Cancer - lung - non-small cell; Non-small cell lung cancer; NSCLC

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:

• Adenocarcinomas are often found in an outer area of the lung.
• Squamous cell carcinomas are usually found in the center of the lung by an air tube (bronchus).
• Large cell carcinomas can occur in any part of the lung. They tend to grow and spread faster than the other two types.

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.

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

• Cough that doesn't go away
• Coughing up blood
• Shortness of breath
• Wheezing
• Chest pain
• Loss of appetite
• Losing weight without trying
• Fatigue

Other symptoms that may be due to NSCLC:

• Weakness
• Swallowing difficulty
• Nail problems
• Joint pain
• Hoarseness or changing voice
• Swelling of the face
• Facial paralysis
• Eyelid drooping
• Bone pain or tenderness

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

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:

• Chest x-ray
• CBC
• Sputum test
• Bone scan
• CT scan
• MRI
• Positron emission tomography (PET) scan
• Thoracentesis

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:

• Bronchoscopy combined with biopsy
• Pleural biopsy
• CT scan directed needle biopsy
• Mediastinoscopy with biopsy
• Open lung biopsy
• Endoscopic esophageal ultrasound (EUS) with biopsy

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:

• Stage 0 - the cancer has not spread beyond the inner lining of the lung
• Stage I - the cancer is small and hasn't spread to the lymph nodes
• Stage II - the cancer has spread to some lymph nodes near the original tumor
• Stage III - the cancer has spread to nearby tissue or spread to far away lymph nodes
• Stage IV - the cancer has spread to other organs of the body such as the other lung, brain, or liver