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Lung cancer is the leading cause of cancer death in the U.S.
1 man out of 17 may get lung cancer.
1 woman out of 18 may get lung cancer.
Black men have a 12% higher risk for lung cancer, but Black women are 16% less likely to get it.
Smoking has the highest risk - 15 to 30 times more likely to get lung cancer.
Up to 20% of people with lung cancer have never smoked.
It's called "non-small cell" because the cancer looks larger than regular lung cells under a microscope. NSCLC is the most common cancer in the lung and makes up about 87% of all lung cancers.
NSCLC is more common in people 65 and older, but anyone can get it.
There are three main types of non-small cell lung cancer:
Bathed in fluid, your lungs sit in a thinly lined space called the pleural cavity.
Carcinoma means the cancer cells start to grow from this lining around your lung and airways. Your airways include your bronchi, bronchioles, and alveoli (tiny air sacs).
Cancer cells grow quickly and often make mistakes called gene changes or mutations.
The mutations help cancer cells invade nearby pleural tissues, lymph nodes, and distant organs.
To spread, lung cancer cells break away from the main tumor and travel through your blood or lymph system.
When lung cancer spreads, a new tumor can form in other parts of your body. Knowing which type of NSCLC you have helps you get the best treatment.
Non-small cell lung cancer (NSCLC) cells don't look like small cell carcinoma and there are many different kinds.
1. Adenocarcinoma
Many common sub-types, but often look like the mucus-making cells from glands that line the tiny air sacs of your lung.
2. Squamous cell carcinoma
Also called squamous carcinoma, tumors start in the flat cells lining the airways and can block your airflow.
3. Large-cell carcinoma
Large-cell tumors lack features of other non-small cell lung cancers and act more like immature lung cells, also called poorly differentiated.
4. Adenosquamous carcinoma and more
Found anywhere in your lung, fast growing adenosquamous carcinoma mixes adenocarcinoma and squamous cancer cells. NSCLC can also include some neuroendocrine neoplasms and more.
Over time, cancer cells can stop responding to your cancer medicines. It's called treatment resistance.
Treatment resistance happens after your lung cancer cells get more gene changes. Some of the mutations also help the cancer cells live, grow, and progress. This can drive the spread of your cancer (called metastasis) to other body parts.
If this happens, your doctor will run tests to identify any new mutations and switch your treatment. They may order:
Imaging tests like CT, PET scans, MRI, or X-rays to pinpoint cancer in your body.
Biopsy to test a small piece of lung or pleural fluid for cancer cells.
Molecular testing to find any new mutations.
Biomarker tests to check for cancer protein targets like PD-L 1 or EGFR.
Immunohistochemistry, which uses special dyes to stain your cancer cells.
Your doctor will review your tests with you and choose the best treatment.
Some targeted treatments and immunotherapies can block specific proteins made from your specific NSCLC mutation.
These medicines can target the NSCLC genetic mutations and work better to:
Some of the most common NSCLC mutations include:
NSCLC is often called "late stage" when the mutations cause your lung cancer cells to:
Your lungs lack nerve endings, and without pain, lung cancer cells can quietly grow. That's why most lung cancers aren't found until later.
Sometimes, you might not feel much different at first. Some people just start with a cough that lingers or comes back.
Once lung cancer invades other organs, you may start to get symptoms.
NSCLC commonly spreads to your:
Symptoms usually depend on where the non-small-cell cancer cells spread.
Lung tumors can grow larger and irritate your airways. Some lung tumors can block airflow or press on nearby nerves.
The pressure on your lung structures and tissues can cause:
Fluid can also build up inside your pleural cavity. The extra fluid can make breathing harder. This extra fluid is called pleural effusion.
About half of people with late-stage NSCLC get serious fluid buildup.
Fluid in the pleural cavity builds up on your lungs.
Fluid builds up in the sac around your heart.
As your cancer grows into other tissues, your symptoms can depend on the location.
But knowing what to look for can help you prevent NSCLC complications.
Stage 3 (III) NSCLC cancer spreads to the tissues or lymph nodes near your lungs and chest, but not to other organs. It's also called locally advanced disease.
You may notice:
If your fingertips look swollen or rounded, also called clubbing, you may have lower oxygen levels in your blood.
Clubbing isn't just tied to cancer — it happens with other chronic lung diseases, too. But it's a good reason to ask your doctor about getting tests like a CT scan.
Non-small cell lung cancer (NSCLC) that grows in other parts of your body often causes signs and symptoms.
Brain:Headaches, confusion, balance changes, seizures, and speech problems.
Eye:A droopy eyelid, smaller pupil, and little to no sweat on one side of your face.
Voicebox:A hoarse or raspy voice.
Lymph Nodes:Swollen lumps in the neck or above your collarbone.
Mid-body:Weakness and fatigue, not having much energy or strength.
Bones:Deep pain — often in your arms, legs, or spine — easier broken bones, and tenderness.
Around the Lungs (Pleural Cavity):Symptoms that won't go away, get worse, or come back:
Stomach:Nausea, not feeling hungry, and losing weight without trying.
Liver:Right-side fullness under the ribs, yellow eyes or skin (jaundice), and nausea.
Adrenal Glands:Back pain, belly pain, fatigue, and dizziness.
Fingers or toes:Rounded, swollen fingertips or toes, also called clubbing.
