Non-Small Cell Lung Cancer
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. More than 8 out of 10 lung cancer cases are NSCLC, according to the American Cancer Society (ACS). NSCLC is very aggressive, but treatments like surgery, chemotherapy, and more can help patients live longer with this cancer.
What Is Non-Small Cell Lung Cancer?
NSCLC is the most widely diagnosed type of lung cancer. In 2022, over 236,000 people in the U.S. alone will be diagnosed with lung cancer — and more than 188,000 of those diagnosed will have NSCLC.
You can develop NSCLC if cells within your lungs mutate and start multiplying at out-of-control rates. Common causes of NSCLC include smoking and exposure to other cancer-causing substances like asbestos.
NSCLC is a very aggressive form of cancer that can spread (metastasize) quickly. Getting diagnosed and treated early on are important steps to living longer. Thankfully, there are many different treatment options for NSCLC — even if you were diagnosed after the cancer had spread.
Further, you might qualify for financial aid if you or a loved one has NSCLC or any other type of lung cancer. Get started right now with a free case review.
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Non-Small Cell Lung Cancer vs. Small Cell Lung Cancer
Non-small cell lung cancer is one of two main types of lung cancer, the other being small cell lung cancer (SCLC). NSCLC cells are bigger than SCLC cells when seen under a microscope, which is where the two cancers get their different names from.
NSCLC and SCLC have many other differences, such as:
| NSCLC | SCLC | |
|---|---|---|
| Aggressiveness | Spreads less quickly | Spreads very quickly |
| Rarity | Very common, making up over 80% of all lung cancer cases | Uncommon, accounting for 10-15% of lung cancer cases |
| Treatments | Many treatment options available, most notably surgery | Less treatments available and surgery is rarely used |
What Causes Non-Small Cell Lung Cancer?
Up to 90% of NSCLC cases are caused by smoking, according to the U.S. National Library of Medicine. How long a person smoked for and how much they smoked per year greatly impacts their risk of NSCLC.
Secondhand smoke and exposure to other toxic substances, like radon, severe air pollution, and asbestos, are all things that can increase a person’s cancer risk. These factors often account for cases of NSCLC in nonsmokers.
How Does Asbestos Exposure Cause Non-Small Cell Lung Cancer?
Asbestos can cause non-small cell lung cancer and any other type of lung cancer. Asbestos is a fiber-like material that was used in thousands of products between the 1930s and early 1980s.
Asbestos was once thought of as a miraculous substance — it resisted heat, water, and sound, making it an ideal building product. However, asbestos fibers can get released into the air and anyone who inhales them is at risk of lung cancer and other diseases.
Many cases of asbestos-related NSCLC are diagnosed each year and most could have been prevented. Manufacturers of asbestos-containing products knew the dangers of asbestos as far back as the 1930s but hid the deadly facts to keep their profits high.
At Lung Cancer Group, we find this corporate negligence unacceptable. Call (877) 446-5767 now to learn if you can pursue financial aid and justice for NSCLC.
Non-Small Cell Lung Cancer Symptoms
- Appetite loss
- Chest pain
- A cough that won’t go away
- Fatigue
- Shortness of breath
- Weight loss
Patients may develop more symptoms as the cancer spreads.
- Drooping eyelids
- Hoarseness
- Pain in the bones
- Shoulder pain
- Swelling in the face
However, the U.S. National Library of Medicine notes that patients with NSCLC may not have any symptoms if the cancer is in its very early stages.
Because of this, those at risk of NSCLC are highly encouraged to get regular lung cancer screenings. These screenings may allow doctors to catch cases of NSCLC (or other types of lung cancer) before symptoms appear.
How Is Non-Small Cell Lung Cancer Diagnosed?
Doctors can make a non-small cell lung cancer diagnosis by using a couple of different tests. According to the National Cancer Institute (NCI), getting a physical exam and talking about your risk factors are the first steps.
Doctors may check for lumps under your skin with a physical exam. They’ll likely want to know if you smoked or were exposed to other possible causes of NSCLC like asbestos, and if there’s any family history of lung cancer.
From there, doctors will likely want to look inside the body using imaging scans if they think a malignancy (cancerous growth) may be present.
