Lung cancer

What is lung cancer?

Lung cancer is when cancer develops in the lungs, your organs used for breathing. It’s usually associated with smoking or environmental exposures, though the cause is sometimes unknown.

What are the types of lung cancer?

There are 2 main types of cancer that can develop in the lungs: 

• Small cell lung cancer (SCLC) – this is linked to smokingand can spread to other parts of the body. Sometimes, this type of lung cancer can produce hormones which cause symptoms such as high blood pressure. 

• Non-small cell lung cancer (NSCLC) – this has 4 subtypes: 

  • Adenocarcinoma – this can develop in younger people who do not have risk factors. Unfortunately, this has the poorest prognosis

  • Squamous cell carcinomas – this is linked to smoking

  • Carcinoid tumours

  • Large cell tumours – these are linked to smoking.

What are the symptoms of lung cancer?

You might not initially experience symptoms in the early stages of cancer, but as the cancer develops, you might begin to notice more of these symptoms:

• Unexpected or unexplained weight loss

• Fever and sweating more at night 

• A new cough or a change in the nature of a chronic cough 

• Chest pain or ache

• Coughing up blood 

• Feeling breathless or getting short of breath more quickly 

• A change in your voice

• Pain when coughing 

• Getting recurrent chest infections 

If you’re worried because you’ve noticed a change in your breathing, or have some of the symptoms listed above, the best thing to do is to book an appointment with a GP in the first instance. They can arrange the necessary tests. 

What causes lung cancer?

The most common cause of lung cancer is cigarette smoking. People who do not smoke can still develop lung cancer, but the risk is much lower. 

Like with other cancers, lung cancer is caused because cells are not replicating as they usually should. This is because of mutations to the genes which usually stops cells from dividing too quickly, leading to cancer. 

Other causes of lung cancer include: 

• Radon exposure 

• Air pollution

• Occupational exposure – this is where you’re exposed to carcinogens in the workplace, such as asbestos, nickel, engine exhaust fumes, silicon and coal

• A family history of lung cancer

Currently, there is no evidence to suggest whether vaping causes lung cancer. 

Sometimes, lung cancers can develop because a cancer that’s somewhere else in the body has spread into the lungs.

How is lung cancer diagnosed?

If a GP suspects that you have symptoms of lung cancer, they’ll refer you for some further tests. Depending on the results they may refer you to a specialist who might carry out more detailed investigations. The main tests they will perform include:

• Chest x-ray – this is usually the first main diagnostic test for lung cancer

• Blood tests – this can be to rule out something like an infection 

• A CT or a PET-CT scan – these allow for more detailed images to be created

• Bronchoscopy – a bronchoscope is a small camera used to visualise your airways

• Biopsy – a sample of tissue is taken so that it can be looked at under a microscope.

What are the stages of lung cancer?

A stage is a way of describing a cancer’s size and where it has spread, if at all. 

Small cell lung cancer (SCLC), which is the less common type of lung cancer, has 2 stages. These are: 

1. Limited disease – this is when the cancer remains in the lungs

2. Extensive disease – this is where the cancer spreads to outside the lungs. 

Non-small cell lung cancer (NSCLC) is staged using a system called TNM, where: 

• T – describes the size of the cancer

• N – describes if the cancer spreads into lymph nodes 

• M – describes if the cancer has spread from the lungs into another part of the body. 

Getting an early diagnosis is important to a better outcome. 

How is lung cancer treated?

Treatment is dependent on the type of cancer, whether it’s spread, the size and position of the cancer, and how healthy you are. With all types, you’ll be referred to a multidisciplinary team (MDT) which is a team of professionals who will discuss the best treatment for you. 

Treatment for small cell lung cancer (SCLC)

• Chemotherapy, which can be used alongside radiotherapy or immunotherapy

• Surgery is not usually used for small cell lung cancer

Treatment for non-small cell lung cancer (NSCLC)

• If you are in good health and the cancer is limited to one of your lungs, it’s likely that surgery is the best option for treatment, with the cancerous tissue removed from the lungs. After the surgery, any remaining cancer cells in the body can be destroyed by chemotherapy

• If the cancer is in one of your lungs but you’re unable to have surgery, you might be offered a combination of chemotherapy and radiotherapy.

When should I speak to a doctor?

If you notice you’ve become short of breath, are coughing up blood, have lost weight recently, or are generally worried about lung cancer symptoms, contacting a GP in the first instance is the most important step. 

Understandably, developing symptoms or receiving a diagnosis of lung cancer is incredibly worrying, so reaching out and receiving other forms of support, whether this be through something like talking therapy or having a good network to help with your journey.