Lung Cancer Health Center

Non-Small-Cell Lung Cancer

Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer. About 85% to 90% of people with lung cancer have NSCLC.

The other major type of lung cancer is called small-cell lung cancer (SCLC).

Types of Non-Small-Cell Lung Cancer

There are three common types of NSCLC:

Squamous cell (epidermoid) carcinoma. About a quarter of lung cancers fall into this category. It starts in cells that line the inner airways of the lungs.

Adenocarcinoma. This type accounts for about 40% of lung cancers. It's the most common kind of lung cancer among nonsmokers. Adenocarcinoma starts in cells that produce mucus and other substances. It often progresses more slowly than other lung cancers.

Large cell (undifferentiated) carcinoma. This type can be found anywhere in the lung. It grows and spreads more quickly than other types. That can make it tougher to treat. It accounts for 10% to 15% of lung cancers.

Symptoms of Non-Small-Cell Lung Cancer

Common symptoms of lung cancer usually occur in later stages of the disease, when a cure is no longer possible. However, if symptoms are caught early enough, treatment may be effective. The most prominent symptoms include:

• Persistent cough that may get worse over time
• Trouble breathing or shortness of breath
• Constant chest pain or discomfort
• Hoarseness
• Bloody phlegm or spit (sputum)
• Infections such as bronchitis or pneumonia that won't go away or that keep coming back
• Fatigue and weakness
• Unintentional weight loss

These symptoms are often caused by something other than cancer. But it's important to see your doctor to determine what's wrong.

Diagnosis of Non-Small-Cell Lung Cancer

There are many tests that can help check if you have lung cancer. They include:

Medical history and physical exam. Your doctor will review your symptoms and your smoking history. You will also be examined for physical signs of disease.

Imaging tests. These tests help your doctor locate possible tumors inside your lungs. They also help show whether the disease has spread elsewhere. Imaging tests include:

• X-rays
• MRIs
• Ultrasounds
• PET scans
• CT scans 

Bronchoscopy. During this test, a flexible fiber-optic tube is inserted into your lungs. This lets your doctor view tumors and take tissue samples (biopsy) for further testing.

Sputum cytology. A lab test in which your phlegm is examined for cancer cells.

Fine-needle aspiration biopsy. A needle is inserted into an abnormal growth or fluid in your lungs. A sample is taken for lab analysis.

Thoracoscopy. Incisions are made in the chest and back that will allow your doctor to insert a scope to examine your chest and biopsy tissue and/or lymph node samples.

Mediastinoscopy. An incision is made above the breastbone, where a scope can be inserted. Biopsies of lung tissue and/or lymph nodes can be performed.

Thoracotomy. A long surgical incision is made in the chest to obtain tissue and lymph nodes.