Vanderbilt Williamson

Non-small Cell Lung Cancer

Non-small cell lung cancer is a disease where cancer cells form in the lung. The kinds of cancer cells vary with each type of non-small cell lung cancer. Each kind grows and spreads in a different way. The types of non-small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look under a microscope:

• Squamous cell carcinoma
• Large cell carcinoma
• Adenocarcinoma

Other less common types of non-small cell lung cancer are:

• Adenosquamous carcinoma
• Carcinosarcoma
• Salivary gland type carcinoma
• Unclassified carcinoma

Diagnosis

These tests can help detect and diagnose non-small cell lung cancer:

• Physical exam and history
• Laboratory tests
• Chest x-ray
• CT scan (CAT scan)
• PET scan (positron emission tomography scan)
• Sputum cytology
• Fine-needle aspiration (FNA) biopsy of the lung
• Bronchoscopy
• Thoracoscopy
• Thoracentesis
• Light and electron microscopy

Symptoms

Non-small cell lung cancer may cause some of these symptoms, but other conditions may cause the same symptoms. See a doctor if you have any of these problems:

• Cough that doesn’t go away
• Trouble breathing
• Chest discomfort
• Wheezing
• Streaks of blood in mucus coughed up from the lungs (sputum)
• Hoarseness
• Loss of appetite
• Weight loss for unknown reason
• Fatigue

Treatment

There are several options for standard treatment:

Surgery: 4 types are used:

• Wedge resection: This takes out the cancer and some of the healthy lung around it.
• Lobectomy: This takes out a whole lobe (section) of the lung.
• Pneumonectomy: Surgery that takes out a whole lung.
• Sleeve resection: Surgery that takes out part of a bronchial tube, which connects your lungs to your windpipe.

Some patients may be treated with chemotherapy or radiation after surgery to make sure the cancer does not come back. This is called adjuvant therapy.

Radiation therapy: Radiation therapy uses x-rays or other kinds of radiation to kill cancer cells or slow their growth.

There are 2 kinds of radiation therapy. The type of treatment used depends on the type and stage of the cancer.

• External radiation therapy: A machine beams radiation into the body, targeting the cancer.
• Internal radiation therapy: Needles, wires or catheters containing a radioactive compound are put into or near the cancer.

Radiosurgery puts radiation on the cancerous area, leaving healthy tissue intact. It can help treat cancer in patients who can’t have surgery.

The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy: Chemotherapy is a treatment using drugs that kill cancer cells or slow their growth. There are several types of chemotherapy available, depending on the type and stage of the cancer.

Targeted therapy: Targeted therapy uses drugs that kill cancer cells without hurting normal ones. To learn more about targeted therapy and other advanced ways of treating cancer, visit our Breakthroughs page.

Laser therapy: This treatment uses a focused beam of energy to kill cancer cells.

Photodynamic therapy (PDT): This treatment uses a drug activated by light and a certain type of laser light to kill cancer cells. The drug is injected into the body, and it collects in cancer cells. Small tubes beam the light into the cancer cells, activating the drug. Cancer cells die, but healthy cells are left along. PDT often treats tumors on or under the skin, or in the lining of organs.

Cryosurgery: This treatment freezes and destroys cancerous tissue.

Electrocautery: This treatment uses a heated instrument to destroy cancerous tissue.

Watchful waiting: This is when doctors keep track of your health, waiting for symptoms to appear or change before starting treatment.

Successful recovery depends on:

• Tumor’s size and whether it is in the lung only or has spread to other places in the body. This is also called the cancer’s stage.
• Lung cancer type
• Whether there are symptoms such as coughing or trouble breathing
• Patient’s general health

Current treatments do not cure this kind of cancer. If you have this condition, talk to your doctor about joining a clinical trial to help in the search for better treatments.

Risk Factors

• Smoking cigarettes, pipes or cigars
• Breathing second-hand smoke
• Being treated with radiation therapy to the breast or chest
• Being around asbestos, radon, chromium, nickel, arsenic, soot or tar
• Living where there is air pollution

When smoking is combined with other risk factors, the risk of getting lung cancer rises.

Related Links

Vanderbilt-Ingram Cancer Center

National Cancer Institute

American Cancer Society

American Lung Association

LUNGevity