What is lung cancer?
Lung cancer occurs when abnormal cells in one or both lungs grow in an uncontrolled way.
Cancer that begins in the lungs is called 'primary lung cancer'. There are 2 main types of primary lung cancer which are classified by the type of cells in which the cancer starts. They are:
- Non-small cell lung cancer — This is the most common type of lung cancer. There are 3 different types:
- squamous cell carcinoma
- large cell carcinoma
- Small cell lung cancer — This is rare. It often grows quickly and spreads to other parts of the body.
Sometimes cancers that started in another part of the body spread to the lungs. This is called secondary lung cancer. It’s not considered to be lung cancer and is treated according to where it started in the body.
What are the symptoms of lung cancer?
There are usually no signs or symptoms in the early stages of lung cancer. However, symptoms develop as the disease progresses. They include:
- persistent coughing
- coughing up blood
- bronchitis or pneumonia that keeps coming back
- loss of appetite
- unexplained weight loss
- shortness of breath
- chest pain or shoulder pain
What causes lung cancer?
Lung cancer happens when there is DNA damage to the cells in the lungs. The main cause of this is smoking tobacco. Smoking is responsible for about 9 in 10 cases of lung cancer in men and about 6 to 7 in 10 in women. Smoking cannabis and passive smoking also increase your risk of lung cancer.
About a fifth of people who develop lung cancer have never been smokers.
There are other factors that increase your risk:
- being exposed to substances such as asbestos and diesel exhaust
- having a family history of lung cancer
- previous lung diseases such as lung fibrosis, chronic bronchitis, emphysema and pulmonary tuberculosis (TB)
When should I see my doctor?
It’s a good idea to see your doctor if you have a new or changed cough that lasts for more than 3 weeks, or if you notice you cough up blood. Other signs of lung cancer might be that you keep getting chest infections, or you have unexplained wheezing or breathlessness.
See your doctor if you are very tired all the time or you are losing a lot of weight without trying to. Developing a hoarse voice may be another sign something is wrong.
How is lung cancer diagnosed?
A number of tests will be performed to investigate symptoms of lung cancer and confirm a diagnosis. Some of the more common tests include:
- Sputum cytology — where the doctor collects sputum from the lungs and looks at it under a microscope.
- Imaging of the lung and nearby organs, which may include chest x-ray, CT scan or MRI scan.
- Bronchoscopy — a thin flexible tube called a bronchoscope, with a light and a video camera on the end, is used to look at the inside of your lungs.
- Biopsy — a sample of tissue is taken from the lung to be examined in the laboratory. This is the only way to confirm cancer.
- Fine needle aspiration — if the suspicious-looking bit of lung can't be reached with the bronchoscope, your doctor may use a thin, hollow needle to take a small piece of the lung out through the chest.
How is lung cancer treated?
Once the tests have been completed, it should be possible to work out what stage your cancer is, what this means for your treatment and whether it is possible to completely cure the cancer.
The type of treatment you will receive for lung cancer depends on several factors including:
- the type of lung cancer you have
- the size and position of the cancer
- how far advanced your cancer is (the stage)
- your overall health
- your desires regarding your treatment
The main treatments are surgery to remove part of the lung or the whole lung, radiotherapy, using high energy x-rays to kill the tumour, chemotherapy, and treatment with anti-cancer drugs.
New treatments for lung cancer are being developed all the time. These include immunotherapy, which uses the body’s own immune system to fight the cancer and targeted therapy, which targets specific mutations in the tumour.
Different types of lung cancer will be treated differently:
- Non-small cell lung cancer can be treated with surgery, radiotherapy or chemotherapy. Other options may include thermal ablation (needles are inserted into the cancer to destroy cells by heating them), immunotherapy (medicines to stimulate the body's own immune system to destroy the cancer), or targeted therapy (medicines that target genetic mutations in cancer cells).
- Small cell lung cancer is usually treated with chemotherapy. Some people with cancer in one lung (limited disease) will have radiotherapy to the chest and brain (called preventive or prophylactic radiotherapy). Because it usually spreads early, surgery is not often used for this type of cancer.
Some people with lung cancer will be offered palliative care to improve their quality of life.
Cancer Council Australia can provide more information on cancer treatments through their website at www.cancer.org.au. They also offer support for you and your loved ones via their helpline on 13 11 20.
Can lung cancer be prevented?
Not smoking is the most effective way to avoid getting lung cancer. However long you have been smoking, it is always worth quitting. Every year that you do not smoke, your risk of getting serious illnesses, such as lung cancer, will decrease. After 10 years of not smoking, your chances of developing lung cancer falls to half that of a smoker — and the risk continues to decline.
A great place to start is to check out the Quit Now website and its variety of information and tools to support you in quitting smoking.
Complications of lung cancer
If you have lung cancer, you might be very short of breath and fluid can build up on your lungs. You might cough up blood. Treatments are available for these symptoms.
Advanced lung cancer can be painful. If it spreads you might develop other symptoms like nausea, headaches and pain in other parts of your body. There are very good pain control medicines available.
A common complication of lung cancer is anxiety and depression. Talk to your doctor about getting support for this. Reducing distress has been shown to result in better physical outcomes for people with lung cancer.
Resources and support
People often feel overwhelmed, scared, anxious and upset after a diagnosis of cancer. These are all normal feelings.
Being open and honest about how you feel and what your family and friends can do to help you may put others at ease. Don't feel shy about telling people that you need some time to yourself if that's what you need.
There are different people in your medical team who can support you. As well as your doctor, a physiotherapist and a specialist lung cancer support nurse can help.
You can find information and support at:
- Cancer Australia website, canceraustralia.gov.au
- Cancer Council Australia’s website cancer.org.au or call their helpline on 13 11 20
- Download the Cancer Council booklet, Understanding Lung Cancer
- The Australian Lung Foundation website, lungfoundation.com.au or call to speak to a lung cancer support nurse on 1800 654 301
- If you have just been diagnosed with lung cancer, Cancer Council Australia has more information and support on their website
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Last reviewed: November 2019