What Is Non-Small Cell Lung Cancer? Symptoms, Stages, Treatment, and More
Updated on July 8, 2025
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There are two main types of lung cancer: small-cell and non-small cell. Non-small cell lung cancer (NSCLC) is the most common type, accounting for roughly 87 percent of all cases.
NSCLC is the out-of-control growth of cells in the tissue of the lungs. These cells can form tumors and spread (metastasize) to other areas of the body, becoming life-threatening.
Non-small cell lung cancer is a very serious illness. If caught early, though, there are effective therapies. For some people whose cancer has spread, new treatments, especially in the emerging fields of targeted therapy and immunotherapy, can slow disease progression and improve quality of life.
Types of Non-Small Cell Lung Cancer
Physicians typically divide NSCLC into two broad categories, squamous cell carcinoma and adenocarcinoma.
Squamous Cell Carcinoma
Squamous cell carcinoma accounts for about 30 to 35 percent of all lung cancer cases. It starts in the squamous cells, flat cells that line the lung's airways. This type of cancer usually grows in the center of the lung. Squamous cell carcinoma is nearly always associated with smoking.
Adenocarcinoma
Adenocarcinoma accounts for about 50 to 60 percent of all lung cancers. Adenocarcinoma often develops in the outer parts of the lung. As with squamous cell carcinoma, it is linked to smoking, though it can also occur in patients who have never smoked. More women develop adenocarcinoma than men, and it's the most common type to affect younger people.
Other Kinds of NSCLC
Less-common forms of NSCLC include adenosquamous carcinoma, large-cell carcinoma, and sarcomatoid carcinoma.
Small-Cell vs. Non-Small Cell Lung Cancer
Non-small cell lung cancer, as the name implies, occurs in cells that are larger than those affected in small-cell lung cancer. Small-cell lung cancer is less common, accounting for only about 10 to 15 percent of all lung cancers, and is nearly always associated with smoking.
NSCLC usually grows more slowly than small-cell lung cancer, and small-cell lung cancer is more likely to spread to other parts of the body before it is diagnosed.
Physicians treat small-cell and non-small cell lung cancers differently, so knowing the type is vital.
Doctors determine the cancer type by performing a biopsy, a procedure to remove a small piece of lung tissue, and examining the cells under a microscope.
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Signs and Symptoms of Non-Small Cell Lung Cancer
Signs of lung cancer usually don't crop up until the disease is at an advanced stage. Even when people do have symptoms, they might mistake them for less dangerous health problems. Physicians may also miss the signs, especially in people who are not smokers.
Sometimes, NSCLC doesn't cause any symptoms at all. Patients might only find out they have lung cancer after getting an X-ray or CT scan for another reason.
When there are symptoms, they may include:
- A cough that doesn't go away or worsens
- Shortness of breath
- Trouble breathing
- Wheezing
- Chest pain or discomfort
- Blood in coughed-up mucus
- Hoarseness
- Weight loss
- Loss of appetite
- Tiredness
- Trouble swallowing
- Swelling in the face or the veins in the neck
Causes and Risk Factors of Non-Small Cell Lung Cancer
Smoking is responsible for about 80 to 90 percent of all lung cancers. Exposure to secondhand smoke can also lead to lung cancer.
Other causes of NSCLC include:
- Radon Radon exposure is the second leading cause of lung cancer. This colorless gas can come up through soil and find its way into buildings through small gaps and cracks.
- Arsenic Drinking water with high levels of arsenic is a lung cancer hazard.
- Radiation Therapy Radiation to the chest area — typically for the treatment of another cancer, such as lymphoma or breast cancer — can lead to lung cancer.
- Air Pollution Extended exposure to air pollution can raise lung cancer risk.
- Other Chemicals Working with or being around certain chemicals can increase the chance of developing lung cancer. Some potentially harmful substances include asbestos, uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, diesel exhaust, gasoline, chloromethyl ethers, chloride, and formaldehyde.
How Is Non-Small Cell Lung Cancer Diagnosed?
Doctors use many different tests to diagnose NSCLC and determine how advanced the cancer is.
These tests could include:
- Physical Exam Doctors might perform a general health check to look for lumps or any other signs of cancer. They may also ask about family history and health habits.
- Blood Tests Lab tests can help doctors diagnose and monitor the disease.
- Chest X-Ray A simple X-ray can let doctors see the organs and bones inside the chest.
- Computerized Tomography (CT) Scan This imaging procedure combines a series of X-ray images taken at different angles to create pictures of areas inside the body.
