Lung cancer

Cancer that starts in the lung is called primary lung cancer. The lungs are the parts of the body we 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 this video, Dr Ranj is joined by Dr David Gilligan for a close look at lung cancer. They talk through its symptoms, testing, stages and treatment options.

There are 2 main types of primary lung cancer. These are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

To find out which type you have, a doctor who is an expert in cell types will examine the cancer cells in a laboratory.

The two types of lung cancer behave in different ways, so your treatment will depend on the type you have.

Macmillan Cancer Support has more detailed information about:

• non-small cell lung cancer and how it's treated
• small cell lung cancer and how it's treated

There are other types of cancer that start in the lung or that sometimes spread to the lung.

Cancers that start in another part of the body, like the breast, bowel or bladder, may sometimes spread to the lungs. This is called secondary lung cancer.

A cancer that affects the pleura, which is the covering of the lungs, is called pleural mesothelioma.

A rare cancer that can start in the lungs is called a neuroendocrine tumour.

If you have symptoms, you'll usually start by seeing your doctor, who will examine you. If they think lung cancer could be causing your symptoms, they'll arrange a chest X-ray. They might also refer you urgently to a chest doctor.

Some people are diagnosed with lung cancer only after they've been admitted to hospital as an emergency. This may happen when the cancer is more advanced and is causing serious symptoms or complications.

Sometimes the diagnosis comes through screening, which is used to find the cancer at an early stage in people who are at risk of it.

At the hospital, a specialist nurse or doctor will examine you and talk to you about the tests you need.

You may need some of the following tests.

If you haven't already had one, you may be asked to have a chest X-ray so the doctor can check your lungs.

Most people with lung cancer have a CT scan. And if you have certain symptoms, you might be sent for one even when your chest X-ray looks normal.

Your doctor may arrange a PET scan and a CT scan together, which is called a PET-CT scan. Doing both at once gives more detailed information about the part of your body being scanned.

You usually have a biopsy to find out if you have lung cancer. A doctor or nurse takes samples of cells or tissue from the abnormal area and checks them for cancer cells. Your cancer doctor or nurse will talk to you about which type of biopsy you'll have.

There are different ways of taking biopsies for lung cancer, including:

• bronchoscopy and biopsy
• CT scan and biopsy
• lung biopsy through the skin
• endobronchial ultrasound scan (EBUS) biopsy
• endoscopic ultrasound (EUS) biopsy
• biopsy of neck lymph nodes

The results tell your doctor whether there is cancer, and which type of lung cancer you have.

Waiting for test results can be a difficult time, and support can help.

Your specialist will usually arrange more tests for lung cancer. These help to show how big the cancer is, where exactly it sits, and whether it has spread.

Sometimes a doctor does a mediastinoscopy instead of an EBUS or EUS. It lets the doctor look at the area in the middle of your chest, called the mediastinum, and at the lymph nodes nearby. You have this test under a general anaesthetic.

With a thoracoscopy, the doctor can look at the lining of your lungs (the pleura) and take a small sample of it, called a biopsy.

An MRI scan uses magnetism to build up a detailed picture of areas of the body. In lung cancer, doctors may use it to find out the size of the cancer and whether it has spread.

Test results help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging. Once your doctors know the stage and grade, they can plan the best treatment for you.

The charity Macmillan Cancer Support has more information about lung cancer staging.

A team of specialists will meet to talk about 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 with you about what to think about when making treatment decisions. You'll need this information before you give your permission to have any treatment.

Treatment for lung cancer depends on the type of lung cancer you have. Macmillan Cancer Support has more information on:

• non-small cell lung cancer
• small cell lung cancer

You may have some treatments as part of a clinical trial.

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 has more information about cancer and your sex life.

Some treatments for lung cancer can affect whether you can get pregnant or make someone else pregnant. If this worries you, talk with your doctor before you start treatment.

Recovery after lung cancer treatment can take time, and some days you may feel better than others.

A healthy lifestyle can support your recovery and help speed it up. Even small changes may improve your wellbeing and your long-term health. If your lifestyle is already healthy, you may still choose to make some positive changes after treatment.