Signs and Symptoms of Non-Small Cell Lung Cancer (NSCLC)

Don
Don
10 Min Read

Medically reviewed by Susan Russell, MDMedically reviewed by Susan Russell, MD

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 80-85% of all cases. Adenocarcinoma, squamous cell carcinoma, and large cell are among the several subtypes of NSCLC, classified by the type of cells that are affected.

Compared to the other major kind of lung cancer, small cell lung cancer, NSCLC spreads and grows more slowly. Some people may not experience symptoms in the earliest stages, but over time, symptoms can become more serious. Early signs like wheezing, cough, and chest pain can give way to other symptoms, such as joint pain or facial swelling, as the cancer spreads.

Like other cancers, non-small cell lung cancer can become fatal, and early detection of the condition can vastly improve the outcomes. This is why it’s important to understand the signs and symptoms of non-small cell lung cancer. 



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When Do Symptoms Usually Start?

Non-small cell lung cancer has different stages: 0-4. These are defined by the severity of the case as well as the extent of spread out of the lungs to other parts of the body. This condition is progressive, and especially if untreated, can lead to severe complications, becoming fatal.

Stages 0 and 1 mean there are cancerous cells and tumors developing in the lungs, with stages 2-4 indicating the cancer has spread to regional lymph nodes (part of the immune system) and eventually distant organs, such as the liver, brain, or other lung.

The early stages of cancer may not cause symptoms. NSCLC is usually advanced by the time signs arise.

Lung and Airway Symptoms 

Most commonly, initial symptoms of NSCLC primarily relate to the lungs and airways. These symptoms can include:

  • Cough that doesn’t go away or gets worse
  • Wheezing or breathing difficulties
  • Hoarse voice
  • Chest pains
  • Recurring/chronic pneumonia or bronchitis (lung infections) or other pulmonary problems
  • Presence of blood when coughing

Alongside these respiratory symptoms, common symptoms of NSCLC are unexplained weight loss, appetite loss, and fatigue.

Bone, Joint, and Muscle Symptoms

As NSCLC starts to spread to other parts of the body, the symptoms grow more severe. Since healthcare providers usually detect this type cancer at later stages, about 20% of cases show signs of spread to the bones at diagnosis. Symptoms can include:

  • Pain or tenderness in the bones and joints, most often in the hips and back
  • Pancoast syndrome, a muscular disorder causing pain in the shoulders and arms, tingling skin, and muscular weakness
  • Thenar atrophy, a loss of muscles in the thumb and palm affecting movement and function
  • Hypertrophic osteoarthropathy, which causes swelling and painful joints in the hand or bent fingers
  • Fingernail or toenail abnormalities or deformities

Head and Neck Symptoms

As the cancer spreads outside of the lungs, fluid buildup and swelling compresses veins and nerves in the head and neck. One large vein that can get pressed on and back up with blood is the superior vena cava, which passes the right lung as the vein carries blood from the head to the heart. This disrupted blood supply is known as superior vena cava syndrome, which causes facial swelling and bulging veins.

Meanwhile, nerve damage due to the progress of NSCLC can cause Horner’s syndrome. This is characterized by a drooping eyelid, smaller pupils (the black part of the eye), and reduced sweating on one side of the face.    

Neurological Symptoms

If late-stage non-small cell lung cancer spreads to the brain—something more common with the adenocarcinoma type of NCSLC—you can experience the following:

  • Headache
  • Vomiting
  • Seizure
  • Areas of vision that are blocked or grayed out
  • Weakness, involuntary movements, or loss of muscle control in a specific location, such as one arm or one side of the face
  • Sensation changes, such as numbness

Digestive Symptoms

Less often, later-stage NSCLC can cause high levels of calcium in the body (hypercalcemia). This occurs as the cancer impacts the parathyroid glands in the neck, the glands responsible for producing the parathyroid hormone, which regulates calcium levels in the blood.

In addition to muscle twitches, muscle weakness, bone pain, and fatigue, hypercalcemia can cause a range of digestive symptoms, including nausea, vomiting, and constipation. You might also experience a loss of appetite and be thirstier than usual.

Is Non-Small Cell Lung Cancer Contagious?

Non-small cell lung cancer isn’t contagious. You cannot spread it to or acquire it from others.

However, it is possible to spread any viruses that might be present in respiratory droplets you cough up. NSCLC frequently causes coughing. When you cough, aim for your elbow to cover your mouth, and keep your hands clean. Avoid close contact with others if you have symptoms of a cold, flu, or other communicable disease to prevent spread.

Like any cancer, NSCLC can also increase your risk of contracting other diseases. As your immune system fights off cancer and responds to treatments like radiation therapy or chemotherapy, the system weakens, making it easier for bacteria or viruses to cause infections.

When to Contact a Healthcare Provider 

Non-small cell lung cancer is always serious and can become fatal. This means you should call your healthcare provider if you’re displaying any sign of lung cancer. This is especially the case if you’re at increased risk for cancer. Risk factors include smoking or having heart problems or chronic obstructive pulmonary disease (COPD).

Life-threatening or severe symptoms call for emergency help. Dial 9-1-1 if you experience any of the following:

  • Loss of consciousness
  • Coughing up large amounts of blood
  • Severe difficulty with breathing
  • Severe pain or discomfort

Questions To Ask Your Provider

When seeking care for non-small cell lung cancer, make sure to ask your healthcare provider questions about your condition and care, such as:

  • How advanced is my cancer?
  • Will my symptoms get worse?
  • Should I expect new symptoms to develop, and when?
  • What are the treatment options for non-small cell lung cancer?
  • What can I do to cope with the side effects of treatments?

A Quick Review 

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. This cancer may not cause symptoms in its earliest stages. When symptoms develop, initial signs include breathing difficulties, chronic cough, lung infection, and chest pains. As the cancer spreads outside of the lungs to other parts of the body, it can cause shoulder pain, neurological symptoms like seizures, and digestive issues.

Frequently Asked Questions

Are symptoms of non-small and small cell lung cancer the same?

While both non-small and small cell lung cancer share symptoms, there some differences between these two types. Small cell lung cancer (SCLC), the rarer of the two, is more aggressive and fast-moving. In contrast to non-small cell lung cancer, it’s also more likely to metastasize, or spread to other parts of the body.

What is the life expectancy for non-small cell lung cancer?

How long someone survives after an NSCLC diagnosis depends on how advanced the cancer is and how far it’s spread. Overall, 28% of people diagnosed are alive five years later. This rises to 65% if the cancer is localized, or confined to the lungs. Cancer spreading to surrounding tissues and lymph nodes, or regional NSCLC, has a 37% five-year survival rate. Severe cases that have spread to distant organs are tougher to manage, with 9% of people surviving five years after diagnosis.

How fast do symptoms of non-small cell lung cancer progress?

Individual cases of NSCLC vary considerably. Factors like cancer stage at diagnosis, specific sub-type, ethnicity or race, and success of treatment can influence how quickly symptoms progress. In one study, researchers found it took a median of 230 days—about seven or eight months—for tumors to double in size. For some people, it took as little as 19 days, while others never saw significant tumor growth.

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