Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It occurs when cancer cells multiply in your lungs and form tumors.

There are three major types of NSCLC:

  • adenocarcinoma
  • squamous cell carcinoma
  • large cell carcinoma

This article will go over the differences and how they can affect treatment and outlook.


Adenocarcinoma is a type of NSCLC that forms in the cells that secrete mucus. It typically develops in the outer portions of your lungs.

Adenocarcinoma primarily affects smokers and former smokers, but it can also affect people who have never smoked. It’s also the type of lung cancer most likely to occur in younger people.

Squamous cell carcinoma

Squamous cell carcinoma is a type of NSCLC that forms in the flat cells that line the insides of your airways. It often falls in the inner portion of the lungs. Smoking is the single biggest risk factor of squamous cell lung carcinomas.

Large cell carcinoma

Large cell carcinoma is sometimes called undifferentiated carcinoma. It grows and spreads quickly. It can form in any portion of the lungs.

This type of NSCLC can be more difficult to treat than adenocarcinoma or squamous cell carcinoma. Large cell lung carcinomas are also more common in men.

Infographic displaying the differences between adenocarcinoma, squamous cell carcinoma, and large cell lung carcinomaShare on Pinterest
Illustration by Jason Hoffman

Other types

There are also some rare types of NSCLC. These include:

  • adenosquamous carcinoma
  • sarcomatoid carcinoma
  • spindle cell carcinomas
  • giant cell carcinomas
  • carcinosarcomas

The first step to getting treatment for NSCLC is to get a diagnosis from a doctor.

At your initial appointment, your doctor will conduct a physical examination and go over your health history with you. They’ll ask questions about any current or past cigarette use.

If your doctor suspects NSCLC, they will order a series of tests to confirm the diagnosis. The tests will also determine the type of NSCLC you have.

Tests might include:

  • Blood work. Blood tests can look for elevated levels of proteins and blood cells that can show cancer.
  • Urine test. A urinalysis can look for substances in your urine that are a sign of cancer.
  • CT scan. A CT scan takes detailed pictures of the inside of your lungs to look for tumors.
  • PET scan. A PET scan can look for places where cancer may have spread. PET scans can also help doctors determine whether nodules found on CT scans might be cancerous.
  • X-rays. X-rays take images that can help look for tumors.
  • Sputum cytology. For this test, you cough up a sample of mucus. The mucus will be analyzed in a lab to look for NSCLC.
  • Bronchoscopy. A bronchoscopy uses a tiny camera on the end of a long and thin tube to look closely at your airways. This can help doctors see tumor type and placement.
  • Endobronchial ultrasound. This is a type of bronchoscopy that uses an attached ultrasound probe. Doctors use it to look for and take a sample of the lymph nodes between your lungs.
  • Biopsy. During a biopsy, a doctor will remove either a tiny piece of lung tissue or a small sample of lung fluid so they can analyze it in a lab.
  • Thoracentesis. During a thoracentesis, your doctor will remove a sample of the fluid between the lining of your chest and lungs for lab analysis. They’ll do this by inserting a long and thin needle into your chest. They can also perform a biopsy at the same time.
  • Thoracoscopy. A thoracoscopy uses a tiny camera to collect images of the lining of your chest and look for tumors. It’s a surgical procedure that doctors will sometimes do at the same time as a biopsy.

Treatment options for NSCLC depend on how far the cancer has spread, the type of NSCLC, and your overall health. Often, doctors will combine multiple treatments. Treatment options include:

  • Surgery. Surgery is the first treatment option in the early stages of all types of lung cancer. Surgery can remove the tumor and surrounding areas of tissue. A surgeon might remove all or part of the affected lung.
  • Ablation. Ablation uses heat to kill cancer cells. It’s an alternative when surgery is not an option.
  • Radiation therapy. Radiation uses energy to kill cancer cells. It can shrink tumors and help treat areas that surgery cannot treat.
  • Chemotherapy. Chemotherapy uses strong medication to kill cancer cells. Doctors recommend chemo when cancer has spread or isn’t responding to radiation. Your type of NSCLC will determine the exact chemo medications you’ll take.
  • Targeted therapy. Targeted therapy uses specialized anticancer medications that attack cancer cells but not healthy cells.
  • Immunotherapy. Immunotherapy teaches your immune system how to fight cancer cells. It can be especially effective when combined with chemotherapy.

According to the American Cancer Society, the overall 5-year survival rate for NSCLC between 2011 and 2017 was 26 percent.

People’s outlook was much better the earlier NSCLC was detected:

  • 64 percent if cancer had not yet spread beyond the lung
  • 37 percent if cancer had spread to nearby parts of the body
  • 8 percent if cancer had spread to distant parts of the body

The type of NSCLC may also affect your outlook. A 2020 study involving more than 500 participants found that people with adenocarcinoma had the longest life expectancy: about 1 month longer than people with squamous cell carcinoma, and 4 months longer than people with large cell carcinoma and other types of NSCLC.

Keep in mind that survival rates rely on previous data. As new treatments for NSCLC continue to be researched and implemented, the outlook for people with all types of NSCLC will continue to improve.

If you’ve just received a diagnosis of NSCLC, your outlook may be better.

NSCLC is the most common type of lung cancer. There are several types of NSCLC. The exact type of NSCLC can affect your exact treatment plan.

Treatment for all types of NSCLC is more successful when you receive a diagnosis in an early stage.

Most cases of NSCLC are from smoking cigarettes. If you smoke or have recently quit smoking, you might be eligible for a lung cancer screening.

Most other insurance plans and Medicare will pay for this screening if you’re eligible. Screening can help you find NSCLC early and get treatment before the cancer spreads.