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Types of non-small cell lung cancer
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. There are three main types:
- Adenocarcinoma –This develops from mucus-producing cells that line the airways.
- Squamous cell carcinoma – This develops in the cells that line the airways.
- Non-small cell lung cancer not otherwise specified (NOS) – This is when the pathologist cannot say for certain which type of NSCLC it is. This type is uncommon.
Smoking cigarettes is the main cause of lung cancer. People who do not smoke can still develop lung cancer, but their risk is much lower.
If someone stops smoking, their risk of developing lung cancer gets lower over time. After about 15 years it is almost the same as a non-smoker.
Lung cancer is also more common in older people.
People who have symptoms usually begin by seeing their GP. If they think your symptoms could be caused by lung cancer, they will arrange either:
If these tests show anything abnormal, your GP will refer you to a chest specialist within 2 weeks. Sometimes they will do this before getting the result of the chest x-ray.
Other tests you may have at the hospital include:
A PET-CT scan combines 2 types of scan. A CT takes a series of x-rays to build up a 3D picture. A PET measures the activity of cells in the body.
The doctor or nurse collects samples (biopsies) of cells or tissue from the lung or nearby lymph nodes. The samples are checked under a microscope for cancer cells. This test can help diagnose lung cancer and show whether it is SCLC or NSCLC. There are different ways of collecting biopsies, including:
Your doctors may arrange more detailed tests on cancer cells taken during a biopsy or surgery. If you have NSCLC the results can tell your doctor if certain targeted or immunotherapy drugs are likely to work for you
Waiting for test results can be a difficult time, we have more information that can help.
Furthers tests after diagnosis
If tests show you have lung cancer, your specialist will arrange further tests. These may be to find out the stage of the cancer:
A mediastinoscopy is when the doctor inserts a long, thin tube into your chest through a small cut at the base of your neck. You have this under a general anaesthetic. They examine the middle of the chest and lymph nodes and take samples of tissue (biopsies).
A thoracoscopy is when the doctor inserts a thin tube through cuts in your chest. You have this under a general anaesthetic. They take samples (biopsies) of the lining of the lungs (the pleura) and can remove fluid that may have collected there.
Breathing and heart tests
Breathing and heart tests are used to check how well your lungs and heart are working. You may have this if your treatment plan involves surgery or radiotherapy.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your doctor will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.
You can read an overview of the different treatment options for NSCLC.
You may have a combination of treatments for NSCLC including:
It may be possible to remove NSCLC with surgery. This will depend on the size and position of the cancer.
Chemotherapy may be given before or after surgery for NSCLC. Or it can be given with radiotherapy treatment. This is called chemoradiation. Chemotherapy can also be given to control symptoms when lung cancer has spread.
Radiotherapy may be used instead of surgery to treat early stage NSCLC. It can also be given with or after chemotherapy. This is called chemoradiation. Radiotherapy can also be given to control symptoms.
Targeted therapy and immunotherapy drugs
You can have treatments to help relieve any symptoms caused by the cancer. This is sometimes called supportive care or palliative care.
Follow-up after treatment
You have regular follow-up appointments after treatment.
You may get anxious before the appointments. This is natural. It may help to get support from family, friends or a support organisation. You can also call the Macmillan Support Line on 0808 808 00 00.