Non-Small Cell Lung Cancer Symptoms and Treatments

All About Non-Small Cell Lung Cancer

diagram showing a lung cancer in the right mid lung field
What are the symptoms, types, causes, and treatments for non-small cell lung cancer?.

Non-small cell lung cancer is the most common type of lung cancer, accounting for at least 80 percent of these tumors. What are they symptoms, types, and causes, and how should these be treated? What should everyone with non-small cell lung cancer know?

Non-Small Cell Lung Cancer Overview

Non-small cell lung cancer is the most common form of lung cancer, and the type of lung cancer most commonly found in women, non-smokers, and young adults.

It does not spread as rapidly as small cell lung cancer but is still often diagnosed when it is at an advanced stage. It's important to note that even though an advanced non-small cell lung cancer is inoperable, it is still treatable. There have been many recent advances in the treatment of lung cancer, and survival rates are improving for all stages of the disease.

It comes as a surprise to many people that never smokers can and do develop lung cancer. In fact, the majority of people who develop non-small cell lung cancer today are non-smokers - they are either former smokers or never smokers. One in five women who develop lung cancer have never smoked. And while lung cancer is decreasing in older people and in men, it is increasing in young adults, especially young, never-smoking women.

Types of Non-Small Cell Lung Cancer

There are 3 primary types of non-small cell lung cancer. These include:


Adenocarcinoma is the most common form of non-small cell lung cancer accounting for up to 50 percent of cases in the United States. Of non-small cell lung cancers, this is the tumor most often found in young adults, women, and people who have never smoked. Lung adenocarcinoma usually begins in the outer regions of the lungs, and can grow quite large before it is detected.

Since these tumors are usually located away from the airways, commonly recognized symptoms such as coughing are less common. Early symptoms are often subtle, with shortness of breath with activity, and a general sense of ill health.

Squamous Cell Carcinoma of the Lungs

Squamous cell carcinoma of the lung used to be more common but now accounts for roughly 30 percent of non-small cell lung cancers in the United States. It usually starts in the bronchial tubes, centrally in the lungs, and is commonly found after people develop a persistent cough, cough up blood, or develop recurrent respiratory infections (due to obstruction of the airways.) It has been speculated that filtered cigarettes have caused the decline in squamous cell lung cancer and that adenocarcinoma is more common now since toxins are inhaled deeper into the lungs.

Large Cell Carcinoma of the Lungs

Large cell lung cancers are less common, accounting for up to 10 percent of non-small cell lung cancers in the United States.

They occur in the outer edges of the lungs and tend to grow rapidly.

Symptoms of Non-Small Cell Lung Cancer

It's very important to be aware of the symptoms of non-small cell lung cancer. Lung cancer CT screening is available for some people who have smoked, but the majority of people need to rely on an awareness of symptoms to find the disease in the earliest stages possible.

Symptoms of non-small cell lung cancer may include:

  • A persistent cough
  • Coughing up blood
  • Shortness of breath, especially with activity
  • Wheezing
  • Hoarseness
  • Recurrent respiratory infections such as pneumonia or bronchitis
  • Unintended weight loss

Diagnosing Non-Small Cell Lung Cancer

The diagnosis of non-small cell lung cancer can be challenging, and it's not uncommon for people to at first be misdiagnosed with something else, such as asthma. Here are some of the tests and procedures often used in the diagnosis and staging of lung cancer.

Staging of Non-Small Cell Lung Cancer

Non-small cell lung cancer is broken down into 4 stages, depending on the size of the tumor and how far it has spread. You can learn more about the stages of non-small cell lung cancer and the TNM system of staging lung cancer, or learn more about specific stages in these articles:

Non-Small Cell Lung Cancer Causes

Smoking is certainly one of the major causes of non-small cell lung cancer, but there are other important causes as well. Exposure to radon in our homes is the second leading cause of lung cancer and the number one cause in people who have never smoked. If you have never tested your home for radon, do so today. Some people may also have a genetic predisposition to lung cancer, and it's notable that if someone has a primary relative with lung cancer - a mother, father, sibling, or child - their risk of lung cancer doubles. Check out these well-known as well as lesser-known risk factors for lung cancer.

