Lung cancer - non-small cell

Alternative Names

Cancer - lung - non-small cell; Non-small cell lung cancer; NSCLC; Adenocarcinoma - lung; Squamous cell carcinoma - lung

Definition

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 common types of NSCLC:

Causes

Smoking causes most cases of lung cancer. The risk depends on the number of cigarettes you smoke every day and for how long you have smoked. Being around the smoke from other people (secondhand smoke) also raises your risk of lung cancer. But some people who do not smoke and have never smoked develop lung cancer.

Research shows that smoking marijuana may help cancer cells grow. But there is no direct link between smoking marijuana and developing lung cancer.

Constant exposure to high levels of air pollution and drinking water that has a high level of arsenic can increase your risk of lung cancer. A history of radiation therapy to the lungs can also increase risk.

Working with or near cancer-causing chemicals or materials can also increase risk. Such chemicals include:

Symptoms

Early lung cancer may not cause any symptoms. Symptoms you should watch for include:

Other symptoms that may be due to NSCLC, often in the late stages:

These symptoms can be due to other, less serious conditions. It is important to talk to your health care provider.

Exams and Tests

The doctor will perform a physical exam and ask about your medical history. You will be asked if you smoke, and if so, how much and for how long. You will also be asked about other things that may have put you at risk of lung cancer, such as exposure to certain chemicals.

When listening to the chest with a stethoscope, the doctor may hear fluid around the lungs.

This may suggest cancer.Tests that may be performed to diagnose lung cancer or see if it has spread include:

In some cases, a piece of tissue is removed from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:

If the biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. Stage means how big the tumor is and how far it has spread. NSCLC is divided into five stages:

Treatment

There are many different types of treatment for NSCLC. Treatment depends on the stage of the cancer.

Surgery is the common treatment for NSCLC that has not spread beyond nearby lymph nodes. The surgeon may remove:

Some patients need chemotherapy. Chemotherapy uses drugs to kill cancer cells and stop new cells from growing. Treatment may be done in the following ways:

Controlling symptoms and preventing complications during and after chemotherapy is an important part of care.

Radiation therapy can be used with chemotherapy if surgery is not possible. Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. Radiation may be used to:

Controlling symptoms during and after radiation to the chest is an important part of care.

The following treatments are mostly used to relieve symptoms caused by NSCLC:

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. 

Outlook (Prognosis)

Outlook varies. Most often, NSCLC grows slowly. In some cases, it can be very aggressive and cause rapid death. The cancer may spread to other parts of the body, including the bone, liver, small intestine, and brain.

Chemotherapy has been shown to prolong the life and improve the quality of life in some patients with stage IV.

Cure rates are related to the stage of disease and whether you are able to have surgery.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of lung cancer, particularly if you smoke.

Prevention

If you smoke, now is the time to quit. Also, try to avoid secondhand smoke,.

References

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, et al., eds. Abeloff’s Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 76.

National Cancer Institute: PDQ Non-Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified 08/08/2013. Available at:http://cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/Patient. Accessed September 24, 2013.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-small cell lung cancer. Version 2.2013. Available at http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed September 24, 2013.


Review Date: 9/20/2013
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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