Is non-small cell lung cancer curable?

Yes. In the early stages, non-small cell lung cancer is curable with surgery to remove the tumor. With early detection through screening and advances in care, more people are surviving NSCLC. A complete cure may not be possible in later stages, but you still have many treatment options.

Is non-small cell lung cancer hereditary?

In some people, yes. However, many people diagnosed with lung cancer don’t have any family history. Smoking is a far greater cause of lung cancer than genetics. It’s estimated that just 8% of lung cancer cases are caused by an inherited genetic change.

What causes non-small cell lung cancer?

In about 90% of cases, the leading cause of non-small cell lung cancer is smoking. Other factors that may lead to an increased chance of lung cancer include exposure to chemicals or substances like asbestos, radon or air pollution. Sometimes, people develop lung cancer without a known cause.

Where does non-small cell lung cancer start?

Non-small cell lung cancer starts in the cells found in the inside lining of your air passages. When these cells multiply and grow rapidly, it can lead to a cancerous tumor forming in the lungs.

How does non-small cell lung cancer affect the body?

Non-small lung cancer changes how your lungs work. This can lead to shortness of breath, coughing or hoarseness. As it spreads, NSCLC can also affect the whole body, including symptoms like fatigue or loss of appetite.

Non-Small Cell Lung Cancer | Baylor Scott & White Health

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What is non-small cell lung cancer?

Non-small cell lung cancer is one of the two main kinds of lung cancer. This cancer occurs when abnormal cells in the lining of the lung start to grow rapidly.

NSCLC tends to grow at a slower rate when compared to small cell lung cancer, and it is often discovered when it has already spread in the lungs. But when non-small cell lung cancer is found early, you have more treatment options. For example, many of our hospitals offer advanced surgical procedures that preserve as much of your healthy lung tissue as possible.

For later stages of NSCLC, you may have access to innovative therapies like immunotherapy or clinical trials. No matter what type or stage of non-small cell lung cancer you have, our team will work with you to understand your options and feel confident in your treatment plan.

Non-small cell lung cancer symptoms

Many non-small cell lung cancer cases aren’t caught in the early stages because they don’t cause any lung cancer symptoms. Patients usually start to experience symptoms when the cancer has already spread, which is why screening is so important. For those deemed as high risk for lung cancer, such as current and past smokers, annual lung cancer screenings help catch lung cancer early—before symptoms begin.

When NSCLC does start to cause symptoms, they may feel similar to other lung conditions, such as a chest infection. While symptoms are often caused by something other than cancer, it’s important to pay attention to what your lungs are telling you and speak with your doctor about any ongoing discomfort.

NSCLC causes and risk factors

Many causes and risk factors for non-small cell lung cancer (NSCLC), specifically a history of smoking, are well known. However, it is possible for people who have never smoked to develop the condition. Other factors, from your environment to your genetics, might play a role, too. Sometimes, it’s possible to develop lung cancer without a known cause.

Some risk factors for non-small cell lung cancer include:

Tobacco use: Smoking is one of the main risk factors for all types of lung cancer. About 80-90% of lung cancers are linked to smoking history, and secondhand smoke may also increase your risk.
Asbestos exposure: People who work with asbestos have an increased risk of lung cancer. Protective equipment is important to help reduce this risk.
Radon: Radon is an odorless gas that naturally occurs in the environment. If high levels of this gas become concentrated indoors, like in your home, this exposure increases your risk of lung cancer.
Air pollution: Regular exposure to high levels of air pollution may also cause you to have a higher risk of lung cancer. You can check your air pollution forecast and avoid outdoor activities when the level is high.
Workplace exposure: Some jobs expose people to other substances or chemicals linked to a risk of lung cancer. These include coal or wood cooking flames, fumes from diesel, radiation exposure or chemicals like arsenic, chromium and nickel.
Existing medical conditions: If you’ve been diagnosed with another lung condition, it may significantly increase your risk for lung cancer, including chronic obstructive pulmonary disease and pulmonary fibrosis.
Previous radiation therapy: If you’ve had radiation therapy in your chest area to treat another type of cancer, it can increase your risk for lung cancer. This could include treatment for breast cancer or some types of lymphoma.
Genetics: Some types of lung cancer may be affected by genetics. If you have a strong family history of lung cancer, talk with your doctor about your risk.

Diagnosing NSCLC

If you have a high risk of lung cancer, an annual screening can diagnose it early, when it’s most treatable. For those between 50 and 80 years old with a history of smoking, a low-dose CT scan can look for early signs of lung cancer before any symptoms appear.

If you’re experiencing any non-small cell lung cancer symptoms, your care team has many different imaging tests and other diagnostic tools to help get to the source of your symptoms. If lung cancer is found, then your team may use additional tests to understand your specific diagnosis and what treatments may work for you.