- Thoracentesis This procedure uses a needle to remove fluid from the space between the lining of the chest and the lung. A pathologist examines the fluid to look for cancer cells.
- Brain MRI This is magnetic resonance imaging of the brain, as lung cancer can spread to the brain.
- PET Scan This is a highly accurate form of scan that can see not only cancer in the lungs but if it has spread to other parts of the body.
If doctors suspect NSCLC, they'll perform a biopsy in order to make an official diagnosis. This procedure involves analyzing lung cells under a microscope.
There are different ways to collect cell samples, including the following:
- Fine-Needle Aspiration Doctors collect tissue or fluid from the lung with a thin needle inserted through a small incision in the skin. An imaging procedure, such as a CT scan, may help physicians locate the target area. For help placing the needle, doctors sometimes use an endoscopic ultrasound. This involves inserting a thin tube, with a light and lens on the end, down the patient's throat.
- Bronchoscopy A bronchoscopy is a procedure done to view the trachea and large airways of the lung and remove tissue samples. Doctors insert a bronchoscope, a slender instrument with a light and lens, through the nose or mouth.
- Thoracoscopy This procedure allows doctors to look at the organs inside the chest and collect samples of lung or lymph node tissue. It involves inserting a thoracoscope (a thin instrument with a light and a lens) through an incision between two ribs.
- Mediastinoscopy A mediastinoscopy helps physicians look for abnormal areas in organs, tissues, and lymph nodes between the lungs, then collect samples. Doctors insert the mediastinoscope (a thin instrument with a light and a lens) through an incision at the top of the breastbone.
- Lymph Node Biopsy With this procedure, physicians remove all or part of a lymph node for examination in the lab.
Stages of Non-Small Cell Lung Cancer
Diagnostic tests allow doctors to determine the stage of cancer. Staging is a way to describe the extent of the disease and help the patient and medical team come up with the best treatment plan.
The stages for NSCLC proceed from 0 to 4. In general, the higher the number, the more advanced the disease:
- Stage 0 The cancer is limited to the inner lining of the lung.
- Stage 1 The cancer is located only in the lung and hasn't spread to nearby lymph nodes.
- Stage 2 The cancer is larger, or has spread to some nearby lymph nodes, whether it's larger or not.
- Stage 3 The cancer is very large, or has spread to nearby tissue or more distant lymph nodes in the chest.
- Stage 4 The cancer has spread to both lungs, the lining (pleura) around the lungs, to fluid in the areas around the lungs, or to distant organs in the body, such as the brain or liver.
In addition to the stage number, doctors also identify lung cancer with a letter (A, B, or C), and a second number (1, 2, or 3). In each case, the higher the number or letter, the more advanced the cancer. A stage 4B lung cancer, for instance, is much further advanced than a stage 1A lung cancer.
Treatment and Medication Options for Non-Small Cell Lung Cancer
Treatment options for NSCLC depend on many factors, including the stage, the type, the genetic makeup, and the patient's overall health.
Surgery
Doctors may recommend surgery if the cancer hasn't spread beyond nearby lymph nodes.
There are different types, including:
- Lobectomy Removal of one of the lobes of the lung
- Wedge or Segment Removal Removal of only a small part of the lung
- Pneumonectomy Removal of the entire lung
Sometimes surgeons use a method that involves only small incisions, known as video-assisted thoracoscopic surgery (VATS). Doctors insert a thoracoscope into the chest, then remove a lung lobe through the scope.
Radiofrequency Ablation
Radiofrequency ablation (RFA) uses high-energy radio waves to heat and destroy tumors. This procedure may be an option for people with NSCLC who have small tumors that are located near the outer edge of the lungs. This is only used for patients who are not good candidates for surgery because of health concerns.
RFA is usually performed as an outpatient procedure, with local anesthesia.
Chemotherapy
Chemotherapy (aka chemo) uses drugs to kill cancer cells. Doctors usually administer it through an intravenous (IV) infusion, but some chemo drugs also come in pill form.
Patients sometimes receive chemo before or after surgery, or at both times, or simultaneously with radiation therapy.
Some commonly used chemo drugs for NSCLC are:
- cisplatin (Platinol)
- carboplatin (Paraplatin)
- docetaxel (Taxotere)
- gemcitabine (Gemzar)
- paclitaxel (Taxol)
- Protein-bound paclitaxel (Abraxane)
- irinotecan (Camptosar)
- vinorelbine (Navelbine)
- pemetrexed (Alimta)
Chemotherapy can cause side effects, such as:
- Hair loss
- Nausea
- Vomiting
- Loss of appetite
- Mouth sores
- Diarrhea
- Constipation
- Fatigue
- Easy bruising or bleeding
- Increased risk of infections
Radiation
Radiation therapy uses high-energy rays or particles to kill cancer cells.