Non-small Cell Lung Cancer Treatments

The treatments for lung cancer are broken down by stage. Treatments overall can be broken down into 2 types. Local treatments treat cancer where it originates and include surgery and radiation therapy. Systemic treatments are broader treatments which address cancer wherever it happens to be in the body and include chemotherapy, targeted therapies, and immunotherapy. Many people with lung cancer receive treatments with both of these forms of therapy. Possible treatments may include:

Surgery - Surgery for lung cancer can sometimes offer the chance for a cure in the early stages of the disease. In addition, some tumors that are initially too extensive for surgery may decrease after chemotherapy or radiation therapy to a point in which surgery is possible. Thankfully, treatments are improving even for those with inoperable lung cancer.

Chemotherapy - Chemotherapy may be done for lung cancer which has spread, or as "adjunctive" treatment for people who have surgery.

Radiation therapy - Radiation therapy may be done along with chemotherapy, and may be done before or after lung cancer surgery. One type of radiation therapy called stereotactic body radiation therapy (SBRT) may be used in an attempt to cure lung cancer in patients who are unable to have surgery for a potentially curative cancer.

Targeted therapies - Targeted therapies are drugs which address specific genetic changes in cancer cells which drive the growth of tumors. This area of treatment is rapidly expanding, with approved treatments being used for those with EGFR mutations, ALK rearrangements, ROS1 rearrangements, as well as other mutations via clinical trials.

Immunotherapy - Immunotherapy is an exciting new approach to lung cancer, with the first drug in this category having been approved in 2015. These treatments work by helping our own immune systems recognize and attack cancer cells.

Clinical trials - According to the National Cancer Institute, everyone with non-small cell lung cancer should consider participating in clinical trials. Learn more about finding clinical trials for lung cancer.


There are numbers which talk about the "average" life expectancy with different stages of lung cancer, but it's important to realize that these are numbers - not people. Everyone is different and responds differently to treatment. In addition, these numbers are probably not a good predictor of how someone will do anyway. Statistics are a measure of how someone did in the past with treatments that were available at that time. Of note is that there were more new treatments approved for lung cancer in the time period from 2011 to 2015, than during the 40 year period preceding 2011. In other words, numbers discussing how someone survived with lung cancer in 2010 probably say little about how someone will do today.

Newly Diagnosed - Support and Coping

If you are newly diagnosed with lung cancer, you are probably feeling terribly frightened and overwhelmed. Check out these tips on the first steps to take after a lung cancer diagnosis.  

Research tells us that learning as much as you can about your cancer may help you cope with your situation better, and may even help with outcomes. Take a moment to learn about how to find good cancer information online. Becoming connected with the community also has many benefits, as you can connect with others facing a similar situation, and also learn what they have learned along the way. Check out these online support groups and support communities.

If Your Loved One Has Been Diagnosed with Lung Cancer

Nobody experiences cancer in isolation, and some people with lung cancer have even commented to me that they feel it is more difficult for their loved ones. In addition to the fears, you may feel completely helpless. Check out this article on when your loved one has lung cancer to learn about what other people with lung cancer wish their loved ones had known. Even though it is necessary after diagnosis for life to focus on your loved one, make sure to take care of yourself as a cancer caregiver. Coping with lung cancer is a marathon, not a sprint.


American Cancer Society. Lung Cancer (Non-Small Cell.) Non-Small Cell Lung Cancer Survival Rates by Stage. 04/30/2014.

National Institute of Health. Medline Plus. Lung Cancer. Updated 08/08/16.

College of American Pathologists. Lung Cancer. Lung Adenocarcinoma. Accessed 10/30/12.

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