Legs:Blood clots in your legs or lungs (pulmonary embolism).
Stage 4 (IV) NSCLC spreads beyond your chest — it's the most advanced stage. Your cancer may be in:
Your symptoms often depend on where the cancer travels.
(opposite lung or pleural lining)
Many symptoms can also come from other health issues or treatment side effects.
Depending on the NSCLC mutations and other factors, your doctor can help you choose the best treatment.
Remember the cancer cell mutations mentioned earlier? This treatment can target those gene changes and focus on your specific cancer cells. It may also cause fewer side effects than chemotherapy.
This medicine helps your immune system find and attack cancer cells. Some people stay on treatment long term - alone or with chemotherapy.
This whole-body treatment helps kill fast-growing non-small-cell lung cancer cells. And it can help if other medicines stop working, with or without a cancer cell mutation. Chemo can also help shrink tumors quickly to ease symptoms.
Focused energy beams can shrink tumors, ease pain, or relieve pressure. Your doctor may use this therapy to prevent or control symptoms in specific areas, like your chest, brain, or bones.
Everyone's lung cancer is different, and tests can show if your cancer has certain mutations, which help tailor your treatment just for you. But these special lab tests can take time, even weeks.
Your health care team will help you keep track of how your treatment works. Regular follow-up visits and scans are key.
But you can also help by speaking up. Tell your doctor if you notice signs or symptoms between visits. This can also
help you prevent lung cancer complications.
Learning about potential complications can help you speak up early if something doesn't feel right. It can also help you and your doctor prevent or slow down serious problems later on.
Spinal cord compression
If the cancer cells spread to your spinal cord, the tumor can press on your nerves. This pressure can cause weakness, tingling, and problems with peeing and bowel movements.
Superior vena cava (SVC) syndrome
Your tumor can press on a large vein that carries blood from your head and arms to your heart. You may notice swelling in your face, neck, or upper chest.
Massive hemoptysis
Tumors can damage blood vessels in your lungs to cause heavy bleeding, and you may cough up large amounts of blood.
Blood clots
Sometimes lung cancer can raise your risk for blood clots. This can cause a higher risk for deep vein thrombosis (DVT) and clots in your lungs (pulmonary embolism).
Horner syndrome
A tumor near the top of your lungs, a superior pulmonary sulcus or Pancoast tumor, can press on nearby nerves. You might notice symptoms like a droopy eyelid, a smaller pupil, or less sweating on one side of your face.
Paraneoplastic syndrome
Some tumors let out substances that change how your nerves, muscles, or hormones work. Symptoms can include muscle weakness, peeing too much, confusion, or balance problems.
Not every symptom means cancer progression, but your care team can act early and tailor treatment to your needs. Speak up early and tell your care team right away if you notice:
You may have concerns or think about taking up too much of your doctor's time. Try to stay open about what's changing, it actually helps your doctor and care team act faster.
They can't fix what they don't know about, so report changes early.
Try to talk of how fatigue shows up in your day instead of just saying "I'm tired."
Can you still climb stairs, cook, or shower without rest? Describe how symptoms limit you to help your doctor decide what treatment or support might help.
Write down when symptoms start, what makes them better or worse, and how they affect your routine.
Bring those notes to each visit or send a message through your patient portal. This helps your team spot patterns and tailor your care.
Tell your doctor about symptoms that limit your day.
Do you have trouble sleeping? Eating? Staying active?
Supportive treatments like breathing therapy, medications, or palliative care can make a real difference.
Mention symptoms, even ones that may feel uncomfortable or embarrassing like sexual changes, bowel issues, or low mood. These are part of your overall health, and your team has ways to manage them.
Ask how to reach your doctor or clinic between visits and who to call after hours. Knowing when and how to get help can ease anxiety and prevent last-minute emergencies.
Let your team know your goals and priorities, whether it's staying independent, minimizing hospital time, or having energy for family. Your care plan can reflect what's most important to you.
Palliative care for lung cancer helps you manage your symptoms and improve your life quality.
Unlike short check-ins, palliative care specialists often give you more time to talk about how you're doing and what matters most.
They'll also help adjust your medications, suggest therapies, or connect you with resources to make daily life easier.
Palliative care can help treat and ease:
And starting early palliative care is even better for you.
Starting palliative care within a month or two after diagnosis with late-stage NSCLC may help you feel better overall and even help you live longer.
One major study showed that people with metastatic NSCLC who got palliative care with regular cancer treatment:
These benefits may come from better symptom control, better emotional well-being, and clearer talks about goals and wishes.
Managing stress, pain, and side effects early can also help you stay strong enough to continue
treatment longer.
Palliative care is just another word for supportive care — you can get it any time after your NSCLC diagnosis.
Hospice starts when you're no longer treating your condition and you'd like to focus solely on symptom management. Choosing hospice means you'll get care that honors your goals and focuses on how you want to spend your time.
The hospice team helps provide comfort, peace, and dignity to you and your family.
Hospice usually starts when you're in the last six months of life, but you can bring it up before that.
Your cancer team can tell you what it involves and what support is available, when that time comes.
The goal of advanced lung cancer care is the same no matter if it's through active treatment, palliative care, or hospice. You'll likely get help to:
Hospice care also extends to your family. Your care team can provide knowledge and show your loved ones where to find support.
Whatever you choose, your advanced lung cancer care team can help. They care about your physical and mental health journey.
