If you or a loved one has received a diagnosis of non-small cell lung cancer, our comprehensive oncology team of specialists at West Cancer Center & Research Institute will work with you to formulate an individualized treatment plan utilizing the most cutting edge treatments and technology.  Our goal is also to provide resources and information to help you better understand and manage your diagnosis.

What is Non-Small Cell Lung Cancer?

This is the most common form of lung cancer and involves 3 major types; adenocarcinoma (cancer in cells that begin in tiny air sacs in the lungs), squamous cell carcinoma (cancer in the cells that line the bronchial tubes), and large cell or undifferentiated lung cancer (a less common type of lung cancer that originates from neuroendocrine cells present in the lungs.

Stages of Non-Small Cell Lung Cancer

Occult (hidden) stage

In the occult (hidden) stage, cancer cannot be seen by imaging or bronchoscopy. Cancer cells are found in sputum or bronchial washings (a sample of cells taken from inside the airways that lead to the lungs). Cancer may have spread to other parts of the body.

Stage 0

Abnormal cells are found in the lining of the airways. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 may be adenocarcinoma in situ (AIS) or squamous cell carcinoma in situ (SCIS).

Stage IA

The tumor is in the lung only and is 3 centimeters or smaller. Cancer has not spread to the lymph nodes.

Stage IB

The tumor is larger than 3 centimeters but not larger than 4 centimeters and has not spread to the lymph nodes.

or

The tumor is 4 centimeters or smaller and one or more of the following is found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

Cancer has not spread to the lymph nodes.

Stage IIA

The tumor is larger than 4 centimeters but not larger than 5 centimeters, has not spread to the lymph nodes and one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

Stage IIB

The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

or

Cancer has not spread to the lymph nodes and one or more of the following is found:

  • The tumor is larger than 5 centimeters but not larger than 7 centimeters.
  • There are one or more separate tumors in the same lobe of the lung as the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.

Stage IIIA

The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or where the trachea divides into the bronchi. Also, one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

or

Cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:

  • The tumor is larger than 5 centimeters but not larger than 7 centimeters.
  • There are one or more separate tumors in the same lobe of the lung as the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.

or

Cancer may have spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:

  • The tumor is larger than 7 centimeters.
  • There are one or more separate tumors in a different lobe of the lung with the primary tumor.
  • The tumor is any size and cancer has spread to any of the following:
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart.
  • Nerve that controls the larynx (voice box).

Stage IIIB

The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

or

The tumor may be any size and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or where the trachea divides into the bronchi. Also, one or more of the following is found:

  • There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart.
  • Nerve that controls the larynx (voice box).

Stage IIIC

The tumor may be any size and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following is found:

  • There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart.
  • Nerve that controls the larynx (voice box).

 

Stage IVA

  • The tumor may be any size and cancer may have spread to the lymph nodes. One or more of the following is found:
  • There are one or more tumors in the lung that does not have the primary tumor.
  • Cancer is found in fluid around the lungs or the heart.
  • Cancer has spread to one place in an organ not near the lung, such as the brain, liver, adrenal gland, kidney, bone, sac around the heart, or to a lymph node that is not near the lung.

Stage IVB

Cancer has spread to multiple places in one or more organs that are not near the lung.

Symptoms of Non-Small Cell Lung Cancer

If you are experiencing any of these symptoms, we urge you to speak to your provider as soon as possible for further examination.

  • Hoarseness or wheezing
  • Chest pain or painful breathing
  • Persistent coughing, particularly without any known cause
  • A cough the produces blood or red-colored phlegm (hemoptysis)
  • Fatigue or feeling unusually tired or weak
  • Difficulty breathing or a shortness of breath
  • Frequent upper-respiratory infections, like bronchitis or pneumonia
  • Bone pain

How to Diagnose Non-Small Cell Lung Cancer

If your provider would like to further investigate the possibility of non-small cell lung cancer, one or more of the following diagnostic procedures may be performed:

BRONCHOSCOPY

A small scope (bronchoscope) with a light and camera is inserted down your throat to exam your lungs to look for abnormalities.

COMPUTERIZED TOMOGRAPHY (CT)

A donut-shaped piece of equipment uses low dose radiation, either with or without a contrast fluid, to detect abnormalities in the lungs.

ENDOBRONCHIAL ULTRASOUND (EBUS)

A small endoscope is connected to an ultrasound and a needle biopsy of the lymph nodes can be taken with an oral approach through your trachea

FINE NEEDLE BIOPSY

A fine needle biopsy with ultrasound guidance takes tissue samples from the suspicious mass or skin thickening through a thin, hollow needle and sends to pathology.

MAGNETIC RESONANCE IMAGING (MRI)

Provides detailed images of the lungs using magnetic fields to identify any abnormalities that may be cancer.

NAVIGATIONAL BRONCHOSCOPY

Electromagnetic navigation is combined with a bronchoscope to find tumors and take biopsies.

POSITRON EMISSION TOMOGRAPHY (PET)

A radioactive substance is injected into your bloodstream to collect in cancerous cells and identify the exact location of your cancer.

SURGERY

A surgical or open biopsy involves removing part or all of suspicious mass if the results of a needle biopsy aren’t clear.

Types of Non-Small Cell Lung Cancer Treatments

Your non-small cell lung cancer treatment plan will vary depending on multiple factors including, but not limited to, your stage of diagnosis, as well as the location of your cancer. Your dedicated team of cancer experts will discuss your treatment options and plan with you, allowing you and your loved ones to consider all possible treatment options for your diagnosis.

CHEMOTHERAPY

Chemotherapy and other medications can be an effective way to control your cancer and relieve your symptoms.

CLINICAL TRIALS

Ask your physician if a clinical trial might be an option for your specific cancer.

STEREOTACTIC ABLATIVE RADIATION (SABR)

High doses of radiation are delivered to destroy the cancer cells with a technique combining image guidance and precise patient positioning.

RADIATION THERAPY

Radiation therapy is the use of high energy beams to kill cancer cells.  With some sarcomas, radiation is given before or after surgery to help reduce the risk of the cancer coming back.  Radiation therapy can also be used to relieve symptoms from cancer.

IMAGE-RADIATION RADIATION THERAPY (IGRT)

Image-guided radiation therapy

INTENSITY-MODULATED RADIATION THERAPY (IMRT)

A highly focused radiation therapy that reduces your treatment time with a 360-degree rotation around your body with a linear accelerator to target your disease with speed and precision.

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