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Non-Small Cell Lung Cancer

Non-Small Cell Lung Cancer (NSCLC)

About 85% of people with lung cancer have non-small cell lung cancer. This cancer is broken down into sub-types. These include squamous cell carcinoma, large cell carcinoma, and adenocarcinoma.

Squamous cell carcinoma

This type of cancer starts in the tissues lining the air passages of the lungs. Squamous cell carcinoma is more likely to appear in people who smoke, and is more prevalent in men than women. Roughly 30% of non-small cell lung cancers are squamous cell carcinomas of the lung.
Symptoms for this type include:

Unexplained weight loss

Chest pain (often aching)

Shortness of breath

Coughing up blood

Non-specific symptoms including fever-weakness, lethargy

Bone pain



Large cell carcinoma

Large cell lung carcinomas begin in the outer part of the lungs and cause fluid to begin building in the space between the tissues that line the lungs. This fluid can then invade the chest wall, causing pain in the chest that gets worse with deep breaths. Large cell carcinoma of the lungs accounts for only 10% and is therefore the least common type of non-small cell lung cancer. Symptoms for this type include:

Chest pain

Coughing up blood



Unexplained weight loss

Mild shortness of breath

Aching in the back, shoulders, or chest



Lung adenocarcinomas typically start in the tissues near the outside portion of the lungs. They may be present for a long time before a patient begins presenting with symptoms and is most commonly found in women, Asians, and people under 45. Lung adenocarcinoma is more likely to appear in non-smokers. Roughly 50% of non-small cell lung cancers are this sub-type.
Symptoms for this type include:

A lasting cough that gets progressively worse

Hoarseness or other vocal changes

Unexplained weight loss or loss of appetite

Chest pain that hurts when you laugh, cough, or breathe deeply

Shortness of breath

Coughing up blood or mucus


Raspy/harsh sounds when breathing

Please note that many cancer symptoms can be a sign of something else. If you’re concerned about your symptoms, call your doctor for a full health screening.


Diagnosing Non-Small Cell Lung Cancer 

Once a physical exam has been performed and your medical history collected, your doctor may order further testing/screening if you’re at risk for lung cancer or if lung cancer is suspected. Non-small cell lung cancer is typically diagnosed through:

  • A bone scan
  • Lung biopsy
  • MRI
  • CT scan
  • PET scan of the chest
  • Examination of sputum/mucus to look for cancer cells


Stages of Non-Small Cell Lung Cancer

Once a diagnosis of non-small cell lung cancer has been reached, the physician will stage the cancer—this is the process of figuring out if the cancer has spread, and if so, to what other part of the body. Staging non-small cell lung cancer is a starting point for beginning the treatment process. NSCLC staging typically uses the letters T,N, and M:

  • T: the size of the tumor and its location.
  • N: this stands for node involvement—whether the cancer has spread to the lymph nodes near your lungs.
  • M: stands for metastasis. This refers to whether or not your cancer has spread to other parts of your body.

Your doctor will stage the cancer with these letters, then expand for more specificity with numbers 0–4. Your doctor will measure the size of the tumor in centimeters to assign the number. The higher the number, the more the cancer has spread.


Non-Small Cell Lung Cancer Prognosis

The prognosis for NSCLC is dependent upon the stage at which the cancer is diagnosed and the sub-type of lung cancer. The relative 5-year survival rate for non-small cell lung cancer (all stages combined) is roughly 18%.

According to the SEER database (which tracks 5-year relative survival rates for NSCLC in the U.S.), the survival rates average as follows:

  • Localized (no sign of cancer spreading outside the lung): 60%
  • Regional (cancer has spread outside the lung to nearby lymph nodes): 33%
  • Distant (the cancer has spread to further regions of the body like the bones, brain, liver, etc.): 6%

Non-Small Cell Lung Cancer Treatment Options

Treatments for non-small cell lung cancer vary depending on the stage of cancer. Your physician will customize your treatment plan based on other factors like your age, overall health, and the specific traits of the type of cancer you have. Some NSCLC treatment options include:

  • Chemotherapy
  • Stereotactic radiation therapy (a type of external radiation therapy that positions the patient to deliver precise radiation to a tumor)/radiation 
  • Surgical procedures including:
    • Pulmonary lobectomy (surgical removal of a lobe of the lung)
    • Pneumonectomy (surgical removal of the lung/part of the lung)

You can read more about stage-specific non-small cell lung cancer treatment options here.


The Lung Docs: Specialized Pulmonary Care

The Lung Docs provides specialized, state-of-the-art pulmonary care to our patients with non-small cell lung cancer in Chattanooga and the surrounding Southeast Tennessee and Northwest Georgia areas.


Dr. Mike’s Approach

I’m Dr. Mike Czarnecki, “The Lung Doc,” and I’m trained in all areas of pulmonary health, including the diagnosis and treatment of non-small cell lung cancer. I will work with you to formulate a personalized NSCLC treatment plan so you can live, laugh, love, and breathe better again! To get started, schedule an appointment online or call our office to speak to someone directly. I can’t wait to meet you!