Imaging scans used to help diagnose NSCLC include:
- CT scans
- MRI scans
- PET scans
- X-rays
Doctors may also take a sputum cytology — a sample of your mucus coughed up from your lungs. Doctors can look at the mucus sample under a microscope for abnormal cells.
If doctors believe you may have lung cancer after these tests, they’ll want to perform a biopsy. Through a biopsy, doctors will remove a sample of fluid or lung tissue from your body and look at it under a microscope.
The biopsy sample may be removed via a needle or a bronchoscopy (where a thin tube with a light is sent down the windpipe). From there, it will be looked at under a microscope to see if a patient has NSCLC or not.
Non-Small Cell Lung Cancer Staging
There are five stages of non-small cell lung cancer, according to the ACS. Stage 0 is the least advanced while in stage IV the cancer is widespread.
Stage 0
In cases of stage 0 non-small cell lung cancer, cancer cells are only found on the top part of the lung lining. This is the easiest stage of NSCLC to treat since the cancer hasn’t spread at all.
Stage I
In stage I non-small cell lung cancer, a lung cancer tumor has started to form.
There are two substages based on the size of the tumor:
- Stage IA: Lung tumors in stage IA are less than 3 centimeters wide.
- Stage IB: Tumors in stage IB are 4 centimeters wide. These tumors may have grown into one of the bronchi (tubes that push air from the windpipe into the lungs) or the pleura (lung lining).
Since it’s still in the early stages, stage I NSCLC patients often qualify for many treatments to help them live longer or totally cure them.
Stage II
Stage II non-small cell lung cancer tumors have gotten larger and may start to spread. However, doctors can often still treat stage II lung cancer cases effectively.
There are two substages:
- Stage IIA: In this stage, the cancer tumors are bigger than 4 centimeters but not quite 5 centimeters.
- Stage IIB: This stage indicates a cancer tumor is bigger than 5 centimeters or is less than 5 centimeters but has reached the lymph nodes. If cancer gets into the lymph nodes, it can cause tumors to form in other parts of the body.
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Stage III
Stage III non-small cell lung cancer often marks the point at which patients start to lose some treatment options. Doctors may or may not be able to remove stage III tumors safely via surgery, which is arguably the most effective NSCLC treatment.
All cases of Stage III NSCLC have spread to the patient’s lymph nodes.
There are three substages:
- Stage IIIA: The tumor may have spread to body parts like the pleura, mediastinum (space between the lungs), the heart, the windpipe, or the diaphragm.
- Stage IIIB: The cancer has grown into nearby lymph nodes around the collarbone or carina (where the windpipe separates into two bronchi) as well as the backbone, heart, windpipe, or other areas from Stage IIIA.
- Stage IIIC: The cancer has spread to lymph nodes on the other side of the body (such as those in the collarbone) as well as any of the body parts from the earlier stages.
Doctors will likely recommend nonsurgical treatments (such as chemotherapy) to help patients with stage III NSCLC. These other treatments can help shrink lung tumors and help patients live longer.
Stage IV
This is the most advanced stage of non-small cell lung cancer. By stage IV, the cancer has spread beyond the lungs to distant parts of the body. It is also known as metastatic or advanced non-small cell lung cancer.
Its substages include:
- Stage IVA: The cancer is found in the lungs as well as in one area outside of the lungs.
- Stage IVB: The NSCLC tumors are found in multiple organs outside of the lungs (like the bones, brain, or liver).
Stage IV NSCLC is the most difficult stage to treat. Sadly, a 2021 study from Frontiers in Oncology noted that 60% to 70% of NSCLC patients worldwide are diagnosed at stage IV.
However, skilled lung cancer doctors will do all they can to help patients live as long as possible with stage IV NSCLC.
What Are the Types of Non-Small Cell Lung Cancer?
Non-small cell lung cancer cases can be classified into different subtypes. Learn about the different types of NSCLC below.
Adenocarcinoma
Lung adenocarcinoma develops in the cells that line the alveoli, tiny sacs at the end of airways where oxygen and carbon dioxide are exchanged, according to the NCI.
Adenocarcinoma is the most common subtype of non-small cell lung cancer, accounting for 4 in 10 cases. Fortunately, there’s a greater chance that doctors will diagnose adenocarcinoma before it has spread.
