Key takeaways
- Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. The most common risk factor is smoking tobacco, but radon, asbestos, air pollution, and other factors can also raise the risk.
- Early-stage NSCLC may be treatable via surgery, but diagnosing lung cancer this early can be challenging, since it doesn’t always cause symptoms. Regular screening can help for those at high risk.
- Other treatments include radiotherapy, chemotherapy, immunotherapy, and targeted therapy.
Non-small cell lung cancer (NSCLC) makes up most cases of lung cancer today. Read on to learn about the types, symptoms, causes, treatments, and outlook for this condition.
There are two main categories of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
Of the two, NSCLC is the most common, comprising
However, because NSCLC is an umbrella term for any lung cancer that isn’t SCLC, it encompasses a wide range of cancer types.
Types of NSCLC
The most common types of NSCLC are:
- adenocarcinoma, which accounts for
40% of all lung cancers - squamous cell carcinoma, which accounts for 25%
- large cell carcinoma, which accounts for 10%
There are also other less common types, such as:
- adenosquamous carcinoma
- sarcomatoid carcinomas
- carcinoid tumors
Within these types, there are also many other subtypes.
In its early stages, NSCLC usually doesn’t cause any symptoms. When symptoms start to develop, they can include:
- persistent cough
- fatigue
- chest pain
- breathing problems
- coughing up blood
- weakness
- unintentional and unexplained weight loss
- joint or bone pains
If the cancer spreads to other areas of the body, it can cause additional or worsened symptoms, such as:
- difficulty breathing
- problems with speech
- pain in areas where cancer cells have spread, such as in bones, head, back, or abdomen
- increased weakness or fatigue
Tobacco and secondhand smoke are
- asbestos
- radon, which is an odorless gas that can accumulate inside buildings
- diesel exhaust fumes
- coal products
- silica dust
- radiation
- arsenic
- air pollution
Genetics and a family history of lung cancer are also risk factors.
To begin with, a doctor will ask you about your symptoms, family history, and medical history. They will also perform a physical examination. If they suspect cancer, they may order tests such as:
If the tests confirm NSCLC, doctors will determine the stage of the cancer, which is important for creating a treatment plan.
To stage NSCLC, doctors
- tumor size
- nodes, or whether it has spread to lymph nodes
- metastasis, or whether it has spread to other parts of the body
There are four stages overall, but each has a series of more detailed substages. The table below presents a broad overview, but for more specific information, speak with an oncologist:
| Stage | Diagnostic factors |
|---|---|
| Stage 0 | Cancerous cells are present in the top layer of cells, but haven’t spread further. |
| Stage 1A | The tumor is no larger than 3 centimeters (cm) in diameter and hasn’t spread further. |
| Stage 1B | The small tumor is between 3 and 4 cm in diameter and hasn’t spread to any nearby lymph nodes. |
| Stage 2A | The tumor is between 4 and 5 cm in diameter and may or may not have spread to nearby lymph nodes. |
| Stage 2B | The tumor is 7 cm or less in size and has spread to nearby lymph nodes. |
| Stage 3 | Stage 3 is categorized into three substages with varying tumor sizes and spread to lymph nodes. Stage 3 cells haven’t spread to distant parts of the body. |
| Stage 4A | The cancer cells have spread within the chest and potentially to one area outside of the chest. |
| Stage 4B | The cancer cells have spread outside of the chest into more than one distant area or organ. |
| Recurrent NSCLC | A recurrence means that cancer cells have returned after treatment. This can vary by location and severity. |
Treatment for NSCLC can vary based on the stage of disease, your health, and other factors. Talk with your doctor about the best treatment option and possible side effects. A combination of treatments may yield the best results.
There are five main ways to treat NSCLC, including:
Surgery
Surgery is often suitable during the early stages of NSCLC. Depending on the location of the cancer, one of the following procedures may be necessary:
- lobectomy (removal of a lobe)
- wedge resection (removal of the tumor and some surrounding tissue)
- segmentectomy (removal of a portion of the lung)
- pneumonectomy (removal of the entire lung)
A doctor may recommend combining surgery with other treatments to ensure all cancer cells are gone.
Radiation therapy
Radiation therapy uses high-energy rays to kill cancer cells and prevent new ones from growing. It can be useful for targeting specific areas, such as the chest. It may also be an option when surgery isn’t.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. For lung cancer, chemotherapy is typically administered through an IV.
