Non-Small Cell Lung Cancer Prognosis: What to Expect with NSCLC

Getting a cancer diagnosis can be a life-changing experience. It is normal to have concerns about what will happen next, and how the condition will affect the rest of your life. It is also natural to worry about whether cancer will affect how long you live. 

Every person with cancer has a different experience. Your age, other health conditions, and type of cancer all affect your prognosis. Your cancer prognosis is how the condition is expected to progress over time.

What is non-small cell lung cancer? 

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. NSCLC begins when cells in the lung mutate and divide uncontrollably. There are different kinds of NSCLC depending on which cells are affected, including: 

• Adenocarcinoma

• Squamous cell carcinoma

• Large cell carcinoma 

What to expect after a diagnosis of non-small cell lung cancer

If you have been diagnosed with NSCLC, the next step is to determine the cancer stage. Cancer staging is based on the size of the tumor and whether or not cancer has spread to other parts of your body. 

In order to stage NSCLC, your team may ask you to do imaging tests to help look for evidence of cancer spread. Some imaging tests for cancer staging include:

• CT scan: A computed tomography, or CT scan, uses X-rays to create cross-sectional pictures of your body. The cross-sectional images, or “slices,” can be combined to create a 3-D image. This image makes it possible to locate the tumor. 

• MRI: During an MRI, a strong magnetic field is used to generate images. MRI is particularly good at providing a detailed look at non-bony structures in the body. 

• PET: Positron emitted tomography, or PET scans, use a radioactive tracer to find areas of increased metabolic activity in the body. Cancer cells are more active than normal cells, and will pick up more tracers, which can then be seen on PET scan. 

If these studies show your cancer has spread, you may need a biopsy. During a biopsy, a small piece of tissue is removed for examination under a microscope to see if cancer cells are present.

Can non-small cell lung cancer be cured? 

It depends. Early stage NSCLC may be cured with surgery and chemotherapy. Early stage means the tumor is small and confined to the lung. Cured means that all cancer is removed and does not grow back. 

Unfortunately, most cases of NSCLC are not diagnosed in time to be cured. But there are treatment options that can help control NSCLC. These treatments can improve life expectancy even if the cancer has spread. 

What is the survival rate of non-small cell lung cancer?

The 5-year survival rate for NSCLC is 28%. This means that of all the people diagnosed with NSCLC, about a third are expected to be alive at the end of 5 years. 

But this number does not apply to everyone with NSCLC. Survival rates are different depending on the type and stage of NSCLC you have. For example, the 5-year survival rate for early stage NSCLC is 65%. But the 5-year survival rate for people with regional NSCLC — or cancer that has spread to nearby lymph nodes — is 37%. Metastatic NSCLC has the lowest 5-year survival rate of 9%. Metastatic cancer is cancer that has spread to other parts of the body.

These numbers seem daunting. But keep in mind that these numbers are based on recent, but not real-time, data. People included in these statistics may not have had access to newer cancer treatments. There are new treatments for NSCLC being developed all the time. And these treatments can help people live longer, even if they have metastatic NSCLC. 

This means in a few years, updated survival rates will likely be higher than the rates that are available today. 

Can treatment of NSCLC improve survival? 

Yes. New treatments — like targeted therapy and immunotherapy — are improving the survival rate of people with NSCLC. 

Targeted therapy uses medication to target specific proteins in cancer cells. This stops them from growing and dividing. Often, these target proteins are the result of gene mutations in the cancer cell. There are over a dozen medications available to treat the different gene mutations associated with NSCLC. 

Immunotherapy helps the body’s immune system destroy cancer cells. Immunotherapy treatments for NSCLC include medications such as pembrolizumab and nivolumab.

Targeted therapy and immunotherapy may be used instead of — or in addition to — traditional treatments like surgery, radiation therapy, and chemotherapy. A team of specialists will help determine what treatment will be most effective for you. 

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Written by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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