCLC, symptoms, causes, treatments, and more.
The main types of non-small cell lung cancer (NSCLC) include:
- squamous cell carcinoma
- large cell carcinoma
Adenocarcinoma of the lung
Adenocarcinoma is a type of cancer that begins in glands that usually secrete mucus and other substances. While adenocarcinoma can occur in other organs, it accounts for around 40% of NSCLC cases.
It typically occurs in people who currently smoke or who have previously smoked. However, adenocarcinoma is also the most common type of lung cancer among people who do not smoke.
Younger people are more likely to experience this type of lung cancer than other types.
Learn more about adenocarcinoma of the lung.
Squamous cell carcinoma
Squamous cell carcinoma is a type of cancer that begins in the squamous cells. The squamous cells are flat cells that line the airways inside the lungs.
This type of cancer typically occurs in the central part of the lungs, near the bronchus or main airway. People with a history of smoking are more likely to experience squamous cell carcinoma.
Squamous cell carcinoma accounts for 25–30% of NSCLC cases.
Learn more about squamous cell carcinoma.
Large cell carcinoma
Large cell carcinoma is a type of cancer that can appear anywhere in the lungs. It typically grows and spreads quickly.
Large cell neuroendocrine carcinoma is a type of large cell carcinoma similar to small cell lung cancer.
Large cell carcinoma accounts for around 10–15% of NSCLC cases.
Vs. small cell lung cancer
Another less common type of lung cancer is small cell lung cancer (SCLC). It accounts for 10–15% of lung cancers.
SCLC is similar to large cell neuroendocrine carcinoma, a type of NSCLC. However, it typically grows more quickly than NSCLC types.
Learn more about the differences between NSCLC and SCLC.
You may not experience any symptoms of non-small cell lung cancer (NSCLC) in the early stages.
Symptoms that you may notice if you have NSCLC include:
- pain in your chest that worsens when you laugh, cough, or breathe deeply
- wheezing or shortness of breath
- cough that worsens or persists
- coughing up blood or phlegm the color of rust
- loss of appetite
- unexplained weight loss
- feeling tired or weak
- repeat or persistent infection, such as bronchitis or pneumonia
Contact your doctor as soon as you experience symptoms of NSCLC.
Learn about the early symptoms of lung cancer.
Lung cancer occurs when malignant cells in the lungs grow. Typically, it starts in one lung and may spread to the other lung. As the cancer advances, the malignant cells may spread to other areas of the body.
The main cause of lung cancer is smoking, which causes around 90% of lung cancer cases.
Other causes of lung cancer include:
- exposure to secondhand smoke, which can cause damage to the lungs over time
- exposure to hazardous chemicals and cancer-causing agents, such as:
- air pollution, including particle pollution and exhaust smoke
- elements in metal production, including arsenic, cadmium, chromium, and nickel
- chemicals such as asbestos, uranium, and some petroleum products
- inherited gene mutations, which may increase your risk of developing lung cancer
You may also develop lung cancer due to cancer metastasizing, or spreading, from other areas in the body. If primary cancer spreads from another part of the body, the resulting lung cancer is secondary cancer.
Treatment for non-small cell lung cancer (NSCLC) can depend on the stage of cancer.
Examples of NSCLC treatments include:
- radiation therapy
- targeted drug therapy
- radiofrequency ablation
Your doctor may recommend surgery for early stage NSCLC.
Types of surgery for NSCLC include:
- sleeve resection
- video-assisted thoracic surgery
- robotically assisted thoracic surgery
Your doctor will explain any surgical procedures they recommend to you. Asking any questions you may have can help you make an informed decision about your treatment options.
Learn more about surgery for lung cancer.
Not everybody with NSCLC will require chemotherapy. Your doctor may recommend chemotherapy:
- before surgery to shrink the tumor
- after surgery to kill any remaining cancer cells
- for advanced NSCLC that has grown into a nearby structure
- for stage 4 or metastatic cancer that has spread to other parts of the body
Learn more about chemotherapy.
Your doctor may recommend radiation therapy as the main treatment, possibly alongside chemotherapy.
They may also recommend radiation therapy to shrink the tumor before surgery or kill any remaining cancer cells after surgery.
Types of radiation therapy include external beam radiation therapy and brachytherapy, also known as internal radiation therapy.
Learn more about radiation therapy.
Targeted drug therapy
Your doctor may recommend target drug therapy for advanced NSCLC. They may recommend it on its own or alongside chemotherapy.
Target drug therapy involves drugs that specifically target changes in cells that help the cancer grow.
Learn more about target drug therapy.
Your doctor may recommend radiofrequency ablation if you have a small lung tumor near the outer edge of the lungs.