Patients might receive this therapy before or after surgery, or both, or while they're getting chemo. Sometimes doctors use it to shrink tumors that have spread to other areas in the body.
The two kinds of radiation therapy for NSCLC are:
- External Beam Radiation This uses a machine outside the body to deliver radiation to the cancer.
- Brachytherapy Doctors place small amounts of radioactive material directly into the cancer or the airway next to the cancer.
Radiation can cause side effects, such as:
- Fatigue
- Nausea
- Vomiting
- Loss of appetite
- Weight loss
- Skin changes, such as blistering or peeling
- Hair loss on treated areas
Targeted Treatments
Targeted therapy works by attaching to or blocking specific targets unique to a cancer cell. Targeted medication can be used alone or in combination with chemo, and can be given as a pill or through IV injection.
Some common targeted treatments for NSCLC include:
- Angiogenesis Inhibitors These medicines block new blood vessel growth. They include bevacizumab (Avastin) and ramucirumab (Cyramza).
- Epidermal Growth Factor Receptor (EGFR) Inhibitors EGFR is a protein on the surface of cancer cells that helps them grow. EGFR is mutated in a subset of lung cancer patients so that the “on” growth signal is always present. Drugs that block the signal from EGFR include afatinib (Gilotrif), gefitinib (Iressa), osimertinib (Tagrisso), and dacomitinib (Vizimpr).
- ALK Inhibitors ALK is a gene that is sometimes abnormal (mutated, or more accurately “rearranged”) in people with NSCLC. Similar to EGFR mutations, these changes result in the “on” growth switch to always be on. Medicines that target the ALK mutation include crizotinib (Xalkor), ceritinib (Zykadia), alectinib (Alecensa), brigatinib (Alunbrig), and lorlatinib (Lorbrena).
- BRAF Inhibitors In some cases of NSCLC, the cells have mutations in the BRAF gene, again, telling the cells to grow in an uncontrolled way. Drugs that block this mutation include dabrafenib (Tafinlar) and trametinib (Mekinist).
- New Developments More recent advances include drugs to treat HER2, KRAS, ROS1, NTRK, and MET mutations, as well as RET rearrangements.
Targeted medicines often cause less severe side effects than chemotherapy, but they can still lead to problems, such as:
- Fatigue
- Bleeding
- Headaches
- Mouth sores
- Loss of appetite
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Skin problems
- Joint pain
- Vision changes
- High blood pressure
- Increased risk of infections
Immunotherapy
Immunotherapy stimulates the body's own immune system to kill cancer cells. It is now incorporated in the first treatment of most patients with lung cancer, other than those who have a specific mutation that can be treated with a targeted therapy.
Immunotherapy medicines are given as an infusion.
Examples of immunotherapy drugs include used for NSCLC include:
- nivolumab (Opdivo)
- ipilimumab (Yervoy)
- cemiplimab (Libtayo)
- pembrolizumab (Keytruda)
- atezolizumab (Tecentriq)
- durvalumab (Imfinzi)
Side effects might include:
- Fatigue
- Cough
- Nausea
- Itching
- Rash
- Diarrhea
- Constipation
- Loss of appetite
- Joint pain
In rare cases, the use of immunotherapy can cause the immune system to attack other parts of the body, which can lead to serious or life-threatening problems in certain organs.
Laser Therapy
Rarely, lasers may be used to treat small tumors in the linings of the airways. They can also open up airways that are blocked by larger tumors.
Doctors pass a bronchoscope down the throat and aim the laser beam at the tumor to burn it away. This procedure is typically done under general anesthesia.
Clinical Trials
Patients with NSCLC may want to consider participating in a clinical trial. These studies take place in various locations around the country. Clinical trials offer access to novel investigational therapies that aren't yet available to the general public.
More information on clinical trials is available on the National Cancer Institute's Clinical Trials Information for Patients and Caregivers page.
Prevention of Non-Small Cell Lung Cancer
You are at increased risk of developing NSCLC if you:
- Smoke or have smoked in the past
- Have been exposed to secondhand smoke
- Have been around cancer-causing agents, such as radon, mustard gas, asbestos, uranium, arsenic, diesel, coal, or others
- Had radiation therapy to your chest
- Have a family history of lung cancer
- Had lung cancer
- Have been exposed to air pollution
- Have taken beta-carotene supplements while being a smoker
There may be certain measures you can take to lower your risk of NSCLC. The first step is to avoid smoking or quit smoking right away. When you stop smoking before cancer develops, your damaged lung tissue starts to repair itself. Quitting smoking can lower your risk of lung cancer and help you live longer, regardless of how many years you've smoked.
