Lung Cancer

Lung cancer is a type of cancer that develops in your lungs. Cancer is a condition where abnormal cells grow and multiply in an uncontrolled way causing damage. Your lungs are the organs in your chest (behind your ribs). When you breathe in, your lungs take in oxygen, and when you exhale, they release carbon dioxide. Healthy lungs are essential for good health. However, lung cancer damages your lungs and may cause serious health complications.

In Australia, lung cancer is the leading cause of death from cancer. It’s the fifth most common cancer, accounting for 9% of all cancers. Almost 14,000 cases are diagnosed every year.

The good news is that you can significantly reduce your risk of developing lung cancer.

Types of lung cancer

There are two main types of lung cancer:

Non-small cell lung cancer (NSCLC)

This is the most common type which accounts for 85% of cases. There are three sub-types of NSCLC:

  • adenocarcinoma — starts in the mucus-producing cells of the lungs

  • squamous cell (epidermoid) carcinoma — usually starts in the large airways of the lungs

  • large cell undifferentiated carcinoma — can be found anywhere in the lungs but is not identified as adenocarcinoma or squamous cell carcinoma.

Small cell lung cancer (SCLC)

These types of lung cancer begin growing in the middle of the lungs. They usually spread more quickly than NSCLC.

Signs and symptoms of lung cancer

Signs and symptoms of lung cancer usually occur during the later stages of the disease. They can include:

  • shortness of breath

  • a persistent, new cough that lasts longer than three weeks

  • changes to an existing cough

  • chest or shoulder pain

  • chest infections that don’t improve or keep recurring

  • a hoarse voice

  • difficulty swallowing

  • spitting up blood

  • enlarged fingertips

  • loss of appetite

  • unexplained weight loss

  • fatigue.

What causes lung cancer?

While several factors increase your risk for lung cancer, the biggest risk is smoking. In Australia, about 90% of lung cancer in men and 65% of lung cancer in women are due to smoking. Risk for lung cancer increases:

  • the earlier you start smoking

  • the longer you smoke

  • the more cigarettes you smoke.

Breathing in other people’s cigarette smoke (second-hand smoking) can also cause lung cancer. If you don’t smoke but live with a smoker, your risk increases by up to 30%.

Other risk factors of lung cancer

People who don’t smoke can still get lung cancer. Other factors that increase your risk include:

  • age

  • family history of lung cancer

  • having had other cancers

  • lung diseases such as pulmonary fibrosis, pulmonary tuberculosis or chronic obstructive pulmonary disease (COPD)

  • exposure to substances like asbestos, radon (radioactive gas), air pollution and some heavy metals.

How is lung cancer diagnosed?

Several tests may be done to check if you have lung cancer. These include:

  • medical history and physical examination

  • Chest X-Ray: this test can show larger tumours that are more than 1cm wide

  • CT Scan: uses x-ray beams to create a cross-sectional image that is able to detect smaller tumours, as well as information about the tumour and lymph nodes.

  • PET scan: used to determine stage of lung cancer after diagnosis

  • blood tests

  • lung function test: checks how well the lungs are working

  • sputum cytology – examining a sample of sputum (phlegm) under the microscope

  • lung biopsy – examining a small sample of tissue or fluid from the lung.

If you’re diagnosed with lung cancer, you may undergo further tests to determine the extent (stage) of your cancer and whether it has spread to other parts of your body. Knowing the stage of your cancer will help your medical team decide on the best treatment for you.

How do you treat lung cancer?

Treatment for lung cancer will depend on what stage of cancer you have. It may involve one or a combination of the following options:11

  • Surgery: some early stage non-small cell lung cancers can be removed by surgery

  • radiation therapy (radiotherapy): can be used alone or in a combination with other treatments in various types of lung cancers

  • thermal ablation: can be used when surgery or radiation are not suitable for stage I non-small cell lung cancers

  • chemotherapy: main treatment for small cell lung cancers

  • immunotherapy: uses specific drugs to stimulate the body’s immune system to fight the lung cancer and can be used to treat some forms of non-small cell lung cancer

  • targeted therapy: targets specific mutations in cancer cells and can be used for advanced non-small cell lung cancer or if the cancer has returned.

  • palliative care: improves quality of life by helping relieve cancer symptoms. It is not aimed at curing the disease, rather its aim is to ensure the patient is comfortable and not suffering from symptoms such as pain and nausea.

What are the stages of lung cancer?

Lung cancer is usually staged. This is the process of determining how much cancer is in your body, and whether it has spread.

NSCLC is divided into six stages (written in Roman numerals).

  • Occult (hidden) stage — Cancer cells are present in sputum or other fluids but not seen in other tests.

  • Stage 0 — The cancer is in the top layers of the cells lining the air passages and has not spread anywhere else.

  • Stage I — Cancer is in the lung only.

  • Stage II — Cancer has spread to nearby lymph nodes or the lining of the lungs.

  • Stage III — Cancer has spread to the lymph nodes between the heart and lungs or has grown into the chest wall. It may also have spread to lymph nodes on the opposite side of the chest or to the lower neck.

  • Stage IV — Cancer has spread to the other lung, or other parts of the body including distant lymph nodes or organs such as bones, liver or brain.

SCLC is divided into two stages

  • Limited stage — cancer is only on one side of the chest

  • Extensive stage — cancer has spread to the other lung or distant sites.

Can you prevent lung cancer?

You can significantly reduce your risk of developing lung cancer by avoiding risk factors such as smoking and exposure to substances known to cause lung cancer.

If you currently smoke, you can reduce your risk by quitting smoking.

When should you see your doctor?

If you have any of the signs or symptoms of lung cancer, you should visit your doctor. This is especially the case if you have risk factors for lung cancer.

You should also talk to your doctor if you smoke and have trouble quitting. They can recommend strategies that may help, such as counselling, medication, and nicotine replacement products.

Support and more information

Lung Foundation Australia provides various free support services including Social Work and nursing support. Other services include peer support groups, pulmonary rehabilitation, multidisciplinary support and education webinar series.

Your local MediADVICE Pharmacist is available to help you manage your health. We can provide advice on medication and products to help you quit smoking. We can also recommend products to help with the side-effects of cancer treatment or refer you to a doctor if necessary.

Find your nearest store

Sources

1Cancer Council, Lung Cancer,https://www.cancer.org.au/cancer-information/types-of-cancer/lung-cancer
2Healthdirect, Lung cancer,https://www.healthdirect.gov.au/lung-cancer
3Mayo Clinic, Lung Cancer,https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620
4Cancer Council, Lung cancer,https://www.cancer.org.au/cancer-information/types-of-cancer/lung-cancer
5Cancer Council NSW, About lung cancer,https://www.cancercouncil.com.au/lung-cancer/about-lung-cancer/
6Mayo Clinic, Lung Cancer,https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620
7Healthdirect, Lung cancer,https://www.healthdirect.gov.au/lung-cancer
8Mayo Clinic, Lung Cancer,https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627
9Cancer Australia, How is lung cancer diagnosed?,https://www.canceraustralia.gov.au/affected-cancer/cancer-types/lung-cancer/how-lung-cancer-diagnosed
10Lung Foundation Australia, Stages: Lung cancer,https://lungfoundation.com.au/patients-carers/conditions/lung-cancer/stages/
11Cancer Council, Lung cancer,https://www.cancer.org.au/cancer-information/types-of-cancer/lung-cancer

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Disclaimer

General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.