What is lung cancer?

Lung cancer is a common cancer. It happens when abnormal cells in the lungs grow in an uncontrolled way.

Lung cancer causes the most deaths in Australia that are related to cancer.

There are two main types of lung cancer.

Non-small cell lung cancer (NSCLC)

NSCLC makes up about 85% (85 per 100 cases) of lung cancers. There are different types of NSCLC, like:

• adenocarcinoma
• squamous cell carcinoma
• large cell undifferentiated carcinoma

Small cell lung cancer (SCLC)

SCLC makes up the remaining 15% (15 per 100 cases) of lung cancers. It usually starts in the middle part of the lungs. It can spread more quickly than NSCLC.

What are the symptoms of lung cancer?

Early lung cancer may not cause many symptoms until after it has spread outside of the lungs.

Common symptoms of lung cancer include:

• a cough that does not go away — you may also cough or spit up blood
• feeling out of breath or wheezing
• chest or shoulder pain
• a chest infection that does not go away or keeps coming back
• fatigue
• unintentional weight loss
• difficulty swallowing

Cancer can spread to other parts of your body. This can cause other symptoms like:

• pain in your stomach (abdomen)
• joint pain
• nervous system symptoms, like changes to your vision
• swelling of your lymph nodes

Many conditions can cause symptoms like these. Having the symptoms does not always mean that you have lung cancer. If you notice any symptoms, it's best to see your doctor.

What causes lung cancer?

Cancers are usually caused by genetic changes (mutations) in your body's cells that happen during your life.

Anyone can get lung cancer.

There are some factors that can increase your risk of developing cancer.

Age

Lung cancer is usually diagnosed in people over 50 years of age.

Sex

Males have a higher chance of having lung cancer than females.

Smoking

Smoking causes many of the cases of lung cancer in Australia. The risk of having lung cancer increases with:

• the number of cigarettes a person smokes
• the number of years they smoke for

Passive smoking can also increase your risk of having lung cancer.

There is some evidence that e-cigarettes contain substances that can cause lung cancer. More research is needed about vaping and lung cancer.

People who vape are 3 times as likely to start smoking cigarettes, which is the most significant cause of lung cancer in Australia.

Family history

If you have a family history of lung cancer, your risk of having lung cancer may be higher.

Lung conditions

You may have a higher chance of developing lung cancer if you already have a lung disease.

These include pulmonary fibrosis and chronic obstructive pulmonary disease (COPD).

Substances that can cause cancer

Exposure to certain substances can increase your risk of developing lung cancer. These include:

• asbestos
• radon
• silica dust
• some heavy metals
• air pollution

If you work in an environment with these substances, you may have a higher chance of getting lung cancer.

When should I see my doctor?

See your doctor if you are concerned about your symptoms, especially if you have a higher risk of getting lung cancer.

Lung cancer screening

Lung cancer screening helps find lung cancer in the early stages, when early treatment works best. Because lung cancer may not have symptoms at first, it is often diagnosed late.

In Australia, the National Lung Cancer Screening Program helps to identify lung cancer earlier. People who have a high risk of having lung cancer can be checked through this program.

Read more about lung cancer screening.

How is lung cancer diagnosed?

To diagnose lung cancer, your doctor will:

• ask you about your health and symptoms
• ask you questions about your medical and family history
• carry out a physical examination

If your doctor thinks you could have lung cancer, they will refer you for tests. These may include:

• blood tests
• imaging scans such as x-ray and computerised tomography (CT) scan
• lung function tests (spirometry) to assess your lung function and health
• tests on a sample of your sputum (phlegm) to check for cancer
• a biopsy

A biopsy is when a small sample of cells is taken. This can be tested in a laboratory to check for cancer. Your doctor may collect a biopsy using a bronchoscopy or a CT-guided lung biopsy.

If needed, your doctor can refer you to a specialist doctor for more tests to confirm if you have lung cancer, like a positron emission tomography (PET) scan.

Staging lung cancer

Using your tests and scans, your doctors will 'stage' your lung cancer. This will help them to plan your treatment.

