Non-small cell lung cancer (NSCLC)

Non-small cell lung cancer (NSCLC) is the most common main type of lung cancer. The other main type is small cell lung cancer (SCLC) but only 10% to 15% of lung cancers are SCLC.

Cancer that starts in the lung is called primary lung cancer. The lungs are the parts of the body that we use to breathe. Lung cancer is the third most common cancer in the UK. About 49,200 people are diagnosed with it each year.

In this video Dr Ranj is joined by Dr David Gilligan to take an in-depth look at lung cancer, exploring its symptoms, testing, stages and treatment options.

Sometimes cancer spreads to the lungs from somewhere else in the body. This is called lung metastases or secondary lung cancer.

There are 3 main types:

• Adenocarcinoma is the most common type. It develops from cells that make mucus and is more often found in the outer area of the lung. Although the main cause is smoking, this type of NSCLC is more common in non-smokers.
• Squamous cell carcinoma develops in the cells that line the airways. It is more often found in the main airways in the centre of the lungs.
• Large cell lung cancer is a very uncommon type that usually starts in the centre of the lungs.
• Sometimes doctors cannot say for certain what type of NSCLC it is. This is called NSCLC not otherwise specified.

Some non-small cell lung cancers are grouped in terms of whether they produce too much of a protein that helps the lung cancer cells to grow. This happens because the lung cancer cells have a certain gene change (mutation).

These cancers usually affect people with adenocarcinoma NSCLC who have not smoked. They can be more common in younger people, especially women. They are also more common in East Asian people. For example:

• ALK positive lung cancer is when the NSCLC cells have a change in a gene called ALK. The ALK Positive UK website provides support and information you might find helpful.
• EGFR positive lung cancer is when the NSCLC cells have a change in a gene called EGFR. The EGPFR Positive UK website also provides information and support.

Smoking tobacco is the cause of most lung cancers and the biggest risk factor. This includes smoking cigarettes, cigars and pipes.

Some people who have never smoked can also get lung cancer. Around 15 in 100 people (15%) diagnosed with lung cancer are people who have never smoked. This is known as non-smoking lung cancer. The Ruth Strauss Foundation has more information.

Lung cancer is more common in older people. There are other possible risk factors, such as passive smoking. We have more information about the causes and risk factors of lung cancer.

The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging. Knowing the stage helps your doctors plan the best treatment for you.

We have more information about the staging of lung cancer.

You will have regular check-ups during and after your treatment. Some people may be on treatment for months or years if it is working well for them.

You might have CT scans or chest x-rays as part of your follow up. Appointments might be in person, or by phone or video. These will be every few months at first, but eventually they may be once a year.

Tell your doctor or specialist nurse as soon as possible if you have any problems or notice new symptoms between appointments.

We have more information about follow-up care after treatment.

People often have many different feelings when they finish cancer treatment. You may feel relieved that treatment has finished, but worried about what will happen in the future.

We have information below about some of the things people ask about after small cell lung cancer treatment. But you may have other questions or need information about something else.

Macmillan is here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.
• Visit our lung cancer forum to talk to people who have been affected by lung cancer, share your experience, and ask an expert your questions.

ALK Positive UK provides support and advocacy and aims to improve the survival and quality of life of ALK positive lung cancer patients in the UK.

EGFR Positive UK provides support and advocacy and aims to improve the overall survival and quality of life of EGFR positive lung cancer patients across the UK.

Roy Castle Lung Cancer Foundation provides information and practical and emotional support for anyone affected by lung cancer.

It can take time to recover after lung cancer treatment. Some days you may feel better than others.

Looking after yourself can help speed up your recovery. Even small lifestyle changes may improve your well-being and long-term health.

Even if you already have a healthy lifestyle, you may choose to make some positive changes after treatment. We have more information on leading a healthy lifestyle after treatment.

It is important to know where to get support or information if you need it. People often need support even some time after non-small cell lung cancer treatment. But sometimes it is difficult to know who to ask for help. To find support:

• ask your GP or someone from your cancer team for advice about support in your area
• search cancercaremap.org to find cancer support services near you
• call us free on 0808 808 0000 or talk to us online - our cancer information and support specialists can offer guidance and help you find what you need.