Non-small-cell lung cancer

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Non-small-cell lung cancer
Synonyms	NSCLC
Pronounce	N/A
Specialty	N/A
Symptoms	Cough, hemoptysis, weight loss, dyspnea
Complications	Metastasis, pleural effusion, superior vena cava syndrome
Onset	Typically in older adults
Duration	Long-term
Types	Adenocarcinoma, Squamous cell carcinoma, Large cell carcinoma
Causes	Smoking, air pollution, genetic factors
Risks	Tobacco smoking, asbestos exposure, radon exposure
Diagnosis	Chest X-ray, CT scan, biopsy
Differential diagnosis	Small-cell lung cancer, tuberculosis, pneumonia
Prevention	Smoking cessation, avoiding carcinogens
Treatment	Surgery, chemotherapy, radiation therapy, targeted therapy
Medication	N/A
Prognosis	Variable, depends on stage and treatment
Frequency	Most common type of lung cancer
Deaths	N/A

Non-small-cell lung cancer (NSCLC) is a type of lung cancer that includes several subtypes of epithelial lung cancers, excluding small cell lung cancer (SCLC). NSCLC accounts for approximately 85% of all lung cancer cases, making it the most common type of lung cancer. The main subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

Subtypes

Adenocarcinoma

PD-L1 positive lung adenocarcinoma

Adenocarcinoma is the most common subtype of NSCLC, accounting for about 40% of all lung cancers. It typically originates in the peripheral lung tissue and is more common in non-smokers and women. Adenocarcinomas are often associated with mutations in genes such as EGFR, ALK, and KRAS.

Squamous cell carcinoma

Squamous cell carcinoma accounts for approximately 25-30% of all lung cancers. It usually arises in the central bronchi and is strongly associated with a history of smoking. Squamous cell carcinoma is characterized by the presence of keratinization and intercellular bridges.

Large cell carcinoma

Large cell carcinoma is a less common subtype, representing about 10-15% of NSCLC cases. It is a diagnosis of exclusion when the cancer cells do not fit the criteria for adenocarcinoma or squamous cell carcinoma. Large cell carcinoma can occur in any part of the lung and tends to grow and spread quickly.

Diagnosis

The diagnosis of NSCLC involves a combination of imaging studies, such as chest X-ray and CT scan, and tissue biopsy. Bronchoscopy and fine needle aspiration are common methods used to obtain tissue samples for histological examination. Molecular testing for specific genetic mutations is also important for guiding targeted therapy.

Staging

Staging of NSCLC is based on the TNM staging system, which considers the size and extent of the primary tumor (T), involvement of regional lymph nodes (N), and the presence of distant metastasis (M). Accurate staging is crucial for determining the appropriate treatment strategy.

Treatment

Pharmaceuticals used in NSCLC treatment

Treatment options for NSCLC depend on the stage of the disease and may include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

Surgery

Surgical resection is the preferred treatment for early-stage NSCLC. Procedures such as lobectomy, pneumonectomy, and wedge resection are commonly performed.

Radiation therapy

Radiation therapy is often used in combination with surgery or as a primary treatment in patients who are not surgical candidates. Techniques such as stereotactic body radiotherapy (SBRT) are used for precise targeting of tumors.

Chemotherapy

Chemotherapy is a standard treatment for advanced NSCLC. Commonly used agents include cisplatin, carboplatin, paclitaxel, and docetaxel.

Targeted therapy

Targeted therapies are used for tumors with specific genetic mutations. EGFR inhibitors and ALK inhibitors are examples of targeted treatments that have improved outcomes in patients with these mutations.

Immunotherapy

Immunotherapy, such as PD-1 and PD-L1 inhibitors, has become an important treatment option for NSCLC, particularly in advanced stages. These therapies help the immune system recognize and attack cancer cells.

Prognosis

The prognosis for NSCLC varies depending on the stage at diagnosis and the patient's overall health. Early-stage NSCLC has a better prognosis, with higher survival rates following surgical resection. Advanced-stage NSCLC has a poorer prognosis, but new treatments have improved outcomes for many patients.

See also

• Lung cancer
• Small cell lung cancer
• Oncology
• Cancer staging