Adenosquamous Carcinoma
Adenosquamous carcinoma tumors have elements of adenocarcinoma and squamous cell carcinoma. It’s a rare subtype, accounting for 0.4% to 4% of lung cancer cases.
Most adenosquamous carcinoma patients are older men with a history of smoking, but anyone can develop this cancer.
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Large Cell Carcinoma
Large cell carcinoma makes up less than 3% of all non-small cell lung cancer cases. It serves as a catch-all for cases of NSCLC that can’t be easily classified as one of the other subtypes.
“Many lung cancers that would have been considered large cell in the past are now being identified as lung adenocarcinoma or squamous cell lung cancer.”
— LUNGevity Foundation
Histopathology of Tumors (a medical journal) notes that most large cell carcinoma patients are diagnosed in their 70s and are long-term smokers.
Large Cell Neuroendocrine Carcinoma
Large cell neuroendocrine carcinoma (LCNEC) is a subtype of large cell carcinoma. Between 1% and 3% of lung cancers are LCNEC. LCNEC is rather unique as its tumors are made up of both SCLC and NSCLC cells.
Unfortunately, LCNEC is more difficult to treat than other subtypes of NSCLC and patient survival rates are often similar to those found in cases of SCLC.
Sarcomatoid Carcinoma
Sarcomatoid carcinoma is a very rare subtype of non-small cell lung cancer. It makes up 0.1% to 0.4% of all cases diagnosed. Most patients are diagnosed when they’re in their late 60s.
This NSCLC subtype responds poorly to chemotherapy and radiation. Thus, doctors will try to completely remove the tumors using surgery. Newer treatments like immunotherapy and targeted therapy may help patients as well.
Squamous Cell Carcinoma
Squamous cell carcinoma is the second-most common subtype of non-small cell lung cancer. It accounts for 25% to 30% of NSCLC diagnoses. This subtype usually develops in the bronchi (tubes that push air from your windpipe into your lungs).
The LUNGevity Foundation notes that this subtype is most commonly linked to smoking — more so than the other subtypes.
Squamous cell carcinoma tumors typically spread less quickly than other NSCLC subtypes like adenocarcinoma.
What Is the Prognosis for Non-Small Cell Lung Cancer?
A prognosis is your projected health outcome after being diagnosed with an illness. Though non-small cell lung cancer is a very serious — and often fatal — cancer, it’s possible to be fully cured and live cancer-free.
“Each year, tens of thousands of people are cured of NSCLC in the United States. And, some patients with advanced lung cancer can live many years after diagnosis. Sometimes patients who are told that their lung cancer is incurable live longer than many who are told that their lung cancer is curable.”
— American Society of Clinical Oncology (ASCO)
An NSCLC prognosis is measured with two factors: life expectancy and survival rate. Learn about each below.
Non-Small Cell Lung Cancer Life Expectancy
Life expectancy is how long you may live with cancer. The average life expectancy for NSCLC is over 13 months, according to a study from the medical journal Cancer Medicine.
NSCLC life expectancies vary depending on the cancer stage at the time of diagnosis, the subtype, and what treatments a patient qualifies for. For example, a 2021 study noted that 1 in 3 patients with stage IV NSCLC die within 3 months.
Further, a study published by the journal Systematic Reviews found that NSCLC patients who don’t get treated live for just over 7 months on average.
This grim fact underscores the importance of getting regular lung cancer screenings and pursuing treatments quickly if you’re diagnosed.
Survival Rate for Non-Small Cell Lung Cancer
Survival rate is the number of patients still alive after a set period of time (usually a certain number of years). The overall 5-year NSCLC survival rate is 26%, according to ASCO.
Like with life expectancies, survival rates vary greatly depending on cancer stage, treatments, and other factors.
- Patients with localized (early-stage) NSCLC have a 5-year survival rate of 63%.
- Patients with metastasized (late-stage) NSCLC have a much lower 5-year survival rate of only 7%.
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Non-Small Cell Lung Cancer Treatments
Treatments for non-small cell lung cancer can help you live longer, ease your symptoms, and improve your overall quality of life. You can pursue NSCLC treatment options even if your cancer is in an advanced stage.
Your cancer care team can recommend treatments based on your NSCLC diagnosis. Learn about top lung cancer treatments below.
