(NSCLC; Non-small Cell Lung Cancer; Non-small Cell Bronchogenic Carcinoma; Small Cell Lung Cancer)
Lung cancer is a disease in which cancer cells grow in the lungs. The most common type of lung cancers are:
- Non-small cell lung cancer—this is more common, and it generally grows and spreads more slowly
- Small cell lung cancer—generally grows faster and is more likely to spread to other parts of the body
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Cancer is when cells grow out of control. The cells form a clump of tissue called a growth or tumor. Cancer cells can invade nearby tissues. It can then spread to other parts of the body.
The following are known to damage to the lungs and cause lung cancer:
- First- or second-hand smoke from cigarettes, cigars, or pipes
- Exposure to asbestos (a type of mineral) or radon (radioactive gas)
Things that may raise the risk of lung cancer are:
- Using chewing tobacco
- Being around second-hand smoke
- Having a lung disease such as tuberculosis
- Family or personal history of lung cancer
- Inhaling certain air pollutants, asbestos, coal dust, or radon
- Having radiation therapy in the past to treat other cancers
- HIV infection
Most professional groups suggest that people who are at high risk be screened for lung cancer with a low-dose CT scan. High risk includes:
- Being 50 to 80 years of age
- Having a history of heavy smoking
- Being a current smoker
- Having quit smoking within the last 15 years
A person with lung cancer may have:
- A cough that gets worse over time and does not go away
- Chest pain that does not go away
- Coughing up blood
- Shortness of breath, wheezing, or hoarseness
- Pneumonia or bronchitis often
- Swelling of the neck and face
- Loss of appetite or weight loss
- Clubbing—tips of fingers and toes become wider and rounder
The doctor will ask about symptoms and past health. A physical exam will be done. The doctor will also ask about any:
- Past or present smoking habits
- Exposure to things that can harm the lungs
- Family history of cancer
Tests may include:
- Sputum cytology—mucus from the lungs is sent to a lab
- Biopsy—a sample of lung tissue is removed and looked at under a microscope
Images of the lungs and chest may be taken with:
The doctor will use results from all the tests to determine the stage of cancer. Staging helps the doctor make a treatment plan. Lung cancer is staged from 1 to 4. Stage 1 cancer has stayed in one place. Stage 4 cancer has spread to other parts of the body.
Lung cancer screening of those who are at high risk may help find lung cancer at early stages.
The goals of treatment are to remove as much cancer as possible and ease symptoms. Treating lung cancer may involve more than one of these methods:
Surgery is done to remove the tumor and nearby tissue. Lymph nodes may also need to be removed. The type of surgery depends on the stage and area. Common choices include:
- Segmental or wedge resection—a small part of the lung is removed
- Lobectomy—an entire lobe of the lung is removed
- Pneumonectomy—an entire lung is removed
Radiation can kill cancer cells and shrink tumors. It may also be used to ease symptoms such as shortness of breath. External radiation is usually used to treat lung cancer. Radiation is directed at the tumor from a source outside of the body.
Chemotherapy is the use of drugs to kill cancer cells. This may be given as pills, injections, or through a catheter. Chemotherapy is often used to kill lung cancer cells that have spread to other parts of the body.
Researchers continue to study ways to treat lung cancer. The National Cancer Institute considers these potential therapies:
- Photodynamic therapy (PDT)—A chemical is injected into the bloodstream. It stays in cancer cells longer than healthy ones. A laser aimed at the cancer activates the chemical. This chemical then kills the cancer cells that have absorbed it. This treatment may also be used to help symptoms.
- Cryosurgery—A treatment that freezes and destroys cancer tissue.
Other treatments that are being researched include:
- Targeted therapy—medicine or substances target parts of the cancer cells.
- Immunotherapy—medicine or substances help the body's immune system fight the cancer.
To help reduce the risk of lung cancer:
- Do not start smoking or vaping. People who smoke or vape should talk to their doctor about how to successfully quit.
- Avoid places where people are smoking.
- Check for radon gas and asbestos in the home. Have these substances removed if they are found.
- Try to avoid or limit being around harmful chemicals while working
- Cancer immunotherapy. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy.html.
- Ettinger, D.S., Wood, D.E., et al. Non-small cell lung cancer, version 3.2022, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 2022; 20 (5): 497-530.
- General information about non-small cell lung cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq.
- General information about small cell lung cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq.
- Krist, A.H., Davidson, K.W., et al. Screening for lung cancer: US Preventive Services Task Force Recommendation Statement. Journal of the American Medical Association, 2021; 325 (10): 962-970.
- Lung cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/lung-cancer.html.
- Non-small cell lung cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/non-small-cell-lung-cancer.
- Small cell lung cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/small-cell-lung-cancer.
- Targeted cancer therapies. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet.
- Thai, A.A., Solomon, B.J., et al. Lung cancer. Lancet, 2021; 398 (10299): 535-554.
- What do I need to know about lung cancer screening? American Lung Association website. Available at: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/learn-about-lung-cancer/lung-cancer-screening.
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