What is Lung Cancer?

Lung cancer is a term used to describe a growth of abnormal cells inside the lung - these cells continue to grow in an unlimited fashion until removed or treated. The abnormal cells stick together and produce a growth or fluid. Doctors call this abnormal cluster of cells a “tumour”. Cancer that starts and grows in the lung is known as primary “lung cancer”. Sometimes, cancer can spread to the lungs having started as a “primary” in another part of the body such as the breast, bowel, or prostate – these cancers are called lung “secondaries” or “metastases“.

What Causes Lung Cancer?

Lung cancer results from damage to genes in lung cells. This damage allows these cells to grow and divide uncontrollably and eventually, spread throughout the body. Tobacco smoke is the biggest cause of lung cancer; with additional cancer causing agents including asbestos, radiation and others. For some people the cause of their cancer cannot be identified.

Types of Lung Cancer

There are two different types of lung cancer: non-small cell lung cancer (NSCLC), is more common and makes up approximately 80% of all lung cancers, and small cell lung cancer (SCLC), which makes up about 20% of lung cancers. Three of the main ‘subtypes’ of NSCLC, are Adenocarcinoma, Squamous Cell Carcinoma and Large Cell Carcinoma. Other less common NSCLC subtypes are carcinoid and adenosquamous. Malignant mesothelioma is a rare form of cancer, caused from Asbestos exposure, and arises in the membranes which surround the lungs.

How is Lung Cancer Diagnosed?

Your Doctor will work with you to choose the most useful tests to identify the type of lung cancer – NSCLC or SCLC. The first aim is for a Pathologist to confirm whether cancer cells can be seen under the microscope. Cancer cells can sometimes be found in phlegm that is coughed up. Sometimes a bronchoscopy needs to be performed; this is a procedure where a slim tube is inserted through the nose or mouth and down the trachea (windpipe). From this tube the doctors are able to look at the air passages and in some cases may be able to get a sample of the lung cancer. Other times, samples are obtained from the cancer by passing a very fine needle, under local anaesthetic, through the chest wall.

Stages of Lung Cancer

In addition to finding out about the type of lung cancer, your Doctor will also identify the stage of the lung cancer. “Stage” refers to the extent of the cancer. “Stage” depends on the size of the cancer in the lung, whether it is present in other organs in the chest, and if it has spread to lymph nodes (glands) or to other parts of the body. NSCLC is staged as: Stage I (small cancer, no spread); Stage II (slightly larger cancer or spread to nearby lymph nodes); Stage III (locally advanced – confined to the chest, but attached to other structures or spread to more distant lymph nodes); Stage IV (involving spread to other parts of the body). Where as SCLC is staged as: Limited (chest only); Extensive (spread beyond the chest).

How is Lung Cancer Staged?

The tests commonly used to stage lung cancer include X-Rays, CT Scans, PET Scans, bone scans, MRIs and sometimes more biopsies are taken to test for cancer cells. Your Doctor will work out with you the most appropriate combination of tests for you.

Who Will Treat Lung Cancer?

Your medical team will consist of your GP and specialists. Depending on the treatment recommendations, specialists may include a respiratory physician, thoracic surgeon, medical oncologist, radiation oncologist, lung cancer nurse, social worker, dietitian, psychologist and others if needed, such as palliative care teams. You and your family or carers are important partners within your health care team. It is important to feel comfortable with your team, that you ask questions and that you express your feelings and wishes in your discussions with your team.

Treatment of Lung Cancer

When doctors are deciding on the best anti-cancer treatment options to offer an individual, they consider the type and stage of the lung cancer, and the wellbeing and wishes of the patient. Early stage (stage I, II) NSCLC is usually treated by surgery to remove the cancer. Sometimes, if an individual with early stage NSCLC is not fit for surgery, treatment with radiotherapy, with or without chemotherapy may be considered. Advanced NSCLC (stage III, IV) is not usually treated with surgery but chemotherapy, radiotherapy and/or targeted therapies are often considered as options. For SCLC, chemotherapy is commonly considered and, in some cases radiotherapy may be part of the treatment plan.

In addition to treating the cancer itself, best practice in lung cancer care also involves supporting you as much as possible throughout your illness. Your healthcare team is there to help ease any physical symptoms you may be experiencing as well as support you and your family emotionally and with the practical issues that may result from your cancer. For all stages of lung cancer it is important to optimise your quality of life as much as possible.

Outcome of Lung Cancer

The outcome from lung cancer will largely depend on the type and stage and the general health of the person with lung cancer. It is important to remember that each person is different and results from statistics may not always be relevant to the person concerned. Different ways to treat lung cancer are emerging all the time and many may be available in clinical trials. You can discuss this with your Doctor. Living with lung cancer There is no ‘right’ way to cope with a diagnosis of lung cancer. Family, carers and friends are an important source of help and support. Joining a support group can be helpful; such as one linked with your local cancer service, the Australian Lung Foundation or Cancer Council. It is important that you know where to turn for advice and help in the medical world – your GP or Nurse can be most helpful in this regard. Other things that may help are getting all the information you want about your cancer, taking care of yourself and keeping generally healthy. If you smoke, you may want to work with your team to stop smoking so you can breathe better, put less strain on your heart and body, and help the treatments work better.

Content Updated October 27, 2009