Avoiding exposure to harmful substances and chemicals can also help you reduce your risk of NSCLC. Additionally, some studies suggest that consuming a diet high in fruits and vegetables can protect you from lung cancer, whether you're a smoker or not.
Non-Small Cell Lung Cancer Prognosis
The outlook for people with NSCLC varies depending on the stage of disease. Stage 1 and 2 cancers have the highest cure rates. There are effective treatments for some stage 3 cancers, and a subset of patients may be cured of their disease. Historically, stage 4 NSCLC was considered treatable — meaning therapy can prolong life — but incurable. But with new therapies, a subset of patients go into remission and may stay in remission.
The challenge is that so many cases of NSCLC are detected when the cancer has already spread throughout the body.
Survival rates tell you the percentage of people who survive a specific type and stage of cancer for a certain amount of time. They're based on population averages and aren't necessarily a prediction for how long an individual will live. Survival rates also include people who die from causes other than cancer. Additionally, the published rates are often based on historical data and do not account for the many advances made in the past decade, in which patients have benefited from new drugs approved by the U.S. Food and Drug Administration.
The survival rates for people with NSCLC range from as high as 65 percent for those in early stages down to 9 percent for those in advanced stages. The average for all stages is 28 percent. It's important to remember that survival rates are only estimates, and they're based on data from previous years, so they are not predictions. The statistics don't reflect the recent positive impact of targeted therapies and immunotherapy.
A doctor can help explain any prognosis in detail.
Does Non-Small Cell Lung Cancer Recur?
NSCLC may recur, meaning it can come back after treatment and a period of time where the patient is considered cancer-free. When lung cancer recurs, it can develop in the lungs or in other areas of your body. But it's still considered lung cancer even if it comes back in a different spot, such as the bones or brain.
If lung cancer returns, the patient and doctor need to discuss a new treatment approach. Clinical trials are also an option.
Screening for Non-Small Cell Lung Cancer
Many medical organizations recommend that people who are at high risk for developing lung cancer be screened with low-dose computerized tomography (LDCT) every year.
The U.S. Preventive Services Task Force (USPSTF) recommends yearly screening for adults who are 50 to 80 years old, have a 20-pack-a-year smoking history, and currently smoke or have quit smoking within the past 15 years. Patients who fall into this category should talk to their doctors about whether lung cancer screening is right for them.
Screening can be stopped once a person has not smoked for 15 years, develops a health problem that might limit his or her life expectancy, or can't or won't have lung surgery.
While some studies have shown lung cancer screening saves lives, others have suggested early screening exposes people to unnecessary risks.
Researchers are looking at simpler and less-expensive ways to screen for lung cancer, such as breath, blood, and saliva tests. These tests are promising areas of research and not yet in clinical use.
Complications of Non-Small Cell Lung Cancer
Lung cancer may cause complications related to the cancer or the side effects of treatment.
As lung cancer grows, you may experience pain. This could be a sign that cancer has spread to other areas of your body, including the bones. Shortness of breath may occur when the cancer blocks the airways. Fluid may build up in the chest, called pleural effusion.
Complications from lung cancer treatments may include:
- Kidney damage
- Low red blood cell count (anemia)
- Low white blood cell count (neutropenia)
- Nerve damage
How Many People Have Non-Small Cell Lung Cancer?
There are 226,650 new cases of lung cancer expected in the United States in 2025, according to American Cancer Society estimates. Of these, 85 to 90 percent will be NSCLC.
Lung cancer is the leading cause of cancer death — by far. More people die of this disease each year than breast, colon, and prostate cancers combined. Lung cancer is the second most common cancer among both men and women (after skin cancer).
Related Conditions to Non-Small Cell Lung Cancer
Some health conditions may increase the risk for lung cancer or overlap with it. These include:
- Cardiovascular Disease (CVD) Smoking is a risk factor for both lung cancer and CVD. CVD is also a leading cause of death in people with lung cancer.
- Chronic Obstructive Pulmonary Disease (COPD) Smoking is also a risk factor for COPD, which includes conditions like chronic bronchitis and emphysema. People with COPD are at greater risk for lung cancer.
