Non-small cell lung cancer
What is Non-small cell lung cancer?
Non-small cell lung cancer is the most common type of lung cancer. It accounts for about 85% of all lung cancer cases. This cancer starts in the cells that line the airways of the lungs.
There are three main subtypes of non-small cell lung cancer. Adenocarcinoma starts in cells that make mucus. Squamous cell carcinoma begins in flat cells lining the airways. Large cell carcinoma can appear in any part of the lung. Each type grows and spreads differently, but all require early detection for better outcomes.
Non-small cell lung cancer typically grows more slowly than small cell lung cancer. Early-stage disease may not cause symptoms, making screening important for high-risk groups. When caught early, treatment options are more effective. Understanding your risk factors and getting appropriate screening can save your life.
Symptoms
- A cough that does not go away or gets worse over time
- Chest pain that worsens with deep breathing, coughing, or laughing
- Shortness of breath or wheezing
- Coughing up blood or rust-colored mucus
- Hoarseness or voice changes
- Repeated lung infections like bronchitis or pneumonia
- Fatigue or feeling very tired
- Unexplained weight loss
- Loss of appetite
- Shoulder or back pain
Many people with early-stage non-small cell lung cancer have no symptoms at all. Symptoms often appear only after the cancer has grown or spread. This is why screening is so important for people at high risk.
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Causes and risk factors
Smoking is the leading cause of non-small cell lung cancer. About 80% to 90% of lung cancer deaths are linked to smoking. Secondhand smoke exposure also increases your risk significantly. The longer you smoke and the more cigarettes you smoke, the higher your risk becomes.
Other risk factors include exposure to radon gas, asbestos, and other toxic chemicals. Air pollution and family history of lung cancer can also play a role. Some people develop lung cancer without any known risk factors. Certain genetic mutations, including BRAF mutations, are found in a small percentage of cases and can influence how the cancer develops and responds to treatment.
How it's diagnosed
Diagnosing non-small cell lung cancer typically starts with imaging tests like chest X-rays or CT scans. If a suspicious area is found, your doctor will order a biopsy. A biopsy removes a small sample of lung tissue to examine under a microscope.
Once cancer is confirmed, additional testing identifies the specific subtype and genetic markers. BRAF mutation analysis and other molecular tests help doctors choose the most effective treatment. These specialized tests look for specific genetic changes in the cancer cells. Talk to your doctor about which tests are right for your situation and diagnosis.
Treatment options
- Surgery to remove the tumor, often for early-stage cancer
- Radiation therapy to kill cancer cells or shrink tumors
- Chemotherapy using drugs to destroy cancer cells throughout the body
- Targeted therapy drugs for cancers with specific genetic mutations like BRAF
- Immunotherapy to help your immune system fight cancer cells
- Quitting smoking immediately to improve treatment outcomes
- Eating a nutrient-dense diet to support your body during treatment
- Staying physically active as much as possible to maintain strength
- Managing stress through mindfulness, support groups, or counseling
- Working closely with an oncology team that specializes in lung cancer
Frequently asked questions
Non-small cell lung cancer grows more slowly and is more common, accounting for 85% of cases. Small cell lung cancer grows quickly and spreads faster. The two types look different under a microscope and require different treatments. Your doctor will determine which type you have through a biopsy.
Yes, about 10% to 20% of people with lung cancer have never smoked. Risk factors for non-smokers include secondhand smoke, radon exposure, air pollution, and family history. Some cases occur with no known risk factors. Anyone experiencing persistent respiratory symptoms should see a doctor.
BRAF mutation testing looks for specific genetic changes in cancer cells. About 1% to 4% of non-small cell lung cancers have BRAF mutations. Finding this mutation helps doctors choose targeted therapies that work specifically against cells with this change. These targeted drugs often work better than traditional chemotherapy for BRAF-positive cancers.
Staging describes how far the cancer has spread, from stage 1 to stage 4. Stage 1 means the cancer is only in the lung. Stage 4 means it has spread to other organs. Staging helps doctors plan treatment and estimate outcomes. Your care team uses imaging tests, biopsies, and sometimes surgery to determine the stage.
Survival rates depend heavily on the stage at diagnosis. The 5-year survival rate for localized non-small cell lung cancer is about 65%. Once the cancer spreads to nearby areas, this drops to about 37%. For distant spread, the rate is around 9%. Early detection through screening dramatically improves outcomes.
Current and former heavy smokers between ages 50 and 80 should discuss screening with their doctor. Screening is recommended if you have a 20 pack-year smoking history. One pack-year equals smoking one pack per day for one year. Low-dose CT scans can find cancer early when it is most treatable.
Yes, lifestyle changes can improve treatment outcomes and quality of life. Quitting smoking immediately is the most important step. Eating a nutrient-rich diet helps your body handle treatment side effects. Regular physical activity maintains strength and reduces fatigue. Stress management techniques support mental health during this difficult time.
Targeted therapies are drugs that attack cancer cells with specific genetic mutations. They work differently than chemotherapy by focusing on molecular changes in cancer cells. Common targets include EGFR, ALK, ROS1, and BRAF mutations. Your doctor will test your tumor to see if targeted therapy is an option for you.
Treatment length varies based on cancer stage and treatment type. Surgery may require weeks of recovery. Chemotherapy typically runs for several months in cycles. Targeted therapy and immunotherapy may continue for many months or even years if working well. Your oncologist will create a treatment plan specific to your situation.
Seek immediate care for coughing up large amounts of blood, severe chest pain, or sudden shortness of breath. Confusion, severe headaches, or bone pain may indicate cancer spread. High fever during treatment could signal infection. Call your cancer care team right away if you experience any concerning symptoms during or after treatment.