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Alternative Names Return to topCancer - lung - non-small cell; Non-small cell lung cancer; NSCLC
Definition Return to top
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It usually grows and spreads more slowly than small cell lung cancer.
There are three forms of NSCLC:
Causes Return to top
Smoking causes most cases of lung cancer. Being around the smoke from others (secondhand smoke) also raises your risk for lung cancer. However, people who do not smoke and have never smoked have become sick with lung cancer.
A review of decades of research has recently shown that smoking marijuana may help cancer cells grow, but there is no direct link between the drug and lung cancer.
High levels of air pollution, working with or near cancer-causing chemicals or materials (such as asbestos), and drinking water containing high levels of arsenic can increase your risk for lung cancer. Radiation therapy to the lungs can also increase the risk.
Symptoms Return to top
Early lung cancer may not cause any symptoms. Symptoms you should watch for include:
Other symptoms that may be due to NSCLC:
Note: These symptoms can be due to other, less serious conditions. It is important to talk to your health care provider.
Exams and Tests Return to top
The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.
When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn't always) suggest cancer.
Tests that may be performed include:
In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:
If the biopsy reveals you do have lung cancer, more imaging tests will be done to determine the stage of the cancer. Stage means how big the tumor is and how far it's spread. Non-small cell lung cancer is divided into five stages:
Treatment Return to top
There are many different types of treatment for non-small cell lung cancer:
Treatment depends upon the stage of the cancer. A combination of treatments may be needed. Research has suggested that chemotherapy or a combination of chemotherapy and radiation therapy prior to surgery might be the best treatment for some patients.
Surgery is the often the first line of treatment for most patients with stage I and II non-small cell lung cancer, and some patients with stage III tumors. Surgery can cure the disease.
Chemotherapy alone is often used when the cancer has spread (stage IV). Chemotherapy has been shown to prolong the life and improve the quality of life in some stage IV patients.
Support Groups Return to top
For additional information and resources, see cancer support group.
Outlook (Prognosis) Return to top
Cure rates are related to the stage of disease and whether you are able to have surgery.
Possible Complications Return to top
Prevention Return to top
If you smoke, stop smoking. It's never too early to quit. Try to avoid secondhand smoke.
Eat a diet rich in fruits and vegetables.
Routine screening for lung cancer is not recommended. Many studies have been done to look at the idea, but scientists have concluded that, at this time, screening would not find help improve a person’s chance for a cure.
References Return to top
Alberg AJ, Ford JG, Samet JM; American College of Chest Physicians. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:29S-55S.
American Cancer Society. Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society; 2008.
Bach PB, Silvestri GA, Hanger M, Jett JR. Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:69S-77S.
National Cancer Institute. Lung Cancer Home Page. Bethesda, MD: U.S. National Institutes of Health. Accessed August 3, 2008
Jett JR, Schild SE, Keith RL, Kesler KA. Treatment of non-small cell lung cancer, stage IIIB: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:266S-276S.
Johnson DH, Blot WJ, Carbone DP, et al. Cancer of the lung_ Non-small cell lung cancer and small cell lung cancer. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 76.Update Date: 11/14/2008 Updated by: James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.