Non-Small Cell Lung Cancer

What is non-small cell lung cancer?

Non-small cell lung cancer (NSCLC) occurs when abnormal cells form and multiply in your lungs. NSCLC is one of two main types of lung cancer. The other is small cell lung cancer (SCLC). NSCLC is the most common type of lung cancer, making up about 80% to 85% of all lung cancer cases.

Small cell lung cancer gets its name because the cancer cells look small and round under a microscope. Generally, SCLC is more aggressive than NSCLC. With non-small cell lung cancer, the cancer cells are larger, and they typically grow slower.

NSCLC may not cause symptoms. So, even though it grows slower than small cell, it’s often diagnosed after the cancer has spread (metastasized) to other areas of your body. That’s why early detection and treatment are so important.

Types of non-small cell lung cancer

There are three main types of non-small cell lung cancer:

1. Adenocarcinoma: Usually forms in the outer portions of your lung
2. Large cell carcinoma: Can develop in any part of your lungs
3. Squamous cell carcinoma: Typically starts in the central part of your lungs

Other types of non-small cell lung cancer include sarcomatoid carcinoma and adenosquamous carcinoma. They’re much less common.

Symptoms of non-small cell lung cancer

Non-small cell lung cancer symptoms can include:

• Chest pain
• Chronic cough
• Coughing up blood
• Hoarseness
• Loss of appetite
• Shortness of breath
• Tiredness
• Wheezing

In some cases, NSCLC may not cause symptoms.

Non-small cell lung cancer causes

NSCLC occurs when normal cells change and grow out of control. But experts don’t always know why it happens in some people and not in others. But they have identified some risk factors. A risk factor is something that increases your chances of developing non-small cell lung carcinoma.

Risk factors

The most common risk factor for lung cancer is a history of smoking. Other known NSCLC risk factors include:

• A family history of lung cancer
• Asbestos exposure
• Exposure to metal and mineral dust
• Exposure to radon, a naturally occurring radioactive gas
• Having respiratory conditions like pulmonary fibrosis or COPD
• Radiation therapy to your breast or chest

Complications of non-small cell lung cancer

Like many other cancers, non-small cell lung cancer can spread to other parts of your body. Most commonly, it can spread to your:

• Adrenal glands
• Bones
• Brain
• Liver
• Lymph nodes
• Skin

How doctors diagnose non-small cell lung cancer

Your healthcare provider will do a physical examination and ask about your symptoms and medical history. If they suspect non-small cell lung cancer, they’ll recommend certain tests to diagnose and stage the disease.

Tests that are used

Medical tests that help diagnose non-small cell lung cancer include:

• Lung biopsy
• Bronchoscopy, which gives your healthcare provider a view inside your airways
• Imaging tests like chest X-rays or CT scans, PET scans and MRI scans of the brain
• Video-assisted thoracic surgery (VATS), which helps your provider get a better look inside your chest

How is non-small cell lung cancer treated?

For cancer that’s only in your lung and nowhere else, your healthcare provider may recommend surgery as a first line of treatment. During this procedure, a surgeon removes the tumor and a small amount of healthy tissue around it. If the cancer has spread beyond the original site, all or part of your lung may need to be removed (lung resection).

Early-stage lung cancer is rare, so many people receive a combination of treatments, including:

• Chemotherapy. Chemotherapy involves using drugs that attack lung cancer. It’s one of the most common NSCLC treatments. Your oncologist might recommend chemotherapy on its own or in combination with other therapies.
• Immunotherapy. This treatment uses certain drugs to boost your immune system so it can recognize and destroy cancer cells.
• Targeted therapy. This treatment uses drugs designed for specific types of lung cancer. Targeted therapy can find and attack specific cancer cells without harming healthy cells.
• Radiation therapy. A radiation specialist uses X-rays to kill cancer by carefully aiming them at the lung cancer wherever it is in your body. Your provider might use it in combination with chemotherapy or on its own.

Recovery time

Recovery after non-small cell lung cancer treatment varies. It depends on several factors like the size and location of the tumor, the type of treatment you receive and your body’s own healing capacity.

Some people may recover in a few months. For others, it might take years. Ask your healthcare provider what you can expect in your situation.

When should I see my healthcare provider?

See your oncologist or visit your nearest emergency room if you develop:

• Breathing problems
• Fever of 100.4 degrees Fahrenheit (38 degrees Celsius)
• Severe pain that doesn’t improve with medication
• New or worsening symptoms

What can I expect if I have this condition?

Life expectancy depends on the stage of cancer and the subtype of NSCLC. For example, the five-year survival rate for early-stage NSCLC is 65%. This means that 65% of people diagnosed with the condition are still alive five years later.

The five-year survival rate for regional NSCLC (when the cancer has spread to nearby tissues or lymph nodes) is 37%. With metastatic non-small cell lung cancer, the five-year survival rate is 9%.

Keep in mind that survival rates are just estimates. They can’t tell you how long you’ll live or how your body will respond to treatment. To learn more about what survival rates mean for you, talk to your healthcare provider.

And the outlook is different for everyone. Non-small cell lung cancer may be curable, especially with early detection and treatment. But certain factors affect your overall prognosis, like cancer type, stage and your overall health.

Even when NSCLC isn’t curable, it’s still treatable in many cases. Many people with non-small cell lung cancer can manage their symptoms successfully.