Non-Small Cell Lung Cancer: The Basics

Author: Christina Bach, MBE, LCSW, OSW-C

Last Reviewed: May 22, 2023

Lung cancer is caused by lung cells growing out of control. As the number of cells grows, they form into a tumor. There are many types of lung cancers. This article will focus on non-small cell lung cancer.

Non-Small Cell Lung Cancer (NSCLC)

85% of all lung cancers.
Generally slower growing than small cell lung cancer.
Divided into different types based on the cells that make up the tumor.
Types: adenocarcinoma, squamous cell carcinoma, and poorly differentiated or large cell carcinoma.

Lung cancer that has spread from the lung to another part of the body is called metastatic cancer. Other types of lung cancer include small cell, mesothelioma, and carcinoid tumors. These cancers are not discussed here.

Risks

Smoking cigarettes (now or in the past) is the leading cause of lung cancer. Lung cancer in non-smokers has been rising in recent years. Other causes for lung cancer include radon, radiation, asbestos, and pollution.

Screening

Smokers or former heavy smokers can have a special test (CT scan) to screen for lung cancer. This test can find lung cancer sooner and may help patients live longer. Speak to your healthcare provider to decide if this test is right for you.

Signs of Lung Cancer

The early stages of lung cancer may not have any signs. As the tumor grows in size, it can cause signs.

Cough (one that doesn't go away or gets worse). A cough is the most common sign. Many long-term smokers have a cough that doesn't go away. If there is a change in your cough, see your doctor.
Chest pain.
Hard time breathing or wheezing.
Coughing up blood or bloody phlegm.
New hoarseness or change in speech.
Having pneumonia or bronchitis that keeps coming back.
Weight loss and loss of appetite.
Feeling tired.

Diagnosis of Lung Cancer

When your healthcare providers think you may have lung cancer, they will order tests. Here are some of the tests:

Chest x-ray.
CT scan ("Cat Scan", a 3-D x-ray).
Sputum cytology (looking at your phlegm for cancer cells).
A PET scan and an MRI scan of the brain are often done to look at other parts of the body where lung cancer can spread.

These tests are important but a biopsy is the only way to know for sure if you have cancer. A biopsy:

Looks at a piece of the lung for cancer cells.
Is used to find out the cancer type, how normal it is [grade], and if it has spread.
May look at samples from lymph nodes to check for cancer.
The biopsy may be done using a bronchoscopy (a small camera passed down your throat into the lungs) or by surgery.

A pathology report sums up these results and is sent to your healthcare provider, typically 5-10 days after the biopsy. This report is an important part of planning your treatment. You can ask for a copy of your report for your records.

Staging Lung Cancer

To guide treatment, lung cancer is "staged." This stage is based on:

Size and location of the tumor.
Whether cancer cells are in the lymph nodes.
Whether cancer cells are in other parts of the body.

Stages range from stage I (smallest, most confined tumors) to stage IV (tumors that have spread to other parts of the body, also called metastatic cancer). The stage and type of lung cancer will guide your treatment plan.

Treatment

Often, these treatments are used:

Surgery: In some cases, surgery is done to remove as much of the cancer as possible.
Chemotherapy: Chemotherapy is the use of medications that can kill cancer cells throughout the entire body. Most patients will receive chemotherapy either given before surgery (called neoadjuvant) or after surgery (called adjuvant). Chemotherapy can also be given before, during, or after radiation therapy.
Radiation therapy: Radiation therapy, the use of high-energy X-rays to kill cancer cells, can be used with surgery, or when surgery is not possible.

This article is a basic guide to non-small cell lung cancer. You can learn more about your type of lung cancer and treatment by using the links below.

Non-small Cell Lung Cancer: Staging and Treatment

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