Medical history and physical exam

Your provider will ask about your medical and family history and perform an exam. Your care team may then recommend specific tests to diagnose the cause of your symptoms.

Imaging tests

Different imaging tests are available to give you and your care team a closer look at your lungs. Some common imaging tests that are used to look for signs of lung cancer and understand if it has spread include:

Chest X-ray: Regular screenings with chest X-rays are not recommended as the primary tool for diagnosing lung cancer. However, signs of lung cancer or visible tumors can be found on an X-ray, so you may have this as an initial test if you’re experiencing symptoms.
Computed tomography (CT) scan: A low-dose CT scan is the primary imaging test used to screen for lung cancer. You may also have a CT scan as a follow-up to another imaging test.
Magnetic resonance imaging (MRI) scan: An MRI scan creates images of soft tissues in the body. This imaging test is often used to see how far lung cancer has spread in the chest.
Positron emission tomography (PET) scan: PET scans help highlight cancer cells in the body using a special radioactive sugar. Sometimes, they are combined with a CT scan to help diagnose lung cancer and see if it has spread.
Bone scan: A bone scan uses a small injection of radioactive tracer to detect lung cancer that has spread to the bones.

Sputum cytology

Sputum, sometimes called phlegm, is the mucus that you cough up from your airways. A sputum cytology test collects samples of your sputum and then looks for cancer cells under a microscope in the lab. This test doesn’t find all lung cancers, so it’s typically performed as part of a broader treatment plan.

Thoracentesis

Thoracentesis takes a fluid sample from your chest to look for cancer cells. During this procedure, a spot on your chest is numbed and a needle is carefully inserted to draw a fluid sample.

Biopsy

A lung biopsy uses several different methods to take tissue samples in or around the lungs. These tissue samples are then reviewed by a pathologist—a doctor who specializes in diagnosing conditions using samples of body tissue or fluid—to look for signs of cancer.

Fine-needle aspiration (FNA) biopsy: A small needle is guided by imaging through spaces between your ribs to take a sample of fluid or tissue from your lung.
Bronchoscopy: Your care team may take a biopsy during a bronchoscopy, which uses a scope inserted through your throat to reach your airways. Many of our locations offer robotic bronchoscopy, which improves precision.
Thoracoscopy or video-assisted thoracic surgery (VATS): Thoracoscopy is a minimally invasive surgical procedure that uses small incisions and surgical instruments guided by a tiny video camera. Your surgeon may take a sample of tissue during the procedure.
Endobronchial ultrasound: This procedure uses ultrasound to guide a bronchoscope down the throat and into the major airways. It can be used to see lymph nodes in your lungs and take samples without an incision.
Endoscopic esophageal ultrasound: Endoscopic esophageal ultrasound combines an upper digestive tract endoscopy with ultrasound imaging. Your care team can reach the nearby lymph nodes and take tissue samples.
Mediastinoscopy or mediastinotomy: These procedures let your surgeon reach the lymph nodes under your breastbone in your chest. Mediastinoscopy uses a small incision and scope, while mediastinotomy uses a slightly larger incision on your chest between the ribs.

Biomarker testing

Some lung cancer cells have specific biomarkers, proteins or mutated genes that are different from healthy cells. As part of your lung cancer diagnosis, you may have biomarker testing , also called molecular testing, to look for these changes. If your test shows a specific biomarker, your care team may recommend therapies that are designed to target it.

Non-small cell lung cancer staging

Based on your diagnostic tests, your non-small cell lung cancer will be put into one of five lung cancer stages, ranging from 0 to 4. The lower the number, the less the cancer has spread in the body.

Stage 0: You only have abnormal cells found in the inner lining of the lungs, and these cells haven’t spread.
Stage 1: The tumor may be up to 4 centimeters, but it’s still only in the lung and hasn’t spread to the lymph nodes.
Stage 2: Your tumor may be larger and have spread into the nearby lymph nodes on that side of the chest.
Stage 3: At this stage, your tumor may be more than 7 centimeters and have spread to lymph nodes in the chest or nearby tissues.
Stage 4: In the most advanced stage, lung cancer has spread to at least one place in the body, far away from the lungs.

Non-small cell lung cancer treatment

Your team will work with you to create a plan for your non-small cell lung cancer treatment. Several treatments are available for your care and the options depend on the stage and type of your cancer.

Unlike small cell lung cancer, surgery is one of the main treatments for non-small cell lung cancer, especially in the earlier stages. Other treatments include ablation procedures, chemotherapy, radiation therapy, targeted therapies and immunotherapy.