Lung cancer is staged using a system called tumour–nodes–metastasis (TNM). This looks at:

• how big the cancer is — T (tumour)
• if it has affected your lymph nodes — N (nodes)
• if it has spread from one body part to another — M (metastasis)

If your cancer began in your lungs, this is called primary lung cancer. If your cancer spread from another body part to your lungs, this is called secondary metastatic lung cancer.

How is lung cancer treated?

If you have lung cancer, your healthcare team will work with you to make a treatment plan. You can ask them any questions you may have. It is your choice to have treatment.

Your treatment plan may include one or a combination of treatments. The best treatment for your lung cancer depends on several factors, like:

• the stage of your cancer
• your general health
• how well your lungs are working
• your preferences
• the goal of treatment

Some treatments aim to remove all signs of cancer — this is known as curative treatment.

Other treatments aim to:

• slow down the spread of the cancer
• manage your symptoms
• improve your everyday life

Surgery

If you have NSCLC that was diagnosed at an early stage, surgery to remove it may be an option. This might include a:

• lobectomy — one lobe of a lung is removed
• wedge resection — part of a lung is removed
• pneumonectomy — one whole lung is removed

Radiotherapy

Radiotherapy damages cancer cells and stops them dividing or spreading.

Chemotherapy

Chemotherapy uses strong medicines to kill cancer cells.

Immunotherapy

Immunotherapy uses medicines that help your immune system find cancer cells and kill them.

Targeted therapy

Targeted therapy is a newer type of medicine. Cancer cells have special features. Targeted therapy treats cancer by attacking cells that have these features.

Other treatment options

Your medical team can also offer treatments to help manage your symptoms. These include:

• exercise training and breathing techniques to help with breathlessness
• placing a tube (stent) to open a large airway, if it has been blocked by cancer
• a pleural tap to drain fluid around your lungs
• nutrition advice from a dietitian to aid your recovery

Living with lung cancer

Having lung cancer can affect your life.

Lung cancer can affect your lung function and make you feel breathless. This can make it harder to do everyday activities. In some cases, you may need oxygen therapy.

Receiving a cancer diagnosis and living with cancer can be difficult. It can impact your mental health. You may experience depression and anxiety. If you experience any mental health problems, it's important to get help. You can start by asking for support from your doctor and loved ones.

There are ways you can look after your mental health. These include:

• doing relaxing activities such as yoga
• taking time for things that you enjoy
• practicing mindfulness

Your doctor can also connect you with support groups.

Your healthcare team

If you have lung cancer, your healthcare team can support you. They may include:

• your doctor
• a radiologist
• a medical and radiation oncologist
• a cancer care nurse
• a surgeon
• allied health professionals such as counsellors and dietitians

If you are confused about who does what in your healthcare team, you can ask your doctor if a cancer care coordinator is available. They can:

• manage your care
• helps you communicate with your healthcare team
• support you and your family

Can lung cancer be prevented?

You can help prevent lung cancer by reducing some of your risk factors.

You can try to quit smoking and avoid second hand smoke or harmful substances.

But there are other risk factors you can't change, like your age and family history.

What are the complications of lung cancer?

Lung cancer can cause complications such as fluid build-up in the space around your lung (pleural effusion). Cancer can be life-threatening.

You may also experience side effects of treatments used to treat your lung cancer. Learn more about different cancer treatments and their potential side effects.

Resources and support

For more information about lung cancer, you can visit the:

• Cancer Australia website to read information on lung cancer.
• Cancer Council website for a factsheet about lung cancer — you can also call their support line on 13 11 20.
• Lung Foundation Australia website for information on understanding your lung cancer diagnosis — you can also use their free phone service to speak with a lung cancer support nurse on 1800 654 301.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Mental Health Support

Call Beyond Blue on 1300 22 4636 or Lifeline on 13 11 14 for mental health support.

Call Medicare Mental Health on 1800 595 212 for advice and to get connected to local mental health services. Check the operating times.

The Lung Foundation Australia have information on support groups for lung cancer. You can find support groups near you on the Cancer Council website.

You can read about Mental health resources.

Aboriginal and/or Torres Strait Islanders

All about cancer for Aboriginal and Torres Strait Islander peoples has a fact sheet about lung cancer.

Languages other than English

You can read the Cancer Australia fact sheet 'Getting the best advice and care - a guide for those affected by lung cancer' in several languages.