Chemotherapy
Chemotherapy medications can circulate through the body to destroy cancer cells and shrink lung tumors. Oncologists (cancer doctors) typically give chemotherapy in cycles — usually a couple of weeks, followed by a recovery period.
A wide assortment of chemotherapy medications may be used to treat NSCLC. The American Society of Clinical Oncology (ASCO) lists nearly 10 chemotherapy drugs commonly used to treat NSCLC, including carboplatin and cisplatin.
Chemotherapy can also be combined with other therapies in what’s known as a multimodal treatment plan. Combining NSCLC treatments may be more effective than using just one treatment by itself.
A 2018 study titled “Pembrolizumab Plus Chemotherapy in Metastatic Non-Small Cell Lung Cancer” saw patients get treated with both chemotherapy and the immunotherapy drug pembrolizumab (Keytruda®).
The combination prevented the cancer from returning for more than 3 months longer than those treated with just chemotherapy.
Immunotherapy
NSCLC (and other types of cancer) can sometimes hide from the body’s immune system and spread rapidly. Immunotherapy boosts the body’s immune system to more effectively destroy cancer cells.
Immunotherapy treatments work by modifying the immune response in different ways.
For example, the immune system creates T cells that secrete a protein called PD-1. However, cancer cells sometimes create a protein PD-L1, which binds to the PD-1 on T cells and prevents the immune system from destroying the cancer cells. Immunotherapy drugs like atezolizumab can prevent this binding from happening so the T cells can kill the cancer cells.
Other immunotherapy drugs target different proteins or substances to achieve similar results.
Radiation Therapy
Radiation therapy allows oncologists to shrink NSCLC tumors using high-powered beams of energy. These beams aren’t painful, but they may cause side effects like fatigue, appetite loss, and more since they also destroy healthy cells.
ASCO notes that radiation therapy is typically used to treat cases of early-stage NSCLC — it’s not possible to safely use it when the cancer is widespread.
Radiation therapy can also be used as an adjuvant treatment (where it supplements other treatments like surgery) in a multimodal treatment plan.
Surgery
Surgery is arguably the best treatment for NSCLC, as it allows doctors to remove all or most of the cancer that can be seen with the naked eye. NSCLC surgeries give patients the best chance at becoming completely cancer free.
Doctors may try to take out only the cancer tumor and nearby tissue, part of the bronchus, a lung lobe (one of five chambers that make up the lungs), or an entire lung with various surgeries. More aggressive surgeries will be used depending on how far the cancer has spread.
According to the NCI and ASCO, there are several types of surgeries used to treat NSCLC.
NSCLC surgery options include:
- Wedge resection: With this surgery, doctors remove the tumor and nearby lung tissue that surrounds it.
- Segmental resection: Also called segmentectomy, this surgery is similar to a wedge resection only more lung tissue is removed. Doctors may also remove nearby lymph nodes. Segmental resections are often performed when lobectomies cannot be done.
- Lobectomy: Doctors remove the entire lobe that the cancer tumor grew on with this surgery. ASCO notes that a lobectomy is believed to be the most effective surgery for NSCLC. Lobectomies are also the most commonly performed NSCLC surgery, as noted by the American Lung Association (ALA).
- Pneumonectomy: This surgery removes the patient’s entire lung where the tumor formed. A pneumonectomy may be recommended if the tumor cannot be removed with a lobectomy or if it’s located in the middle of the lung.
- Sleeve resection: Doctors remove part of the bronchus that’s become cancerous, along with the cancer tumor. The noncancerous ends of the bronchus are then reattached. The ALA notes that this surgery may allow a patient to avoid a pneumonectomy.
However, if a patient is diagnosed with stage III or stage IV NSCLC, the cancer might be too widespread to fully remove with surgery. Doctors will then likely recommend other lung cancer treatment options like chemotherapy or radiation instead.
Targeted Therapy
Through targeted therapy, doctors try to destroy genes, proteins, or other substances that allow cancer tumors to grow and spread.
One such treatment looks to destroy epidermal growth factor receptors (EGFRs), which are proteins that trigger cell growth if other proteins called epidermal growth factors (EGFs) attach to them. A targeted therapy called an EGFR inhibitor stops this process and prevents the cancer cells from multiplying.
