Lung cancer - non-small cell

Alternative Names

Cancer - lung - non-small cell; Non-small cell lung cancer; NSCLC

Symptoms

Early lung cancer may not cause any symptoms. Symptoms you should watch for include:

• Cough that doesn't go away
• Coughing up blood
• Shortness of breath
• Wheezing
• Chest pain
• Loss of appetite
• Losing weight without trying
• Fatigue

Other symptoms that may be due to NSCLC:

• Weakness
• Swallowing difficulty
• Nail problems
• Joint pain
• Hoarseness or changing voice
• Swelling of the face
• Facial paralysis
• Eyelid drooping
• Bone pain or tenderness

Note: These symptoms can be due to other, less serious conditions. It is important to talk to your health care provider.

Exams and Tests

The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.

When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn't always) suggest cancer.

Tests that may be performed include:

• Chest x-ray
• CBC
• Sputum test
• Bone scan
• CT scan
• MRI
• Positron emission tomography (PET) scan
• Thoracentesis

In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:

• Bronchoscopy combined with biopsy
• Pleural biopsy
• CT scan directed needle biopsy
• Mediastinoscopy with biopsy
• Open lung biopsy
• Endoscopic esophageal ultrasound (EUS) with biopsy

If the biopsy reveals you do have lung cancer, more imaging tests will be done to determine the stage of the cancer. Stage means how big the tumor is and how far it's spread. Non-small cell lung cancer is divided into five stages:

• Stage 0 - the cancer has not spread beyond the inner lining of the lung
• Stage I - the cancer is small and hasn't spread to the lymph nodes
• Stage II - the cancer has spread to some lymph nodes near the original tumor
• Stage III - the cancer has spread to nearby tissue or spread to far away lymph nodes
• Stage IV - the cancer has spread to other organs of the body such as the other lung, brain, or liver

References

Mehra R, Moore BA, Crothers K, Tetrault J, Fiellin DA. The association between marijuana smoking and lung cancer: a systematic review. Arch Intern Med. 2006 Jul 10;166(13):1359-67.

American Cancer Society. Cancer Facts and Figures 2006. Atlanta, Ga: American Cancer Society; 2006.

U.S. Preventive Services Task Force. Lung cancer screening. Ann Int Med. 2004;140:738-739.

Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 3rd ed. Orlando, Fl: Churchill Livingstone; 2004:1690-1701.