- Idiopathic Pulmonary Fibrosis This is a progressive scarring of the lungs that makes it difficult to breathe. It has no known cause. People with idiopathic pulmonary fibrosis are at greater risk for lung cancer.
Questions to Ask Your Doctor
- What type of NSCLC do I have?
- Where is the cancer?
- What stage is the cancer?
- Will I need any other tests before we can talk about a treatment plan?
- Have my cancer cells been checked for gene changes that could affect my treatment options?
- What treatments do you recommend? Why do you recommend these treatments?
- Are there other treatment options that I should consider?
- How much experience do you have in treating this type of cancer?
- What are the chances that my cancer can be cured?
- What will the treatment be like?
- How long will treatment last?
- How will I know if the treatment is working?
- What will my options be if my cancer comes back?
- Should I get a second opinion?
- Where can I find credible information about my cancer?
- Are there clinical trials I should explore for the treatment of my cancer?
- Will my health insurance cover my treatments? Who can help me with insurance issues?
Support for People With Non-Small Cell Lung Cancer
The organizations below can help patients cope with their diagnosis and learn more about their disease.
This foundation focuses on increasing quality of life and survivorship for people diagnosed with lung cancer by accelerating research into early detection and more effective treatments, as well as providing community, support, and education for individuals and families affected by lung cancer.
This is a nonprofit that supplies free, professional support services for people with lung cancer, as well as treatment information. It also offers lung cancer support groups led by oncology social workers.
Lung Cancer Research Foundation
This advocacy organization is a source for information and free publications about the disease. Its goal is to improve lung cancer awareness and fund research.
The ALA offers numerous services and endorses local support groups called the Better Breathers Club. Aimed at patients and caregivers who are affected by chronic lung diseases, the Better Breathers Clubs meet regularly at locations around the country.
Cancer Financial Assistance Coalition
This group is an alliance of organizations that help cancer patients manage their financial challenges.
The ACS has many resources to support people with lung cancer. The organization funds programs to help patients with healthcare-related lodging expenses and transportation. Its National Cancer Information Center provides information and support to people with cancer 24 hours a day, 365 days a year.
This is a go-to source for reliable information about cancer topics, research, and clinical trials.
ClinicalTrials.gov is a searchable database of ongoing research studies.
The Takeaway
- Smoking is a major cause of NSCLC, though some may develop it from exposure to radon, air pollution, secondhand smoke, radiation therapy, or other chemicals.
- If the cancer hasn't spread to your lymph nodes, doctors will typically remove the cancer through surgery. If the cancer has spread, you may use a combination of chemo, radiation, targeted therapy, and immunotherapy to treat the NSCLC.
- Survival rates are based on historic data. Treatments are always improving and new treatments may have been approved since the data was collected.
Common Questions & Answers
What's the difference between non-small cell and small-cell lung cancer?
NSCLC develops in cells that are larger than those affected in small-cell lung cancer. NSCLC is more common and grows more slowly than small-cell lung cancer.
What are the symptoms of non-small cell lung cancer?
NSCLC may not cause any symptoms until the disease is advanced. When symptoms do occur, they may include a lingering cough, difficulty breathing, chest pain, coughing up blood, and fatigue.
Can I get non-small cell lung cancer even if I don't smoke?
Smoking is responsible for the majority of lung cancers, but there are also other causes of lung cancer, such as exposure to secondhand smoke, radon, radiation, air pollution, and other chemicals.
How long will I live with non-small cell lung cancer?
The outlook for people with NSCLC varies depending on the cancer stage. Newer therapies are helping many patients go into remission or even find a cure. Your doctor can help explain your prognosis in detail.
Resources We Trust
- Cleveland Clinic: Non-Small Cell Lung Cancer
- Mayo Clinic: Lung Cancer Screening
- Memorial Sloan Kettering Cancer Center: New Lung Cancer Treatments Aim to Reduce Deaths in 2025 and Beyond
- GO2 for Lung Cancer: HelpLine and Support
- American Lung Association: Better Breathers Club
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Meet Our Experts
Tingting Tan, MD, PhD
Medical Reviewer
Tingting Tan, MD, PhD, is a medical oncologist at City of Hope National Medical Center.
Dr. Tan's research has been published in multiple medical and scientific journals, including Oncologists, Cancer Cell, and Genes and Development.
A graduate of the Beijing Medical University, Tan holds an M.D. from Peking University Health Science Center and a Ph.D. from Rutgers University. Her training includes fellowships at the University of California San Francisco Cancer Research Institute and the Fox Chase Cancer Center at Temple University.
Julie Lynn Marks
Author
Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.
Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.