Radiofrequency ablation involves heating the tumor with high-energy radio waves. Your surgeon will insert a thin probe through your skin and into the tumor. An electric current then passes through the probe to heat the tumor and destroy the cancer cells.
Immunotherapy involves taking medications that encourage your immune system to respond to cancer cells.
Laboratory tests may be necessary to check for certain proteins before your doctor can recommend certain types of immunotherapy.
Your doctor will be able to explain any possible side effects of immunotherapy before you begin treatment.
Learn more about immunotherapy for cancer and treatments for NSCLC.
It is important to contact your doctor as soon as you have concerns about non-small cell lung cancer (NSCLC).
You may not experience any symptoms in the early stages of NSCLC. However, seeking medical advice as soon as you experience symptoms can help ensure an early and accurate diagnosis.
To accurately diagnose the condition, your doctor may take your full medical history and perform a physical examination. They may also arrange for tests to confirm the cause of any symptoms you are experiencing.
Tests your doctor may order if you have symptoms of non-small cell lung cancer (NSCLC) include:
- imaging tests, which can include:
- thoracentesis, which involves analyzing fluid from your lungs
- biopsy, such as bronchoscopy or needle biopsy, which involves removing a tissue sample for analysis
- sputum cytology, which involves analyzing mucus you cough up from your lungs
If you receive a lung cancer diagnosis, your doctor may also arrange lung function tests. These tests can check how well your lungs are performing.
Find out more about how doctors test for lung cancer. You can also learn what to expect with an early lung cancer diagnosis.
If you receive a non-small cell lung cancer (NSCLC) diagnosis, your doctor may refer to the stage of the cancer.
Staging for NSCLC is complex. Below is a simplified version of the stages of NSCLC.
|Stage 0||At this stage, the cancer is only in the top layer of cells that line the airways.|
|Stage 1||At this stage, the cancer is in the lung, but it has not spread to the lymph nodes.|
|Stage 2||At this stage, the cancer may extend into the chest and lymph nodes near the lung. Two or more separate tumor masses may grow in the same lung. This stage of cancer has not spread to other parts of the body.|
|Stage 3||At this stage, the cancer has spread to nearby lymph nodes or to other organs in the chest. This stage includes two or more tumors in one lung or a partially blocked airway.|
|Stage 4||At this stage, the cancer grows beyond the lung. It may spread to the other lung, organs in the chest, distant lymph nodes, or body sites such as the brain. Stage 4 NSCLC is also called metastatic lung cancer.|
Learn more about the types and stages of lung cancer.
You may experience complications of non-small cell lung cancer (NSCLC). Complications can occur as the condition progresses or as a side effect of treatment.
Possible complications may include:
- breathing difficulties
- gastrointestinal complications
- hair loss
- skin reactions
- changes within your nervous system
- anxiety or depression
Contact your doctor if you experience side effects of treatment or develop complications as the cancer progresses. They will be able to advise on how you can manage or reduce these complications.
Find out more about the complications of lung cancer.
“Doubling time” refers to how long it takes for a group of cells to double in size. A 2019 study finds that the median tumor doubling time for non-small cell lung cancer (NSCLC) is 230 days. This means that it takes 230 days for the size of the tumor to double.
Contact your doctor for more information about how long it may take for an NSCLC tumor to grow.
You may not always be able to prevent non-small cell lung cancer (NSCLC).
As smoking is the main cause of lung cancer, avoiding or quitting smoking may help reduce your risk of developing NSCLC.
Other steps you can take to reduce your risk of NSCLC include:
- avoiding secondhand smoke and tobacco
- avoiding exposure to radon or chemicals that are known to cause cancer
- eating a healthy, balanced diet to help strengthen your immune system
You can also contact your doctor for more advice on reducing your risk of lung cancer.
Find out more about lung cancer prevention.
The prognosis for non-small cell lung cancer (NSCLC) may depend on various factors, such as:
- the type of NSCLC
- the stage of the cancer
- your medical history
- what treatments you receive
- any other conditions you have
If you discuss your prognosis with your doctor, they may refer to the 5-year survival rate. This is a common statistic that explains the percentage of people alive 5 years after receiving a diagnosis. This is relative to people who do not have cancer.
The overall 5-year relative survival rate for lung cancer is 18.6%. However, this may be greater or smaller depending on the various factors outlined above.
Contact your doctor if you wish to discuss the prognosis. They will be able to provide you with more information.
Find out more about lung cancer survival rates and prognosis.
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It accounts for around 80–85% of lung cancer cases. Common types of NSCLC include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Smoking is the main cause of NSCLC. Other causes include exposure to secondhand smoke or tobacco, cancer-causing agents, and air pollution.
You may not experience any symptoms in the early stages. It is important to contact your doctor as soon as you experience symptoms or have concerns about lung cancer. This will help ensure you receive an accurate diagnosis and begin treatment as soon as possible.