Gene mutations in NSCLC cells can make the cancer spread faster as well. Other targeted therapies try to counteract this. For example, crizotinib can prevent mutated anaplastic lymphoma kinase (ALK) and ROS1 genes from making proteins that cancer cells need to survive.
Your oncologists can see which targeted therapies (if any) you qualify for.
Clinical Trials
Clinical trials allow cancer patients to access newer and possibly more effective treatments. Trials test upcoming cancer treatments in a controlled setting.
Clinical trials may provide hope to patients whose cancer didn’t respond well to standard NSCLC treatments or comes back (recurs).
For example, an ongoing clinical trial for stage 4 non-small cell lung cancer is looking at how immunotherapy (with or without chemotherapy) may help patients.
You can find a list of active NSCLC clinical trials by visiting the cancer.gov Clinical Trials page or speaking with your health care team. Keep in mind that you may not qualify for every NSCLC clinical trial depending on your cancer stage, overall health, or other factors.
Palliative Care
Palliative care focuses on easing symptoms of a patient’s illness. Palliative care may be recommended in cases of advanced NSCLC.
Many of the treatments listed earlier (including chemotherapy, surgery, and radiation) can be used as palliative care if they’re scaled down. For example, a minor surgery or a low dose of radiation can be used to shrink lung cancer tumors and reduce a patient’s symptoms.
Help for Non-Small Cell Lung Cancer Patients
No one deserves to develop non-small cell lung cancer. If you or someone you love has been recently diagnosed, know that there is hope.
If the cancer is caught early on, ASCO notes that it’s possible to be fully cured of NSCLC with surgery. Other treatments like chemotherapy, radiation, and more can also be used to help destroy as much of the cancer as possible and ease a patient’s symptoms.
Besides medical help, it’s important to know that financial help could be available to you as well. You may qualify for financial compensation to pay for NSCLC treatments that can save your life. Find out your eligibility right now with a free case review.
FAQs About Non-Small Cell Lung Cancer
How serious is non-small cell lung cancer?
NSCLC can be life-threatening, and this is made worse by the fact that 8 out of 10 patients are only diagnosed after the cancer has spread.
Go to a doctor as soon as possible if you might have lung cancer. Getting treatments quickly will give you the best chance of living longer with NSCLC. If you’re diagnosed in the cancer’s early stages, doctors might be able to cure you.
Which is worse: non-small cell lung cancer or small cell lung cancer?
All types of lung cancer can be deadly without treatment. That said, SCLC is even more aggressive than NSCLC and there are less treatments available.
Thankfully, lung cancer oncologists are well-trained to treat any type of lung cancer. You may be able to achieve long-term survival even if you’re diagnosed with late-stage SCLC or NSCLC.
Is non-small cell lung cancer the same as mesothelioma?
No. NSCLC is a different type of cancer entirely from mesothelioma. Though mesothelioma can spread into the lungs, it doesn’t start there. Mesothelioma is a cancer that affects the linings of major organs, like the lungs, abdomen, heart, or testicles.
Mesothelioma also has a different prognosis — which is often worse than NSCLC — and requires different treatments.
Finally, mesothelioma is only caused by asbestos exposure while NSCLC can be caused by smoking, asbestos, radon, and other factors. Talk to your doctor to make sure you’ve been properly diagnosed before starting treatment.
Besides helping those with lung cancer, our team also helps those with mesothelioma. Learn if you qualify for financial aid right now: Call (877) 446-5767.
What is the survival rate of non-small cell lung cancer?
NSCLC has an overall 5-year survival rate of 26%. That said, the survival rate varies depending on the cancer’s stage.
ASCO notes that the 5-year survival rate of early-stage NSCLC is 63%, while those diagnosed with late-stage NSCLC have a 5-year survival rate of just 7%.
It’s important to note that some NSCLC patients can live long past the average survival rate as well — even if they’ve been diagnosed with late-stage cancer.
Can non-small cell lung cancer spread?
Yes. NSCLC can spread quickly throughout the body without treatment. It often spreads to the bones, brain, or liver, according to ASCO.
Getting diagnosed and treated before the cancer spreads is very important, as NSCLC (like all other cancers) is much easier to treat if it’s contained.
