Non-Small Cell Lung Cancer

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Non-Small Cell Lung Cancer 101  

Lung cancer, which starts when cells from the lung tissue multiply out of control and form a mass (or tumor) in the lung, is the leading cause of cancer death in both men and women. However, as with many types of cancer, the chance of curing the disease is increased when it is caught early. There are two main types of lung cancer, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). While both cancers affect the lungs, they have several key differences, including how they are treated and the prognosis (or probable course and outcome) of the disease. This article contains information about NSCLC.  

What Is Non-Small Cell Lung Cancer? 

About 80 to 85 percent of lung cancers are NSCLC. Cancer cells originate from lung tissues. NSCLC grows more slowly than SCLC. Early diagnosis is critical in the treatment of NSCLC. The cause of NSCLC is unknown. Although it is usually associated with a history of smoking, this cancer can also occur in non-smokers. Other risk factors for NSCLC include exposure to indoor pollutants such as asbestos, metal dust, or mineral dust; a history of chronic obstructive pulmonary disease or HIV/AIDS; and previous radiation therapy.   

The symptoms of NSCLC and SCLC are similar:  

  • Difficulty breathing or wheezing 
  • Chest pain or discomfort 
  • A cough that does not go away or gets worse over time 
  • Blood in saliva 
  • Difficulty swallowing 
  • Hoarseness 
  • Loss of appetite 
  • Unexplained weight loss 
  • Swelling in the face and/or neck veins 
  • Fatigue

What Are the Types of Non-Small Cell Lung Cancer? 

The most common subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.  

  • Adenocarcinoma: This is the most common type of NSCLC in many parts of the world. Adenocarcinoma is usually found in the outer parts of the lung and may spread to the lymph nodes. Lung adenocarcinomas begin in cells that normally secrete substances such as mucus. It is more common in women than men. Although this form of NSCLC is associated with a smoking history, it can also occur in non-smokers. 
  • Squamous cell carcinoma: This form of NSCLC starts in squamous cells, which are flat cells that line the inside of the lungs, and most often in the main airway (or bronchus). This type of cancer has also been associated with a history of smoking. 
  • Large cell carcinoma: These malignancies can appear anywhere in the lung. They tend to grow and spread rapidly, which can make treatment a challenge. Sometimes called undifferentiated carcinoma.

What Is The Difference Between Non-Small Cell Lung Cancer and Small Cell Lung Cancer? 

  • NSCLC has a better prognosis than SCLC. 
  • When SCLC cells are examined under a microscope, they appear small and round. Non-small cell lung cancer cells are larger. 
  • NSCLC grows slowly, while SCLC grows much more aggressively. 
  • NSCLC is far more common, accounting for up to 85 percent of lung cancer cases. SCLC is rarer and accounts for 10 to 15 percent of cases. 
  • According to the National Cancer Institute, the overall five-year survival rate for NSCLC is 26 percent. The overall five-year survival rate for SCLC is 7 percent. 

NSCLC is classified in four stages: 

  • Stage I: The cancer is in only one lung. 
  • Stage II: The cancer is larger than in stage I and may have spread to lymph nodes in the chest. 
  • Stage III: The cancer has reached lymph nodes and other structures in the lungs and chest area. 
  • Stage IV: The cancer has spread to both lungs and/or other parts of the body.

SCLC is generally classified in two stages: 

  • Limited stage: The cancer is limited to one side of the chest, which typically means one lung and possibly nearby lymph nodes. 
  • Extensive stage: The cancer has spread widely throughout one or both lungs, and possibly to other parts of the chest and other distant organs. 

Sources: American Cancer Society, Cleveland Clinic, MedicineNet, WebMd