What is non-small cell lung cancer?

Cancer that starts in the lung is called primary lung cancer. There are two main types of primary lung cancer - non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

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 carcinomaThis 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.

If you have been told you have a rare type of NSCLC called ALK+ lung cancer, you can find information and support at ALK Positive UK.

Causes and symptoms of non-small cell lung cancer

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.

If you are worried about lung cancer, we have more information about the risk factors and the signs and symptoms.

Diagnosis of non-small cell lung cancer

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:

PET-CT scan

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.

Biopsy

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:

Molecular testing

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:

  • Mediastinoscopy

    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).

  • Thoracoscopy

    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.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • Ultrasound scan

    An ultrasound scan uses sound-waves to look at parts of the body, such as the liver, to see if the cancer has spread.

  • 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.

Stages of non-small cell lung cancer

The stage of a cancer describes its size and if it has spread. The stage will be based on your test results.

You and your doctors can then talk about the best treatment choices for you.

Treatment for non-small cell lung cancer

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:

Surgery

It may be possible to remove NSCLC with surgery. This will depend on the size and position of the cancer.

Chemotherapy

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

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

Targeted therapy and immunotherapy drugs can be used to treat advanced NSCLC. Your doctor will do tests on the cancer cells to find out if certain drugs are suitable for you.

Ablation treatments

Ablation treatments use heat or laser light to treat very early-stage lung cancers. Ablation treatment can also be used if the cancer is blocking an airway.

Supportive treatment

You can have treatments to help relieve any symptoms caused by the cancer. This is sometimes called supportive care or palliative care.

After non-small cell lung cancer treatment

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.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and well-being and help your body recover.

How we can help

Macmillan Cancer Support Line
The Macmillan Support Line offers confidential support to people living with cancer and their loved ones. If you need to talk, we'll listen.
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