Surgery

If you have early-stage, non-small cell lung cancer, surgery helps remove all or as much of the tumor as possible while preserving the remaining healthy lung tissue. Our lung cancer care teams offer several surgical options, including minimally invasive approaches for your care.

Lobectomy: One of the most common options in early-stage lung cancer is a lobectomy, which removes just the lobe (section) in the lung where the tumor is located.
Wedge resection: This surgical procedure removes the area of cancer in your lung and a wedge shape of healthy tissue around it.
Segmentectomy: A segmentectomy removes only one segment of the lobe that contains cancer, rather than an entire lobe.
Pneumonectomy: A pneumonectomy may be needed if all the cancer can’t be removed with a lobectomy. This procedure takes out your entire lung on one side.

Radiofrequency ablation

Radiofrequency ablation is used to destroy harmful cells using heat from high-energy radio waves. In lung cancer, radiofrequency ablation can be used to destroy small tumors that are located near the outer edge of your lung.

Radiation therapy

You may have radiation therapy and other treatments like surgery or chemotherapy for non-small cell lung cancer. Radiation therapy uses high-energy rays from outside the body or radioactive materials placed inside the body to target cancer.

External beam radiation therapy (EBRT): EBRT is the most common radiation therapy for non-small cell lung cancer. It targets cancer in your lungs and areas where it has spread, using focused radiation rays from outside the body.
Brachytherapy: Brachytherapy is internal radiation therapy. It places radioactive material into or near the tumor, often using a small pellet, seed, wire or catheter.

Chemotherapy

Several chemotherapy drugs are used today to treat non-small cell lung cancer. While the very early stages of the condition may not need any chemotherapy, it’s common to have it incorporated into your treatment plan when lung cancer has spread.

Neoadjuvant chemotherapy: This term means that you will have chemotherapy treatments before you have surgery. It may help shrink your tumor or reduce the chances of your NSCLC returning.
Adjuvant chemotherapy: Adjuvant chemotherapy is given after lung cancer surgery. The goal is to destroy cancer cells that might remain in your body after your surgery.

Surgery may not be an option for locally advanced NSCLC, where your cancer has started to spread to nearby tissues. In this case, you’ll have chemotherapy and potentially radiation therapy. For metastatic NSCLC, when non-small cell lung cancer has spread to distant areas of the body, chemotherapy could help slow its growth.

Targeted drug therapy

Targeted therapy is often a treatment in later stages of non-small cell lung cancer and can be used alongside chemotherapy. These drugs target specific gene mutations or proteins that differentiate your lung cancer cells different than healthy cells. As they specifically target cancer cells, targeted therapies tend to have fewer side effects than chemotherapy.

Monoclonal antibodies are a common type of targeted therapy for non-small cell lung cancer. These lab-made antibodies mimic the natural antibodies used by your immune system, helping your body better target and kill cancer cells.

Immunotherapy

Immunotherapy is another group of therapies used for non-small cell lung cancer, especially in the later stages of treatment. These therapies work by helping your immune cells better find and attack cancer.

One of the most common types of immunotherapies for NSCLC is immune checkpoint inhibitors. These block specific “checkpoints” on cancer cells to allow your immune cells to recognize the cells as harmful and destroy them.

Frequently asked questions

Is non-small cell lung cancer curable?

Yes. In the early stages, non-small cell lung cancer is curable with surgery to remove the tumor. With early detection through screening and advances in care, more people are surviving NSCLC. A complete cure may not be possible in later stages, but you still have many treatment options.
Is non-small cell lung cancer hereditary?

In some people, yes. However, many people diagnosed with lung cancer don’t have any family history. Smoking is a far greater cause of lung cancer than genetics. It’s estimated that just 8% of lung cancer cases are caused by an inherited genetic change.
What causes non-small cell lung cancer?

In about 90% of cases, the leading cause of non-small cell lung cancer is smoking. Other factors that may lead to an increased chance of lung cancer include exposure to chemicals or substances like asbestos, radon or air pollution. Sometimes, people develop lung cancer without a known cause.
Where does non-small cell lung cancer start?

Non-small cell lung cancer starts in the cells found in the inside lining of your air passages. When these cells multiply and grow rapidly, it can lead to a cancerous tumor forming in the lungs.
How does non-small cell lung cancer affect the body?

Non-small lung cancer changes how your lungs work. This can lead to shortness of breath, coughing or hoarseness. As it spreads, NSCLC can also affect the whole body, including symptoms like fatigue or loss of appetite.

Non-Small Cell Lung Cancer

What is non-small cell lung cancer?

Non-small cell lung cancer vs. small cell

Non-small cell lung cancer symptoms

NSCLC causes and risk factors