Symptoms and Signs of Non-Small-Cell Lung Cancer (NSCLC)

Medical Author:
Medically Reviewed on 11/6/2021

Doctor's Notes on What Is Non-Small-Cell Lung Cancer (NSCLC)?

Non-small-cell lung cancer (NSCLC) is a general term for all lung cancers that are not the small-cell type of lung cancer. NSCLC's have several types: adenocarcinoma, bronchoalveolar, squamous cell, and large cell carcinoma. Signs and symptoms are absent in about 10% of patients with NSCLC and are found incidentally. The NSCLS types can produce one or more of the following symptoms: cough, shortness of breath, wheezing, difficulty taking a deep breath, blood in sputum when coughing, repeated pneumonia infections, chest pain, possibly hoarseness, and difficulty swallowing. NSCLC can metastasize to other organs like the liver, adrenal glands, bones, and brain where other symptoms, related to the specific organ, may develop. In addition, NSCLC's infrequently may indirectly cause high calcium blood levels, increased hormone production, and blood clots.

Causes of symptoms and signs of NSCLC's are due to pressure that the tumors place on lung tissues, blood vessels, and/or nerves or by lung tissue invasion by the cancer cells. However, the cause of the development of the NSCLC types of cancers themselves is tobacco smoking in about 90% of individuals; secondhand smoke is also a risk factor. Other links to NSCLC development can be asbestos exposure, radon gas, and other environmental agents like aromatic polycyclic hydrocarbons, beryllium, nickel, copper, chromium cadmium, and diesel exhaust.

What Are the Treatments for Non-Small Cell Lung Cancer (NSCLC)?

Treatment options for NSCLC are varied. According to the American Cancer Society, treatments are based mainly on the stage or extent of the cancer although lung function, the patient's health, and the cancer's traits can play a role. The following is a simplified list of NSCLC stages (0-IVB represent increasing severity of NSCLC) and include treatment options:

  • Stage 0: Surgery (small tumor completely removed), or photodynamic therapy, laser, or internal radiation
  • Stage I: Surgery (lung lobectomy, wedge resection, for example); options for chemotherapy and radiation therapy after surgery
  • Stage II: Surgery (lung lobectomy, possible pneumonectomy, and/or lymph node removal, for example); options for chemotherapy and radiation after surgery
  • Stage IIIA: usually starts with chemotherapy and radiation together; some patients may get surgery, immunotherapy, and may qualify for targeted drug therapy
  • Stage IIIB: usually starts with chemotherapy and radiation therapy; surgery cannot remove all of the cancer cells, immunotherapy may be the first treatment
  • Stage IVA: NSCLC spread only to one other body site (like the brain); treatment may first treat the other site with surgery and radiation before treating the lung cancer
  • Stage IVB: In this severe stage where NSCLC has spread throughout the body, the cancer is often treated first by targeted therapy, especially if the cancer cells have a certain genetic makeup.

Your medical team will help determine the best treatment for your NSCLC.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.