Chemotherapy can improve the outlook or reduce symptoms during all stages of lung cancer.
Targeted therapy
Targeted therapies address cancer cells specifically by targeting genes, proteins, or other substances that the cancer cells need.
New targeted therapies are helping people live longer and better with lung cancer. Speak with your doctor to see if any targeted therapies are right for you. They may need to conduct additional testing to determine whether you’re a candidate.
Immunotherapy
Immunotherapy, or biologic therapy, activates your body’s immune system to fight cancer cell growth. This type of therapy is often recommended for later-stage cancer or when other therapies aren’t suitable.
NSCLC treatment by stage
Treatments will vary based on many factors, and your doctor will tailor your treatment to you, sometimes combining therapies.
Here are some
| NSCLC stage | Common treatments |
|---|---|
| Stage 0 | surgery, photodynamic therapy (PDT), laser therapy, brachytherapy (internal radiation) |
| Stage 1 | surgery, radiation, chemotherapy |
| Stage 2 | surgery (sometimes including nearby lymph nodes), radiation, chemotherapy, targeted therapies |
| Stage 3A | surgery, chemotherapy (often combined with radiation), targeted therapies, immunotherapy |
| Stage 3B | surgery, chemotherapy (often combined with radiation), targeted therapies, immunotherapy |
| Stage 4A | surgery if health is stable, chemotherapy, radiation, targeted therapies, and immunotherapy to prolong life (other treatments, including PDT or laser therapy, may reduce symptoms) |
| Stage 4B | targeted therapies, immunotherapy, chemotherapy, and radiation to help prolong life (clinical trials for new therapies are a good option) |
Your doctor may try a different treatment if the initial treatment has stopped working. Tumors can sometimes be treated with surgery, while progression to the lymph nodes may warrant chemotherapy.
Cancers can recur after successful treatment. Treatment options will depend on the location and severity of the recurrence. It’s important to understand your diagnosis and treatment goals after a recurrence.
The outlook for NSCLC depends on several factors, including stage, location, and cancer type.
A 2025 American Lung Association (ALA) report states that the national average 5-year survival rate for any type of lung cancer is around:
- 65% for early, localized cancer
- 37% for regional cancer, which may have spread to the lymph nodes
- 10% for distant cancer, which has spread further
- 17% for unstaged tumors
These figures represent how many people survived at least 5 years based on the stage of their cancer at diagnosis. But it isn’t a prediction or a guarantee, and these figures include all types of lung cancer, including SCLC, which tends to grow faster.
Overall, the incidence of lung cancer in the United States is decreasing, and survival rates, in many states, are improving.
Because lung cancer doesn’t often cause symptoms in the early stages, though, screening is recommended for anyone at high risk.
Some risk factors for lung cancer, such as genetics, are out of your control – but there are many other ways to substantially reduce the risk of getting it.
The
Other steps you can take to reduce your risk of developing the disease include:
- asking others in the household who smoke to do so outdoors
- testing the home for radon
- following safety protocols when working with any cancer-causing substances
- not disturbing any building materials that might contain asbestos – if doing so is necessary, hire a professional asbestos removal company
- eating a balanced diet
If you may have a high risk of developing lung cancer, it’s important to speak with your doctor about lung cancer screening.
This involves having a yearly CT scan to check for signs of lung cancer. It’s noninvasive and can detect lung cancer before symptoms begin. According to the ALA, regular screening can reduce deaths from lung cancer by up to 20%.
Without treatment, lung cancer will grow and spread. It can cause a wide array of complications, such as:
- difficulty breathing
- pain
- infections
- weight loss
When lung cancer spreads, it may also affect many other body parts, such as the esophagus, bones, or brain.
Anyone with symptoms that concern them, such as a persistent cough, should speak with a doctor, especially if they have a history of smoking, a family history of lung cancer, or other risk factors.
If you’re over 50 and currently smoke, or have smoked in the last 15 years, talk with your doctor about lung cancer screening.
Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. Generally, NSCLC grows more slowly than small cell lung cancer, but it has similar risk factors and potential complications.
For early stage NSCLC, surgery to remove the cancer may be an option. Other treatments include radiotherapy, chemotherapy, immunotherapy, and targeted therapy. A doctor can advise on the best therapies for your situation.
The outlook for NSCLC is improving all the time, and clinical trials may be an option. Speak with your doctor about your goals to help you live a longer, healthier life.