Lung cancer
Lung cancer
Cancer that begins in the lung is known as primary lung cancer. The lungs are the organs you use to breathe.
Lung cancer is the third most common cancer in the UK. About 49,200 people are diagnosed with it each year.
In a video, Dr Ranj is joined by Dr David Gilligan to take an in-depth look at lung cancer. They explore its symptoms, testing, stages and treatment options.
Types of lung cancer
There are 2 main types of primary lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).
To find out which type of cancer you have, your cancer cells will be examined in a laboratory by a doctor who specialises in cell types.
The two types behave differently, so your treatment will depend on which one you have. Macmillan Cancer Support has more detailed information on non-small cell lung cancer and how it's treated, and on small cell lung cancer and how it's treated.
There are other cancers that start in the lung, or that sometimes spread to it. Cancers that begin elsewhere in the body, such as the breast, bowel or bladder, may sometimes spread to the lungs. This is called secondary lung cancer.
A cancer that affects the pleura, the covering of the lungs, is called pleural mesothelioma. A rare cancer that can start in the lungs is called a neuroendocrine tumour.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
Causes
What causes lung cancer?
Smoking tobacco is behind most cases of lung cancer, and it remains the single biggest risk factor. This includes smoking cigarettes, cigars and pipes.
It's worth knowing that some people who have never smoked can still develop lung cancer. Around 15 in every 100 people (15%) diagnosed with lung cancer have never smoked. This form is known as non-smoking lung cancer.
For more detail on the causes and risk factors of lung cancer, Macmillan Cancer Support offers further information.
Diagnosis
If you have symptoms, the first step is usually a visit to your GP, who will examine you. If they feel that lung cancer could explain what you're feeling, they will arrange a chest X-ray, and may refer you to a chest specialist urgently.
For some people, lung cancer comes to light only after they are admitted to hospital as an emergency. This can happen when the cancer has already advanced and is causing serious symptoms or complications.
In some cases, lung cancer is picked up through screening, which is meant to catch the disease in people at risk, at an early and more treatable stage.
At the hospital, a specialist nurse or doctor will examine you and talk you through the tests you may need.
You may need some of the following tests.
Chest X-ray
If you have not already had one, you may be given a chest X-ray to check your lungs.
CT scan
Most people have a CT scan. If you have certain symptoms, your doctor may still arrange a CT scan even if your chest X-ray looks normal.
PET-CT scan
You may have a PET scan and a CT scan done together. A PET-CT scan gives more detailed information about the part of the body being examined.
Biopsy
You will usually need a biopsy to confirm whether you have lung cancer.
During a biopsy, a doctor or nurse takes a small sample of cells or tissue from the abnormal area to check it for cancer cells. Your cancer doctor or nurse will explain which type of biopsy is right for you.
There are several ways of taking a biopsy for lung cancer, including:
- bronchoscopy and biopsy
- CT scan guided biopsy
- lung biopsy through the skin
- endobronchial ultrasound scan (EBUS) biopsy
- endoscopic ultrasound (EUS) biopsy
- biopsy of lymph nodes in the neck
The biopsy results tell your doctor whether cancer is present and, if so, which type of lung cancer you have.
Waiting for test results can be an anxious time. Macmillan Cancer Support has more information that may help while you wait.
Other tests for lung cancer
Your specialist will usually arrange further tests to learn more about the size and position of the cancer, and whether it has spread.
Mediastinoscopy
A mediastinoscopy is sometimes done instead of an EBUS or EUS. It allows the doctor to look at the area in the middle of the chest, known as the mediastinum, along with the nearby lymph nodes. This test is done under general anaesthesia.
Thoracoscopy
A thoracoscopy allows the doctor to examine the lining of the lungs, called the pleura, and take a biopsy of it.
MRI scan
An MRI scan uses magnetism to build a detailed picture of areas inside the body. Doctors may use it to check the size of a cancer and whether it has spread.
Tests on lung cancer cells
Your doctors will usually arrange more detailed testing of the lung cancer cells, sometimes called molecular testing. These results tell your cancer doctor whether targeted therapy drugs or immunotherapy drugs are likely to work for you.
Macmillan Cancer Support has further information for anyone who has just been diagnosed with cancer.
Staging of lung cancer
Test results help your doctors understand more about the size and position of the cancer, and whether it has spread. This process is called staging. Knowing the stage and grade helps your doctors plan the treatment that is best for you.
Macmillan Cancer Support has more information about lung cancer staging.
Treatment
Treatment for lung cancer
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your doctor, cancer specialist or nurse will explain the different treatments and their side effects. They’ll also talk to you about things to consider when making treatment decisions. You’ll need this information before you give your permission to have any treatment.
Treatment for lung cancer will depend on the type of lung cancer you have.
Macmillan Cancer Support have more information on:
- non-small cell lung cancer
- small cell lung cancer
You may have some treatments as part of a clinical trial.
Macmillan Cancer Support have information on getting organised before cancer treatment.
After lung cancer treatment
You’ll have regular check-ups during and after your treatment. Some people may be on treatment for months or years if it’s working well for them.
You might have CT scans or chest X-rays as part of your follow up. Appointments might be in person, or by phone or video.
Tell your doctor or specialist nurse as soon as possible if you have any problems or notice new symptoms between appointments.
Macmillan Cancer Support have more information about follow-up care after treatment.
Support after lung cancer
People often have many different feelings when they finish cancer treatment. You may feel relieved that treatment has finished, but worried about what will happen in the future.
It’s important to know where to get support or information from if you need it. People often need support even some time after lung cancer treatment. But it can be difficult to know who to ask for help.
Ask your GP or someone from your cancer team for advice about support in your area.
Macmillan Cancer Support also has further information to support you. You can:
- phone the Macmillan Support Line on 0808 808 00 00
- chat to Macmillan specialists online
- use the Macmillan lung cancer forum – you can talk to others affected by lung cancer, ask questions and share your experience
- user the Cancer Care Map to find cancer support services near you
Other organisations who offer information and support include:
- ALK Positive UK – provides support and aims to improve the survival and quality of life of ALK positive lung cancer patients
- EGFR Positive UK – provides support and aims to improve the survival and quality of life of EGFR positive lung cancer patients
- Roy Castle Lung Cancer Foundation – provides information and support for people affected by lung cancer
Sex life
Lung cancer and its treatment can affect your sex life. There are ways to improve your sexual well-being and to manage any problems.
Macmillan Cancer Support have more information about cancer and your sex life.
Fertility
Some cancer treatments can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it’s important to talk with your doctor before you start treatment.
Complications
Wellbeing and recovery
It can take time to recover after lung cancer treatment. Some days you may feel better than others.
A healthy lifestyle can help speed up your recovery. Even small lifestyle changes may improve your wellbeing and long-term health.
Even if you already have a healthy lifestyle, you may choose to make some positive changes after treatment.
Macmillan Cancer Support have more information on leading a healthy lifestyle after treatment.
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